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July 26, 2000

Cost-effectiveness of Pneumococcal Vaccine

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;284(4):440-441. doi:10.1001/jama.284.4.436

To the Editor: Dr Lieu and colleagues1 used pneumococcal vaccine efficacy estimates of 7%, 19%, and 20% for the prevention of simple otitis media (OM), complex OM, and OM requiring tympanostomy tube placement, respectively. These estimates are extrapolations of the vaccine efficacy against OM when the vaccine was given to infants in a 4-dose series as conducted in the Northern California Kaiser Permanente trial.2 Although the conjugate vaccine is immunogenic in older children, I question the validity of using the same efficacy data to calculate the cost-effectiveness of a single "catch-up" dose in older children.

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