青少年和成人百日咳疫苗加强免疫策略卫生经济学研究的系统评价

Health and economic evaluations of pertussis booster vaccination for adolescents and adults:a systematic literature review

目的系统评价青少年和成人百日咳疫苗加强免疫的卫生经济学研究质量和结果。方法通过Pubmed、中国知网等数据库检索2000年1月-2020年1月发表的青少年和成人百日咳疫苗加强免疫卫生经济学研究文献,采用卫生经济研究统一整理评估报告标准(Consolidated health economic evaluation reporting standards,CHEERS)评分(满分24分)评价文献质量,分析卫生经济学评价结果。结果共纳入符合标准的研究文献16篇,均为国外文献,文献的CHEERS评分平均为22.56分(范围:20-24分)。针对青少年或成人百日咳加强免疫策略,8篇研究认为符合成本效果或节约成本(7篇研究人群为青少年),5篇研究认为在一定条件下(如百日咳发病率>50/10万)符合成本效果,3篇研究认为不符合成本效果。结论纳入的研究文献质量较高;经济学评价结果倾向于支持青少年百日咳加强免疫策略,而成人加强免疫策略评价结果差异较大。建议开展中国百日咳免疫策略的卫生经济学研究。

Objective To evaluate the quality and results of health and economic studies on pertussis booster vaccination in adolescents and adults.Methods We used Pubmed and CNKI databases to identify health and economic evaluations of pertussis booster vaccination that were published between 2000 and 2019;we assessed the quality of the literature using the Consolidated Health Economic Evaluation Reporting Standards(CHEERS)(top score is 24 points).We reviewed results of health and economic evaluations.Results Sixteen studies were included in the systematic review;all were from other countries.The average CHEERS score was 22.56 points(range:20-24 points).Booster vaccination for adolescents or adults was cost-effective or cost-saving in 8 studies(7 studies were conducted in adolescents),was cost-effective under certain conditions(e.g.pertussis incidence>50 cases per 100000 population)in 5 studies,and was not cost-effective in 3 studies.Conclusions The quality of the included studies was high.Health and economic evaluations indicated that pertussis booster vaccination for adolescents is favorable,but is controversial for adults.We suggest conducting health and economic evaluations of pertussis immunization strategies in China.