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Worries on cost hold up pneumococcal vaccine

Government vaccine advisers have stalled on a decision to introduce the pneumococcal conjugate vaccine into the childhood schedule because of doubts over whether it would be cost-effective.

The vaccine had been at the top of the Joint Committee on Vaccination and Immunisation's list for entry into the childhood immunisation programme.

But a Health Protection Agency evaluation of the cost-effectiveness of introducing the vaccine, submitted to the Joint Committee on Vaccination and Immunisation, has failed to provide robust enough evidence to support the move.

The committee said at its latest meeting the HPA analysis was based on 'assumptions' and the 'imprecision' of the epidemiology of pneumococcal disease and more information was needed on the vaccine's potential impact.

It concluded: 'The presently available evidence suggested the cost-benefit of a pneumococcal conjugate programme was probably unjustifiable.'

The JCVI said its line could change if research proved the vaccine could be less costly, if adequate protection could be achieved from few doses and if vaccinating children could produce herd immunity and protection against antibiotic-resistant strains.

The HPA, which advises the Government on public health, highlighted combating pneumococcal disease in children in its five-year corporate plan earlier this month.

It said introducing the jab could cut deaths from meningitis in a few years.

Dr George Kassianos, RCGP immunisation spokes-man and a GP in Bracknell, Berkshire, said pneumococcal disease was the second biggest cause of meningitis in the UK and the vaccine was the only chance of reducing the burden of infection. 'American experience since the introduction of the vaccine into their childhood immunisation programme shows it is safe and effective in preventing disease in young children for whom the vaccine is primarily indicated, and may be reducing the rate of disease in adults,' he said.

'The vaccine provides an effective new tool for reducing disease caused by drug-resistant strains.'

The HPA said it supported the JCVI's view that more evidence was needed before a pneumococcal vaccine programme could be recommended.

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