Hybrid vaccination protocol could cut whooping cough cases by 95 percent, Santa Fe Institute, March 29, 2016.
Whooping cough is making a major comeback in the United States right now, and public health officials are struggling with what to do about it. Now, two SFI researchers have a surprising proposal: go back to an old vaccine—one that was largely abandoned 25 years ago because of relatively minor side effects—but do it for just the first of the usual five doses. Doing so, they says, could cut pertussis cases by 95 percent and save $142 million per year.
Abstract
Epidemiological and Economic Effects of Priming With the Whole-Cell Bordetella pertussis Vaccine, JAMA Pediatrics, March 28, 2016.
Importance
Current acellular pertussis vaccines may not protect against transmission of Bordetella pertussis.
Objective
To assess whether a priming dose of whole-cell pertussis (wP) vaccine is cost-effective at reducing pertussis infection in infants.
Design, Setting, and Participants
Mathematical model of pertussis transmission fit to US incidence data in a simulation of the US population. In this simulation study conducted from June 2014 to May 2015, the population was divided into 9 age groups corresponding to the current pertussis vaccination schedule and fit to 2012 pertussis incidence.
Interventions
Inclusion of a priming dose of wP vaccine into the current acellular pertussis vaccination schedule.
Main Outcomes and Measures
Reductions in symptomatic pertussis incidence by age group, increases in wP vaccine–related adverse effects, and quality-adjusted life-years owing to changing vaccine schedule.
Old Vaccine, New Tricks: Revive Early Pertussis Shot, Study Says, livescience, March 28, 2016.
Results
Switching to a wP-priming vaccination strategy could reduce whooping cough incidence by up to 95% (95% CI, 91-98), including 96% (95% CI, 92-98) fewer infections in neonates. Although there may be an increase in the number of vaccine adverse effects, we nonetheless estimate a 95% reduction in quality-adjusted life-years lost with a switch to the combined strategy and a cost reduction of 94% (95% CI, 91-97), saving more than $142 million annually.
Conclusions and Relevance
Our results suggest that an alternative vaccination schedule including 1 dose of wP vaccine may be highly cost-effective and ethically preferred until next-generation pertussis vaccines become available.