COST/BENEFIT OF IMMUNIZATION FOR PERTUSSIS AND HAEMOPHILUS TYPE B

Key words: Acellular pertussis vaccines, Whole-cell pertussis vaccine, Haemophilus type b, Epidemiology, Cost/benefit analysis

The Author proposes a cost/benefit analysis for pertussis and haemophilus type b vaccines. Cost/benefit of the new acellular pertussis vaccines is higher than for the wholecell vaccines due to the higher cost of the former, but better acceptance of the acellular vaccine by paediatricians and by users due to reduced incidence of side effects may favour higher coverage. Calculations are difficult for the Hib vaccine. The incidence of invasive disease due to Hib in Italy has been evaluated by two different studies. The national surveillance system showed an incidence oif 5 per 100.000 children under 2 years, while a smaller cohort study showed an incidence of 24 cases/100.000 children under 2 years. Under notification in the first study and geographical selection in the second may explain the difference. The incidence of invasive Hib disease in Italy seems to be substantially lower than in Northern European countries. Due to the high cost of the Hib vaccine, it may be questioned whether Hib immunization is a priority in Italy. Hib vaccine remains indicated in high risk cases.