The unattainable criteria for new infant vaccines

Hum Vaccin Immunother. 2018 May 4;14(5):1179-1187. doi: 10.1080/21645515.2017.1328334. Epub 2017 Jun 19.

Abstract

Background: In 2013, the US Advisory Committee on Immunization Practices (ACIP) opted against adding meningococcal vaccines to the infant schedule due to poor cost-effectiveness. This raises a policy question: if meningococcal disease is too rare to justify routine vaccination, are there other vaccine-preventable causes of US infant deaths that could be supported?

Methods: We tabulated US infant deaths from 2009-2013 using the CDC WONDER database. These causes of death were then categorized into one of 3 categories: 1) vaccine-preventable using currently available interventions; 2) potentially vaccine-preventable within the next 10 years; and 3) not preventable.

Results: From 19.8 million births (3.9 million/year), ∼122,000 infants died (0.62%). Of these, 181 (0.15% of all deaths) were preventable using currently available vaccines, while an additional 779 were categorized as potentially preventable in the next 10 y. By exclusion, 121,040 (99.2%) were judged 'not vaccine-preventable'. Meningococcal deaths contributed at most 0.03% of all infant deaths, but accounted for 17-34% of current vaccine-preventable deaths.

Conclusions: The low number of vaccine-preventable deaths in the US makes it increasingly difficult to justify the introduction of any new infant vaccines.

Keywords: ACIP; cost-effectiveness; infant mortality; meningitis; meningococcal vaccine; vaccines.

MeSH terms

  • Cause of Death
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Immunization Schedule*
  • Infant
  • Infant Mortality*
  • Male
  • Meningococcal Infections / immunology
  • Meningococcal Infections / microbiology
  • Meningococcal Infections / mortality*
  • Meningococcal Infections / prevention & control
  • Meningococcal Vaccines / economics
  • Meningococcal Vaccines / therapeutic use*
  • Neisseria meningitidis / immunology
  • Treatment Outcome
  • United States / epidemiology
  • Vaccination / economics*
  • Vaccination / methods

Substances

  • Meningococcal Vaccines