[Cost-effectiveness of pneumococcal vaccination among patients with chronic heart failure].

Aim      To analyze the cost-effectiveness of pneumococcal vaccination in 40- and 65-year-old patients with chronic heart failure (CHF).Material and methods  Analysis was performed by Markov modeling from the perspective of the healthcare system. The evaluation was based on Russian epidemiological data taking into account results of international studies. The analyzed schedule of vaccination included one dose of 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent polysaccharide vaccine (PPSV23) after one year and vaccination with only one dose of PCV13. The time horizon of the study was 5 years. Costs and life expectancy were discounted at 3.5% per year.Results The cost-effectiveness of vaccination for both 65-year-old and 40-year-old CHF patients is very high: the incremental cost of one additional QALY (Quality-Adjusted Life Year) for PCV13+PPSV23 vaccination is 113.24 thousand rubles, while vaccination with PCV13 entails a reduction in costs by 556.50 rubles per one vaccinated patient. For vaccination of 40-year-old CHF patients with PCV13+PPSV23, the incremental costs per 1 QALY will be 519.72 thousand rubles, while for vaccination with PCV13 it will be 99.33 thousand rubles.Conclusion      Pneumococcal vaccination of CHF patients reduces the associated morbidity and mortality and is highly cost effective.

[PRINCIPLES OF MONITORING OF ADVERSE EVENTS AFTER VACCINATION IN RUSSIAN FEDERATION AND THE WORLD].

Difference in terminology accepted in our and foreign countries for designating disease of post-vaccination period is shown. Analysis ofthe existing regulating documents in Russian Federa- tion regarding registration of adverse events in post-vaccination period and system of registration accepted in many countries of the world and recommended by WHO is presented. In Russian Federation in accordance with the documents ofthe Federal Service of Surveillance for Protection of Consumers Rights and Human Welfare only certain conditions (post-vaccinal complications) are subject to registration. In accordance with WHO recommendations. all adverse events taking place 1 month after the vaccination must be registered. Summarization of these data allows to detect interconnection between these conditions and vaccination or prove the lack thereof.