Development and pharmacoeconomic evaluation of selective vaccine prophylaxis of meningococcal infection in children

Matveev V.A.

Vitebsk State Order of People’s Frendship Medical University, Vitebsk, Belarus

Objective: To develop and pharmacoeconomically assess the optimal variant for vaccination against meningococcal infection (MI) in children.
Material and Methods. This study utilized published research data, as well as our own data: 185 children aged 1 month to 18 years with generalized forms of MI (GFMI).
Results. Among the patients included in the analysis the majority (71 of 79, or 89.9%) died from fulminant MI (FMI). Its predictors were identified, the main one of which in individuals under 3 years of age was thymomegaly (TM) grade II-III (OR=120.00 in comparison with other GFMI). FMI was diagnosed in subjects aged over 1 month, while over 30% of deaths from this form of the disease were accounted for by subjects of 7 months of age. A selective vaccination regimen for FMI was developed to protect against FMI based on the obtained data. The proposed approach is based on the detection of TM stage II-III at 3, 6, and 12 months of age using ultrasound, followed by inclusion of only these children in the vaccination program for meningococcal groups A, C, Y, W and B. The proposed option provides approximately 4.9 times greater cost effectiveness in terms of preventing fatal outcomes from MI compared to universal vaccination of children in the first year of life.
Conclusion. The proposed selective vaccination against MI aimed at preventing FMI in children is preferable for use.