Cost-effectiveness of pertussis booster vaccination of 6-year-old children

Primary pertussis vaccination in the Russian Federation is carried out with 3 doses of the vaccine against diphtheria, whooping cough and tetanus at 3; 4.5 and 6 months. At 18 months, children are revaccinated against diphtheria, whooping cough and tetanus. At the age of 6-7 and 14 years, children are revaccinated against diphtheria and tetanus without the whooping cough component. Observational studies have shown that the clinical effectiveness of vaccination against whooping cough significantly decreases over time. The aim of the work is to assess the cost-effectiveness of revaccination of 6-year-old children against whooping cough infection. Material and methods. A modeling study of the cost-effectiveness of revaccination of 6-year-old children against whooping cough using an acellular vaccine was carried out from the societal perspective (direct medical and indirect costs were estimated) taking into account the herd effect of vaccination. The incidence of whooping cough and mortality associated with it corresponded to the official indicators of the Ministry of Health of the Russian Federation. In the base case the time horizon of the study is 12 years. The analysis of the costs of whooping cough therapy was carried out on the basis of the of the State Guarantees Program for the Free Provision of Medical Care to Citizens for 2024 and for the planning period of 2025 and 2026. Vaccination costs were calculated taking into account the weighted average price of the vaccine during government procurement in July-August 2024. Indirect costs were estimated based on gross domestic product (GDP) loss due to temporary disability of patients’ parents and death of patients. Costs and quality-adjusted life expectancy were discounted by 3% per year. Results. The incremental cost-effectiveness ratio (ICER) of revaccination of children aged 6 years against whooping cough is 205.110 thousand rubles / QALY. The volume of averted costs is 2.642 thousand rubles per vaccinated child, including 0.416 thousand rubles – averted direct medical costs and 2.226 thousand rubles – averted indirect costs. Conclusion. Taking into account the accepted assumptions, а booster dose of pertussis vaccine to 6-year-old children can be considered as a highly cost-effective intervention.