Abstract

MORALES VARGAS, Ricardo. Evaluación y evidencia para la vacunación contra rotavirus y vacunación contra Streptococcus pneumonia en Costa Rica. Rev. costarric. salud pública [online]. 2006, vol.15, n.29, pp.66-76. ISSN 1409-1429.

Two posible health interventions were evaluated and compared for application in Costa Rica: a) vaccination against Rotavirus, and b) vaccination against Streptococcus pneumonia. Analysis of existing printed and electronic literature was the method of choice, and criteria used were based on International Network of Agencies of Health Care Technlogy Assessment (INHATA) and of PAHO/WHO criteria for developing countries. Based on available references, these two interventions were compared in terms of safety, efficacy, efectiveness, utility and cost-benefit criteria, as well as on their organizational, ethical and social effects. Children under 5 years of age and the elderly over 65 years of age were chosen as target groups. Published economic data for health system costs and market prices for vaccines were used. Based on the criteria above, as well as the breadth and quality of the literature regarding both interventions, it is concluded that vaccination against Rotavirus could be of a higher impact in Costa Rica in terms of cases avoided and further Phase III studies are recommendable at the national level to evaluate its effectiveness. Even though vaccination against Streptococcus pneumonia (C/B =2,4) could be a more cost/benefit favoring alternative than the Rotavirus intervention (C/B =2,7) when analyzed in the medium and long term, the intervention against rotavirus is a better alternative when only annual costs after the first year are considered. Results of a global evaluation, using the above criteria, proposed by the author, favors intervention against rotavirus.

Keywords : vaccination; rotavirus; Streptococcus pneumonia; Costa Rica; evaluation; health technology assessment; evidence based medicine.

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