Cost-Effectiveness of Conjugate Pneumococcal Vaccines in At-Risk Adults Aged 18 to 64 Years
Bibliographic record
Abstract
Eight economic evaluations (6 peer-reviewed, 2 summarized in a single grey literature source) assessing the cost-effectiveness of pneumococcal conjugate vaccines in adults aged 18 to 64 years at high risk of invasive pneumococcal disease (IPD) in high-income countries were identified. The 2 economic evaluations summarized in the single grey literature source were industry-sponsored analyses. A version of the results was previously summarized by the Public Health Agency of Canada. As such, the methods and results of the industry-funded models are only summarized in Appendix 3 for this review. None of the peer-reviewed studies identified assessed the cost-effectiveness of pneumococcal 15-valent conjugate vaccine (PCV15), pneumococcal 20-valent conjugate vaccine (PCV20), or pneumococcal 21-valent conjugate vaccine (PCV21). Of the peer-reviewed studies, 2 were conducted in the US, 2 in South Korea, 1 in Spain, and 1 in Hong Kong. All results were presented in terms of incremental cost-effectiveness ratios (ICERs) (i.e., incremental cost per quality-adjusted life-years gained). Four studies concluded that 1 dose of pneumococcal 13-valent conjugate vaccine (PCV13) was cost-effective relative to either no vaccination, 2 doses of PCV13, PCV13 plus 2 doses of pneumococcal polysaccharide 23-valent vaccine (PPSV23), or 2 doses of PPSV23. Two studies concluded that PCV13 plus PPSV23 was cost-effective relative to either no vaccination or 1 dose of PPSV23, but the studies did not evaluate the cost-effectiveness of PCV13 alone. The studies did not all consider the same vaccination strategies. The sources used to parameterize vaccine effectiveness in the peer-reviewed studies are highly uncertain, as the clinical evidence was either not representative of the target population or heavily reliant on expert input and assumptions. The generalizability of the economic evaluations may be limited because the study settings were notably different from Canada. To estimate the potential cost-effectiveness of pneumococcal conjugate vaccines in Canada, a de novo economic evaluation conducted from a setting is Canada is required.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.033 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.009 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".