Cost of pneumococcal vaccine underestimated ten-fold.

Hum Vaccin. 2011 May 1;7(5). [Epub ahead of print]

Puliyel Jacob

Cost of pneumococcal vaccine
underestimated ten-fold
I commend Professor Light1 for his article on the pneumococcal AMC. His excellent article was however marred by a typographic error that overestimates the benefit from the vaccine at least ten-fold. I hope you will permit it to be corrected so the scientific record is accurate. The author quotes a paper by Madhi et al to suggest that 360 lives are saved per 100,000 vaccinated.2 This is a mistake. Madhi et al., in fact suggests only 360 “cases of pneumonia” are prevented by vaccinating 100,000 children (3.6 cases per 1000 vaccinated is the figure they use). Not all children with pneumonia die. The Unicef suggests that in areas with inadequate medical services, up to 10 % die.3 Even assuming this high death rate, deaths averted by pneumococcal vaccine will be 36/100,000 vaccinated—not 360. The cost per life saved is ten-fold higher than calculated and this will be $47,220. The pneumococcal vaccine cannot be considered
cost effective in developing countries. It is probably unethical to promote a vaccine with such low utility here. It is of note that GAVI in their response, make no effort to draw attention to this error in the original article by Light.
Jacob Puliyel,
St Stephens Hospital; Delhi, India
Jacob Puliyel
St Stephens Hospital; Delhi, India
*Correspondence to: Jacob Puliyel; Email:
Submitted: 4/02/11; Accepted: 4/18/11
DOI: 10.4161/hv.7.5.16276
1. Light DW. Human Vaccines2011; 7: 138-141.
2. Madhi SA, et al. Bulletin of the World Health
Organization. 2008; 86: A.