Burden and cost of hospital admissions for vaccine-preventable paediatric pneumococcal disease and non-typable Haemophilus influenzae otitis media in New Zealand

Introduction Streptococcus pneumoniae ( Sp .) is a leading cause of paediatric bacterial meningitis, pneumonia and acute otitis media, as is non-typable Haemophilus influenzae (NT Hi ) for acute otitis media. In 2008, a 7-valent conjugated pneumococcal vaccine (PCV7) was included in the New Zealand (NZ) childhood immunization schedule. Objective To estimate the potentially vaccine-preventable annual hospital admissions and cost to the NZ Government of paediatric admissions for pneumococcal disease and NT Hi otitis media prior to the immunization programme. Methods Admissions (2000–7) and deaths (2000–5) in children aged 30 days after discharge from a previous admission. Informed by the literature, pneumococcal pneumonia episodes were estimated at 33% of all-cause pneumonia admissions; Sp. and NT Hi otitis media episodes were estimated jointly at 72% of otitis media admissions. Each episode was assigned a single diagnosis according to the following hierarchy: meningitis > bacteraemia > pneumonia > otitis media. Incidence rates for episodes were determined for 2000–7 (meningitis, bacteraemia and pneumonia) and 2006–7 (otitis media). Annual DRG-based costs for pneumococcal meningitis, bacteraemia, pneumonia and otitis media were estimated as (episode rate) × (DRG cost weight per episode) × (2007 population) × (national price per cost weight). Results Episode rates for pneumococcal meningitis, bacteraemia and pneumonia were stable in 2000–7, highest in the second 6 months of life and declined steeply over the first 5 years of life. Mean rates per 100 000 in 2000–7 were 18.4, 27.6 and 464 for pneumococcal meningitis, bacteraemia and pneumonia, respectively, for children aged