Caregivers' willingness to pay to reduce the number of vaccine injections in infants.
ABSTRACT As part of a larger face-to-face immunization coverage survey, 1347 families of infants (18-24 months) were questioned on their willingness to pay for a reduction in the number of concomitant vaccine injections. The median willingness to pay for a reduction by 1 injection was 5 EUR. The responses fell into 3 broad categories (willing to pay nothing at all, or anything, or a finite amount) and were hardly influenced by socioeconomic determinants. These results suggest that more sophisticated methods are required, and similar analyses should exert a similar level of caution when presenting their results.
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ABSTRACT: To investigate the duration of the presence of maternal antibodies to measles in infants. Prospective study (May 2006 to November 2008). Five hospitals in the Province of Antwerp, Belgium. Of 221 pregnant women recruited, 207 healthy woman-infant pairs were included-divided into a vaccinated group (n=87) and naturally immune group (n=120), according to vaccination documents and history. Measles IgG antibodies measured by enzyme linked immunosorbent assay (ELISA) at seven time points (week 36 of pregnancy, birth (cord), and 1, 6, 9, and 12 months); decay of maternal antibody in infants modelled with linear mixed models. Vaccinated women had significantly fewer IgG antibodies (geometric mean titre 779 (95% confidence interval 581 to 1045) mIU/ml) than did naturally immune women (2687 (2126 to 3373) mIU/ml) (P<0.001). Maternal values were highly correlated with neonatal values (r=0.93 at birth). Infants of vaccinated women had significantly lower antibody concentrations than did infants of naturally immune women (P<0.001 at all ages over the follow-up period). Presence of maternal antibodies endured for a median of 2.61 months-3.78 months for infants of naturally infected women and 0.97 months for infants of vaccinated women. At 6 months of age, more than 99% of infants of vaccinated women and 95% of infants of naturally immune women had lost maternal antibodies according to the model. This study describes a very early susceptibility to measles in infants of both vaccinated women and women with naturally acquired immunity. This finding is important in view of recent outbreaks and is an argument for timeliness of the first dose of a measles vaccine and vaccination of travelling or migrating children under the age of 1 year.BMJ (online) 05/2010; 340(may18 2):c1626. DOI:10.1136/bmj.c1626 · 16.38 Impact Factor
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ABSTRACT: Immunization is an important and cost-effective public health intervention to protect the population from illness. In Poland, in addition to free of charge vaccines, listed in the national program on immunization, self-paid vaccinations for pneumococcal, meningococcal, rotavirus, varicella, influenza infections and combination vaccines are recommended. The study objective was to measure the coverage and influencing determinants of self-paid vaccinations in 0-5-year-old children seen between June 2009 and January 2010 at 3 randomly selected GP practices located in one region in the south-western part of Poland. Parents of the children who were seen consecutively were invited to participate and complete questionnaires on socio-demographic data and other factors related to paid vaccination. The response rate: 93.3%. Among the 308 parents (18-50 years old, median 31 years) who agreed to participate, 77.9% (95%CI: 73.0-82.2%) had their child vaccinated with at least one paid vaccine. Combination vaccines were most commonly chosen (62.3%), followed by a pneumococcal (36.4%), influenza (14.7%), meningococcal (13.3%), and rotavirus (12.7%) vaccine. Most parents admitted that their decision was based on a healthcare worker's initiative informing them about the topic. The multi-variable regression model revealed that parent's factors: age≥25 years, high socio-economic status, having one child, and health system factor, i.e. practice location were each associated with greater odds of child immunization The high cost of a vaccine was associated with more than five times lower chance to immunize a child. Observed high coverage rate regarding self-paid vaccines among young children was influenced mostly by combination vaccines. As the cost of a vaccine was an important barrier for the immunization, the gradual introduction of some of currently self-paid vaccines in a national program would be of value. Future interventions on self-paid vaccination coverage should be more tailored, focusing especially on young parents with low income who have more than one child.Vaccine 10/2013; 31(48). DOI:10.1016/j.vaccine.2013.09.056 · 3.49 Impact Factor
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ABSTRACT: The objective of this work is to demonstrate the potential time and labor savings that may result from increased use of combination vaccinations.The study (GSK study identifier: HO-12-4735) was a model developed to evaluate the efficiency of the pediatric vaccine schedule, using time and motion studies. The model considered vaccination time and the associated labor costs, but vaccination acquisition costs were not considered. We also did not consider any efficacy or safety differences between formulations. The model inputs were supported by a targeted literature review. The reference year for the model was 2012.The most efficient vaccination program using currently available vaccines was predicted to reduce costs through a combination of fewer injections (62%) and less time per vaccination (38%). The most versus the least efficient vaccine program was predicted to result in a 47% reduction in vaccination time and a 42% reduction in labor and supply costs. The estimated administration cost saving with the most versus the least efficient program was estimated to be nearly US $45 million. If hypothetical 6- or 7-valent vaccines are developed using the already most efficient schedule by adding additional antigens (pneumococcal conjugate vaccine and Haemophilus influenzae type b) to the most efficient 5-valent vaccine, the savings are predicted to be even greater.Combination vaccinations reduce the time burden of the childhood immunization schedule and could create the potential to improve vaccination uptake and compliance as a result of fewer required injections.Medicine 01/2015; 94(4):e357. DOI:10.1097/MD.0000000000000357 · 4.87 Impact Factor