Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor
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.
Fontanarosa PB, Le C. Cost-effectiveness of Pneumococcal Vaccine. JAMA. 2000;284(4):440-441. doi:10.1001/jama.284.4.436