Cost-effectiveness of pertussis vaccination schedule in israel

Dean Langsam, Dor Kahana, Erez Shmueli*, Dan Yamin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Pertussis is a highly contagious bacterial disease that primarily affects infants. To optimize the pertussis vaccination schedule in Israel and evaluate the cost-effectiveness of alternative strategies that add or remove booster doses, we developed an age-structured model for pertussis transmission. Our model was calibrated using 16 years of data from laboratory-confirmed pertussis cases in Israel. Costs and quality-adjusted life years (QALYs) projected by the model within 12 years from the implementation of the considered interventions were compared with the current vaccination schedule. We found that by using the same number of vaccines administered today, the targeting of children at the age of six instead of seven would be predicted to be the optimal schedule to decrease both outpatient visits and hospitalizations. We also found that any increase in maternal vaccination coverage is likely to be cost-effective, with an incremental cost-effectiveness ratio of $77,000–$97,000 per QALY. By contrast, the contribution of the second booster dose is limited, with a probability of only 0.6 to be cost-effective at $110,000/QALY saved. Additional effort should be invested to encourage maternal vaccination against pertussis. We recommend moving the first booster to age six and prudently considering the necessity of the second booster dose.

Original languageEnglish
Article number590
Issue number6
StatePublished - Jun 2021


FundersFunder number
Israel National Institute for Health Policy Research164-16


    • Cost-effectiveness analysis
    • Pertussis
    • Population model
    • Transmission model
    • Vaccine allocation
    • Waning immunity


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