Usefulness of pneumoccocal vaccination in elderly in Dutch general practice. A systematic review

E. Hak, G.A. Van Essen, D.E. Grobbee, E. Buskens, I.M. Hoepelman, Th.J.M. Verheij

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    Abstract

    Aim: We tried to get insight into the usefulness of a large-scale pneumococcal immunization program among elderly in Dutch general practice. Design: Systematic review of the literature. Methods: We searched for relevant publications on six different aspects of usefulness in Online Contents (1992-1997), Science Citation Index (1992-1997) and Medline (1996- 1997). Effectiveness studies were ranked according to level of validity and precision. Cited cost-effectiveness analyses determined prevalent direct costs from a societal perspective. Results: Among all pneumococcal infections, pneumonia has most impact on public health but valid and precise data on incidence rates in general practice are lacking. Pneumococcal polysaccharide vaccines induce a protective antibody response in patients at risk. Until now, data on clinical vaccine effectiveness are controversial. Immunization of elderly patients can efficiently be carried out in the GP's office, but annual costs will exceed 16 million guilders. Cost-effectiveness estimates calculated for the situation in the Netherlands, Belgium and United States range from savings to more than NLG 65.000,- per live-year saved. Data on the incremental effectiveness as opposed to influenza vaccination alone are not available yet. Conclusion: Evidence for usefulness of large-scale immunization of elderly against pneumococci is conflicting and its introduction in Dutch general practice seems therefore premature.
    Translated title of the contributionUsefulness of pneumoccocal vaccination in elderly in Dutch general practice. A systematic review
    Original languageDutch
    Pages (from-to)470-475
    Number of pages6
    JournalHuisarts en Wetenschap
    Volume41
    Issue number10
    Publication statusPublished - 13-Nov-1998

    Keywords

    • Pneumococcus vaccine
    • aged
    • aging
    • antibody response
    • cost effectiveness analysis
    • drug efficacy
    • general practice
    • geriatrics
    • high risk population
    • human
    • Netherlands
    • review
    • Streptococcus infection
    • vaccination

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