Zusammenfassung
Die überzeugenden Ergebnisse der allgemeinen Säuglingsimpfung mit konjugierten Pneumokokkenimpfstoffen
vier Jahre nach Einführung in den USA machen eine Neubeurteilung der Empfehlung in
Deutschland erforderlich. Die epidemiologische Situation in Deutschland und die bisherige
Strategie werden beschrieben. Die Wirksamkeit der allgemeinen Pneumokokkenimpfung
mit konjugierten Impfstoffen wird anhand der klinischen Studien und der Erfahrungen
mit Bevölkerungsprogrammen dargestellt. Dabei zeigt sich eine rasche und nachhaltige
Reduktion von Todes- und Krankheitsfällen durch Pneumokokkeninfektionen. Durch das
Erzeugen einer Herdenimmunität stellt sich auch die Kosten-Nutzen-Relation insgesamt
positiv dar. Die Auswertung der gesundheitsökonomischen Untersuchungen weist selbst
aus der Krankenkassenperspektive die generelle Säuglingsimpfung als kostensparend
aus. Sowohl die Effekte auf Mortalität und Morbidität als auch die Ökonomie lassen
die Pneumokokkenimpfung als präventivmedizinische Maßnahme von vergleichbarem Nutzen
mit den eingeführten Routineimpfungen einordnen. Die Übersicht über die Impfempfehlungen
macht die Notwendigkeit einer Fortschreibung der deutschen Regelungen deutlich.
Abstract
Convincing results of conjugated pneumococcal vaccination since introduction as universal
infant immunization in the United States makes it inevitable to reconsider current
recommendation of its use in Germany. The epidemiological situation in Germany is
described as well as the control strategy in place. Vaccine efficacy is demonstrated
by outcome of clinical trials and results from population-based epidemiological surveillance
data which demonstrate early and sustained reduction of mortality and morbidity due
to pneumococcal infections. Health economic analyses reveal positive cost-effectiveness
and cost-benefit relations due to the herd-immunity induced by universal immunization.
Even from perspective of German health insurances a cost saving scenario can be expected.
Impact on reduction of disease burden and attractive health economic effects make
pneumococcal vaccination as preventive tool absolute comparable with well accepted
routine childhood vaccinations. The review of existing recommendations and hurdles
to implementation in the German system show potential for improvement.
Schlüsselwörter
Konjugierte Pneumokokkenimpfstoffe - Krankheitslast - Impfwirksamkeit - Gesundheitsökonomie
- STIKO-Empfehlungen
Key words
Conjugated pneumococcal vaccine - disease burden - vaccine efficacy - health economy
- STIKO-recommendations
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