PIN47 CRITICAL SUCCESS FACTORS FOR THE UPTAKE OF NOVEL VACCINES ONTO NATIONAL IMMUNUSATION PROGRAMMES

Abstract

The HPV (human papillomavirus) vaccine has been one of the most successful vaccines in the past decade, securing rapid inclusion onto national immunization programmes (NIP). By contrast, the HZ (herpes zoster) vaccine, another recent launch, has failed to gain widespread coverage. The aim of this research is to compare these cases based on cost effectiveness in order to understand underlying criteria for successful vaccine uptake. We conducted a literature review using databases (Cochrane library, Medline and Google scholar) for the time period 1995 −2010. Key search words included HPV, HZ, vaccination, economic evaluation and cost effectiveness. Extracted studies were selected based on pre-determined inclusion and exclusion criteria. Despite low incidence rates for cervical cancer in some countries, the HPV vaccine was considered to be cost effective with ratios ranging from $14,149 to $29,580/QALY. It provides long term protection in a young population. Although the HZ vaccine displayed a similar CE range, $16,229 to $28,325/QALY, this was heavily dependent on age (optimal years being 60-70). Consequently, the HZ vaccine is indicated for the elderly. It is also considered to provide waning immunity after initial vaccination. From a public health point of view, the HZ vaccine was not as well received as the HPV vaccine. In addition to vaccine efficacy, long term immunity and safety, there are additional factors which influence vaccine uptake. For example there are substantial public good aspects of vaccination with long term societal returns reflected in maximal population coverage. In particular, awareness and support from the medical profession, particularly general practitioners, also assist in the perception of societal value that a vaccine can provide. These factors are all very important considerations beyond economic evaluation, and therefore have great influence over inclusion onto NIPs.