Influenza and pneumococcal vaccination of HIV-infected patients

A policy analysis

David N. Rose, Clyde B. Schechter, Henry S. Sacks

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Objective: To analyze the policy of vaccinating human immunodeficiency virus (HTV)-infected young adults against influenza and pneumococcal infections. Methods: Transition state model of clinical immune deterioration of HIV infection, published data, and experts' estimates for the uncertain variables. Outcome measures are the number of influenza and pneumococcal infection hospitalizations and deaths prevented over 10 years and cost-effectiveness ratios. Patients: Hypothetical cohort of HIV-infected 30-year-old patients. Results: Although pneumococcal vaccine effectiveness diminishes with advanced HIV disease, the risks of pneumococcal infection rise substantially. Pneumococcal vaccination was therefore found to be a reasonable prevention strategy at all HIV disease stages: few vaccinations are needed to prevent hospitalizations and deaths, and the vaccination strategy is cost-effective. By contrast, influenza incidence is low among young adults, and HIV-related immunodeficiency increases influenza risks only minimally. Because the vaccine is administered yearly, many more vaccinations must be administered and fewer hospitalizations and deaths are prevented than with pneumococcal vaccination. The costs to extend life expectancy are high, and beyond the costs of other prevention strategies for persons with moderate to severe immunodeficiency. Conclusion: Pneumococcal vaccination is a reasonable prevention strategy for HIV-infected patients at all stages of immunodeficiency. Fewer hospitalizations and deaths are prevented by influenza vaccination, making it a far less cost-effective prevention strategy than pneumococcal vaccination.

Original languageEnglish (US)
Pages (from-to)160-168
Number of pages9
JournalThe American journal of medicine
Volume94
Issue number2
StatePublished - Feb 1993
Externally publishedYes

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Policy Making
Human Influenza
Vaccination
HIV
Pneumococcal Infections
Hospitalization
Costs and Cost Analysis
Young Adult
Pneumococcal Vaccines
Life Expectancy
HIV Infections
Cost-Benefit Analysis
Vaccines
Outcome Assessment (Health Care)
Incidence

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Influenza and pneumococcal vaccination of HIV-infected patients : A policy analysis. / Rose, David N.; Schechter, Clyde B.; Sacks, Henry S.

In: The American journal of medicine, Vol. 94, No. 2, 02.1993, p. 160-168.

Research output: Contribution to journalArticle

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