Estimated XXXX and Economic Burden of Four Major Adult Vaccine-Preventable Diseases in the United States, 2013.

@entity1 @entity10479 @entity66 @entity55 @entity5695 @entity4091 @entity683 @entity2258
UNASSIGNED: Low uptake of routinely recommended adult immunizations is a public health concern. Using data from the peer-reviewed literature, government disease-surveillance programs, and the @entity10479 Census, we developed a customizable model to estimate @entity1 and economic burden caused by four major adult vaccine-preventable diseases (VPD) in 2013 in the United States, and for each @entity10479 state individually. To estimate the number of cases for each adult VPD for a given population, we multiplied age-specific incidence rates obtained from the literature by age-specific 2013 Census population data. We then multiplied the estimated number of cases for a given population by age-specific, estimated medical and indirect (non-medical) costs per case. Adult VPDs examined were: (1) @entity683 , (2) @entity66 (both invasive @entity55 ), (3) @entity4091 ( @entity4091 ), and (4) pertussis ( @entity5695 ). Sensitivity analyses simulated the impact of various epidemiological scenarios on the total estimated economic burden. Estimated @entity10479 annual cost for the four adult VPDs was  26.5 billion (B) among adults aged 50  years and older,  15.3B (58  %) of which was attributable to those 65 and older. Among adults 50 and older, @entity683 , @entity66 , @entity4091 , and pertussis made up  16.0B (60  %),  5.1B (19  %),  5.0B (19  %), and  0.4B (2  %) of the cost, respectively. Among those 65 and older, they made up  8.3B (54  %),  3.8B (25  %),  3.0B (20  %), and 0.2B (1  %) of the cost, respectively. Most (80-85  %) pneumococcal costs stemmed from @entity2258 ( @entity2258 ). Cost attributable to adult VPD in the United States is substantial. Broadening adult immunization efforts beyond @entity683 only may help reduce the economic burden of adult VPD, and a pneumococcal vaccination effort, primarily focused on reducing @entity2258 , may constitute a logical starting place. Sensitivity analyses revealed that a pandemic @entity683 season or change in size of the @entity10479 elderly population could increase these costs dramatically.
