A critical literature review of health economic evaluations in pertussis booster vaccination.

A review of worldwide economic evaluations of pertussis booster vaccination for adolescents and adults was conducted. Thirteen cost-effectiveness, cost-utility and economic impact models were identified. The most frequently studied strategies were adolescent booster, one-time adult booster, adult decennial boosters and cocoon strategy. All studies evaluating adolescent booster suggested this was a cost-effective or cost-saving strategy compared with no booster vaccination. Conclusions concerning adult vaccination, alone or in combination with adolescent vaccination, vary between studies. Studies were often strongly affected by assumptions regarding the amount of unreported cases and lack of reliable input data on real incidence, other epidemiological inputs, costs associated with mild disease and herd immunity effects. Reviewed studies were generally in favor of pertussis booster vaccination, but did not identify any optimal vaccination strategy. Future economic evaluations should explore a wider range of strategies, taking into account country-specific considerations.