

Journal of Health and Medical Sciences
ISSN 2622-7258







Published: 05 February 2025
Reduced Costs of Managing Adverse Reactions with DT3aP-HBV-IPV/Hib Versus DT2aP-HBV-IPV-Hib in Vietnam: Results of a Cross-Sectional Survey and Mathematical Projections of Vaccination of Infants
Ahmed Mohy, Georgios Nikitas, Maurine Duchenne, Victoria Genovez, Giacomo Casabona, Elizabeth Hennessy, Minh Nguyen, Elena DeAngelis, Alen Marijam, Désirée Van Oorschot
GSK, Amaris Consulting, Adelphi Real World

Download Full-Text Pdf

10.31014/aior.1994.08.01.227
Pages: 33-47
Keywords: Acellular Pertussis, Adverse Reactions, Childhood Vaccination, Healthcare Resource Utilization, Hexavalent Vaccine, Vaccine Costs, Vaccine Hesitancy
Abstract
In Vietnam, hexavalent vaccines are routinely given during early childhood. Hexavalent vaccines DT3aP-HBV-IPV/Hib and DT2aP-HBV-IPV-Hib differ in composition and therefore, reactogenicity, with DT3aP-HBV-IPV/Hib shown to cause fewer adverse reactions (ARs) than DT2aP-HBV-IPV-Hib. Online surveys for physicians and parents/caregivers who manage post-vaccination ARs in children were used to explore AR management in the Vietnamese private healthcare setting. Survey data were used to estimate healthcare resource utilization (HCRU) and its associated costs, and indirect costs to parents/caregivers. A mathematical projection tool used survey results to approximate the difference in costs associated with post-vaccination childhood AR management following primary doses of DT3aP-HBV-IPV/Hib versus DT2aP-HBV-IPV-Hib. Parent/caregiver attitudes towards childhood vaccination in relation to management of ARs in their children were also explored. Around a third of parents/caregivers in Vietnam reported that their child experienced post-vaccination AR(s), the management of which led to significant HCRU and indirect costs to parents/caregivers. A primary dose of DT3aP-HBV-IPV/Hib compared with DT2aP-HBV-IPV-Hib led to 420 985 fewer ARs in Vietnam. Subsequently, HCRU burden and associated direct costs were reduced by ~11% and indirect costs to parents/caregivers were reduced by 14%. Parents/caregivers reported indirect costs of ~3 million VND per parent/caregiver per AR to manage ARs in their children. Additionally, parents/caregivers reported notable emotional concerns over ARs of rashes, diarrhea, and fever. However, despite costs and emotional burdens, most parents/caregivers did not express hesitancy toward future vaccinations. The substantial financial benefits of a vaccine with fewer ARs should be considered from a cost effectiveness perspective by decision-makers when evaluating vaccine alternatives.
References
Brown, K. F., Kroll, J. S., Hudson, M. J., Ramsay, M., Green, J., Long, S. J., Vincent, C. A., Fraser, G., & Sevdalis, N. (2010). Factors underlying parental decisions about combination childhood vaccinations including MMR: A systematic review. Vaccine, 28(26), 4235−4248. https://doi.org/10.1016/j.vaccine.2010.04.052.
European Medicines Agency 2021a. Hexaxim. Retrieved December 2024, from https://www.ema.europa.eu/en/medicines/human/EPAR/hexacima
European Medicines Agency 2021b. Infanrix Hexa. Retrieved December 2024, from https://www.ema.europa.eu/en/medicines/human/EPAR/infanrix-hexa
George, M., Pérez Martin, J., AbdelGhany, M., Gkalapi, F., Jamet, N., Kosse, R., Ruiz GarcÃa, Y., Turriani, E., & Berlaimont, V. (2023). Reduced reactogenicity of primary vaccination with DT3aP-HBV-IPV/Hib compared with DT2aP-HBV-IPV-Hib among infants: Mathematical projections in six countries. Hum Vaccin Immunother, 19(1), 2202124. https://doi.org/10.1080/21645515.2023.2202124
GSK. (2023). Data on file.
Happe, L. E., Lunacsek, O. E., Marshall, G. S., Lewis, T., & Spencer, S. (2007). Combination vaccine use and vaccination quality in a managed care population. Am J Manag Care, 13(9), 506–512. https://www.ajmc.com/view/sep07-2531p509-512
Jit, M., Huyen, D. T. T., Friberg, I., Van Minh, H., Kiet, P. H. T., Walker, N., Nguyen, V. C., Tran, N. D., Toda, K., Hutubessy, R., Fox, K., & Nguyen, T. H. (2015). Thirty years of vaccination in Vietnam: Impact and cost-effectiveness of the national Expanded Programme on Immunization. Vaccine, 7(33), A233–A2399. https://doi.org/10.1016/j.vaccine.2014.12.017
Knuf, M., Haas, H., Garcia-Corbeira, P., Turriani, E., Mukherjee, P., Janssens, W., & Berlaimont, V. (2021). Hexavalent vaccines: What can we learn from head-to-head studies? Vaccine, 39(41), 6025–6036. https://doi.org/https://doi.org/10.1016/j.vaccine.2021.08.086
Kurosky, S. K., Davis, K. L., & Krishnarajah, G. (2017). Effect of combination vaccines on completion and compliance of childhood vaccinations in the United States. Hum Vaccin Immunother, 13(11), 2494–2502. https://doi.org/10.1080/21645515.2017.1362515
Li, S., Gong, T., Chen, G., Liu, P., Lai, X., Rong, H., Ma, X., Hou, Z., & Fang, H. (2022). Parental preference for influenza vaccine for children in China: A discrete choice experiment. BMJ Open, 12, e055725. https://doi.org/10.1136/bmjopen-2021-055725
Lieu, T. A., Black, S. B., Ray, G. T., Martin, K. E., Shinefield, H. R., & Weniger, B. G. (2000). The hidden costs of infant vaccination. Vaccine, 19(1), 33–41. https://doi.org/10.1016/S0264-410X(00)00154-7
Liu, Y., Yang, Y., Zhou, J., Zhang, X., Gu, L., & Xu, Y. (2024). Economic burden of pertussis in children: A single-center analysis in Hangzhou, China. Hum Vaccin Immunother, 20(1), 2343199. https://doi.org/10.1080/21645515.2024.2343199
Marshall, G. S., Happe, L. E., Lunacsek, O. E., Szymanski, M. D., Woods, C. R., Zahn, M. D., & Russell, A. (2007). Use of combination vaccines is associated with improved coverage rates. Pediatr Infect Dis J, 26(6), 496–500. https://doi.org/10.1097/INF.0b013e31805d7f17
Mohy, A., Permatasari, D., Wijoyo, J., Kwanthitinan, C., Mitisubin, J., Fonseka, T., & George, M. (2024). Reactogenicity of Primary Vaccination with Hexavalent Vaccines in Infants: Mathematical Projections in Four Southeast Asian Countries. J Health Med Sci, 7(2), 51–63. https://doi.org/10.31014/aior.1994.07.02.318
Mukherjee, P., Akpo, E. I. H., Kuznetsova, A., Knuf, M., Silfverdal, S., Kosalaraksa, P., & Mihalyi, A. (2021). Hexavalent vaccines in infants: A systematic literature review and meta-analysis of the solicited local and systemic adverse reactions of two hexavalent vaccines. Expert Rev Vaccines, 20(3), 319–330. https://doi.org/10.1080/14760584.2021.1892493
Nguyen, T. D., Dang, A. D., Van Damme, P., Nguyen, C. V., Duong, H. T., Goossens, H., Theeten, H., & Leuridan, E. (2015). Coverage of the expanded program on immunization in Vietnam: Results from 2 cluster surveys and routine reports. Human Vaccines and Immunotherapeutics, 11(6), 1526−1533. https://doi.org/10.1080/21645515.2015.1032487
Obohwemu, K., Christie-de Jong, F., & Ling, J. (2022). Parental childhood vaccine hesitancy and predicting uptake of vaccinations: A systematic review. Prim Health Care Res Dev, 23, e68. https://doi.org/10.1017/S1463423622000512
Özen, M. E., Ünüvar, E., Yıldırım, A., Akmand, H., Mevlitoğlu, S., & Pehlivan, T. (2024). A worldwide overview for hexavalent vaccines and a glimpse into Turkiye’s perspective. Human Vaccines and Immunotherapeutics, 20(1), 2345493. https://doi.org/10.1080/21645515.2024.2345493
Saleh, E., Swamy, G. K., Moody, M. A., & Walter, E. B. (2017). Parental approach to the prevention and management of fever and pain following childhood immunizations: a survey study. Clin Pediatri (Phila), 56(5), 435–442. https://doi.org/10.1177/0009922816675116
Truong, B. Q. Q., Ong, K. I. C., Shibanuma, A., Kiriya, J., & Jimba, M. (2024). Adaptation and application of the Parent Attitudes About Childhood Vaccines survey tool in the Vietnamese language: A cross-sectional study. BMC Public Health, 24(1), 946. https://doi.org/10.1186/s12889-024-18389-x
Ventola, C. L. (2016). Immunization in the United States: Recommendations, barriers, and measures to improve compliance: . Pharmany and Therapeutics, 41(7), 426–436.
Vu, D. T., Thuy, T. P., Radigue, C., Nguyen, D. Q., Da Costa, X., B'Chir, S., & Vidor, E. (2019). Immunogenicity and safety of fully liquid hexavalent vaccine given to Vietnamese infants previously vaccinated at birth with hepatitis B vaccine. The Southeast Asian Journal of Tropical Medicine and Public Health, 50(6), 1055–1077.
WHO Recommendations for Routine Immunization. (2024). https://www.who.int/publications/m/item/table1-summary-of-who-position-papers-recommendations-for-routine-immunization
World Health Organisation: Ten threats to global health in 2019. (2019). Retrieved December 2024 from https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019
World Population Prospects 2022: Summary of Results. (2022). Retrieved October 2024 from https://www.un.org/development/desa/pd/content/World-Population-Prospects-2022#:~:text=World%20Population%20Prospects%202022%20is%20the%20twenty-seventh%20edition%20of%20the
Zhou, F. J., Shefer, A., Wenger, J., Messonnier, M., Wang, L., Lopez, A., Moore, M., Murphy, T., Cortese, M., & Rodewald, L. (2014). Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics, 2014(4), 577–585. https://doi.org/10.1542/peds.2013-0698