Silver Book

Infectious Diseases

Vaccine preventable illnesses and diseases continue to cause significant sickness, hospitalization, pain, disability, and death in the United States.  Pneumonia causes somewhere between 300,000 and 600,000 hospitalizations in older adults each year, and more than 50% of flu-related hospitalizations are in people age 65 and older.  Around 50% of the more than 1 million cases of shingles each year are in people age 60 and older.

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    • Unplanned Hospital Readmissions & Costs Following Sepsis Hospitalizations
      Among 187,697 hospital admissions for medical reasons that were associated with an unplanned 30-day readmission,  147,084 had a diagnosis of sepsis, 15,001 had a diagnosis of AMI, 79,480 were diagnosed with heart failure, 54,396…  
    • Cost of infectious disease in unvaccinated individuals
      Unvaccinated individuals are responsible fror almost 80% ($7.1 billion) of the $9 billion economic burden of vaccine-preventable diseases in 2015.  Note that the cost is based on the vaccine-preventable illnesses…  
    • Cost of vaccine-preventable diseases
      Vaccine-preventable diseases relevant to the ten vaccines recommended for US adults, cost an estimated $9 billion in 2015.  
    • Immunization significantly lowers rates of leading infectious diseases
      Impact of Immunization on the Number of Annual Cases of Disease in the USA  
    • Drastic reduction of morbidity from vaccine-preventable disease in 20th century
      In the 20th century, vaccines have reduced the morbidity from vaccine-preventable diseases by as much as 89–100%.  
    • Eradication of infectious diseases from vaccination
      Spanning more than 200 years of research and development, 10 infectious diseases have been at least 90 percent eradicated in the United States thanks to vaccines.  
    • Vaccines in development 2013
      Biopharmaceutical research companies are developing 271 vaccines for infectious diseases, cancer, neurological disorders, allergies, and other diseases.  
    • Vaccines in development 2013
      Vaccines in development for 2013  
    • Negative value of antibiotics to drug companies
      The value of an antibiotic to a drug company is negative $50 million- compared to the positive value of $1 billion for a new musculoskeletal drug.  
    • Vaccines save lives and money
      Between 2001 and 2010, vaccine use prevented an estimated 170,000 severe pneumococcal infections and 10,000 deaths, and saved an estimated $310 million in direct medical costs each year.  
    • Pneumonia Death Rate by Age in 2004
      Pneumonia Death Rate Per 100,000 By Age: United States, 2004  
    • Global use of vaccine prevents death
      Compared to estimated deaths without vaccination, global use of vaccination in 2001 prevented: 61% of measles deaths; 69% of tetanus deaths; 78% of pertussis (whooping cough) deaths; 94% of diphtheria…  
    • Flu causes close to 1/2 of lost workdays and low productivity in adults 50-64 during flu season
      During influenza season, influenza-like-illness is responsible for 45% of workdays lost and for 49% of low productivity days among working adults aged 50–64 years.  
    • Significant savings from zoster vaccine
      In a cost-effectiveness analysis, investigators estimated the zoster vaccine cost $44,000 per quality-adjusted life year saved for a 70-year-old woman.  
    • Use of shingles vaccine could save $82 to $103 million
      Use of the shingles vaccine in immunocompetent adults ages 60 and older could save between $82 and $103 million in healthcare costs associated with the diagnosis and treatment of shingles,…  
    • Potential savings from shingles vaccine
      Use of the shingles vaccine in immunocompetent adults ages 60 and older could save between $82 and $103 million in healthcare costs associated with the diagnosis and treatment of shingles,…  
    • Shingles vaccine could improve QALY and save money
      Vaccination of 1 million people age 60 and over with the shingles vaccine would result in 11,919 non-discounted and 8,782 discounted QALYs (quality of life years) gained and save around…  
    • Economic value from flu vaccine in elderly
      As over 60% of the economic burden of influenza falls on those ages 65 and older, programs to reduce the impact of influenza on older Americans would have the greatest…  
    • Each flu case prevented could save $60 to $4,000
      The influenza vaccination could save between $60 and $4,000 per case prevented.  
    • Savings from flu vaccine
      Vaccination for influenza resulted in an average annual cost savings of $13.66 per healthy working adult vaccinated.  
    • Cost of pneumonia vaccine
      Addition of PCV13 (13-valent pneumococcal conjugate vaccine) to previously recommended pneumococcal polysaccharide vaccine for immunocompromised adults cost $70,937 per quality adjusted life year compared to no vaccine.  
    • Potential value of pneumonia vaccine
      Use of PCV13 (13-valent pneumococcal conjugate vaccine) in older adults is estimated to have the potential to reduce total healthcare costs by $3.5 billion and total societal costs by $7.4…  
    • Value of smallpox eradication
      An estimated $100 million spent in eradicating smallpox from 1967 to 1977 saved the world around $1.35 billion a year.  
    • Value of polio eradication
      Eradication of polio is estimated to produce savings to governments of $1.5 billion per year.  
    • Cost of measles much higher than vaccine
      One case of measles can cost 23 times as much as a single vaccination to prevent it.  
    • Cost effectiveness of MMR vaccine
      For every dollar spent on the MMR (measles, mumps, and rubella) vaccine, $21 is saved.  
    • Vaccines cost ~$50 per healthy life year saved
      Most vaccinations cost less than $50 per healthy life year saved. In contrast, treating hypertension costs between $4,340 and $87,940 per healthy life year saved.  
    • Cost savings from immunization
      Every dollar spent on immunization saves $6.30 in direct medical costs – a total savings of $10.5 billion. When including indirect costs such as lost days of work, disability,…  
    • Shingles vaccine would reduce healthcare use
      Use of the shingles vaccine in immunocompetent adults could eliminate more than 300,000 outpatient visits, 375,000 prescriptions, 9,700 emergency room visits, and 10,000 hospitalizations.  
    • Use of shingles vaccines significantly reduced disease burden
      Use of a live attenuated VZV (varicella-zoster vaccine) in a randomized trial reduced the burden of illness from shingles by 61.1% and the incidence of postherpetic neuralgia (PHN) by 66.5%.  
    • Shingles vaccine reduces incidence by >50%
      Use of a live attenuated VZV (varicella-zoster vaccine) in a randomized trial reduced the incidence of shingles by 51.3%.  
    • ~One-third of shingles death preventable with vaccine
      Approximately one-third of shingles deaths may be preventable through vaccination.  
    • Annual flu vaccine could save 275,000 QALYs
      Offering the influenza vaccine annually to all people over the age of 50 would save around 275,000 quality-adjusted life years over the lifetimes of a birth cohort of 4 million.…  
    • Staff vaccination in nursing homes reduces mortality rates of residents
      Mortality rates in nursing home residents were 42% lower in facilities with higher staff vaccination coverage compared with control facilities.  
    • Staff flu vaccination reduces incidence of staff and patients
      Vaccination of staff in a tertiary care facility over a period of 12 influenza seasons increased vaccination coverage from 4% to 67%, reduced laboratory-confirmed cases of influenza amongst staff from…  
    • Influenza vaccine use reduces antibiotic use
      Use of LAIV (live attenuated influenza virus) in healthy adults ages 18 to 65 reduced antibiotic use by 43% to 47%.  
    • Flu vaccine use reduces disease burden
      Use of the LAIV (live attenuated influenza virus) in healthy adults ages 18 to 64 reduced febrile illness by 19% and upper respiratory tract illnesses by 24%. It also…  
    • Flu vaccine use can reduce illness risk in U.S. by 60%
      Recent studies from the Centers for Disease Control and Prevention show that the influenza vaccine can reduce the risk of illness in the overall U.S. population by around 60%. …  
    • Over 6 years, flu vaccine prevented >110,000 hospitalizations and 5.8 million medical visits
      Over a 6-year period (2005 – 2011), the influenza vaccine prevented more than 110,000 hospitalizations and 5.8 million medical visits.  
    • Over 6 years, flu vaccine prevented ~13 million cases
      Over a 6-year period (2005 – 2011), the influenza vaccine prevented an estimated 13 million influenza cases–between 1.1 million and 5 million annually.  
    • Use of pneumonia vaccine in children reduced rates in adults age 65+
      Within a year of introduction of PCV7 (7-valent pneumococcal conjugate vaccine) for use in the U.S. in infants, children under 2 years, and high risk children ages 2 to 4;…  
    • Effectiveness of pneumonia vaccine
      PPSV23 (pneumococcal polysaccharide vaccine) protects against 23 types of pneumococcal bacteria and is 60% to 80% effective in preventing pneumococcal bacteremia in adults over the age of 65 who are…  
    • Vaccines in development 2013
      137 vaccines are currently in development in the U.S. for infectious diseases.  
    • Eradication of smallpox has saved 40 million lives worldwide
      Since global vaccination efforts wiped out smallpox disease in 1979, infections in 350 million people have been prevented and 40 million lives have been saved.  
    • Polio vaccination prevented 5 million cases of paralysis since 1988
      Vaccination for polio reduced the number of worldwide cases from more than 300,000 per year in the 1980s to only 2,000 in 2002—also preventing an estimated 5 million cases of…  
    • Pertussis vaccination reduced global cases
      Vaccination helped reduce global pertussis (whooping cough) cases from 3 million per year to less 250,000.  
    • Diptheria vaccine significantly reduced annual cases
      Vaccination has played a significant role in reducing diphtheria cases from 80,000 in 1975 to less than 10,000 per year.  
    • Measles vaccines reduced cases from 6 million to 1 million per year
      Vaccination for measles reduced the number of worldwide deaths from 6 million in 1974 to less than 1 million per year.  
    • Life years saved from infectious disease eradication
      Infectious disease eradication in the U.S. led to the following annual life years saved (LYS): 5,811,852 for measles 42,702 for tetanus 212,690 for polio 1,685,740 for smallpox  
    • Shingles causes an average of 129 hours lost work per episode
      Patients with shingles (including those progressing to postherpetic neuralgia) lose an average of over 129 hours of work per episode, including losses of 12 or more hours of work time  
    • Vaccine-eligible account for majority of shingles-related hospitalizations
      The shingles vaccine-eligible population (i.e., persons aged 60 years or older) accounted for 74% of the total annual shingles-related hospital charges in 2004.  
    • Costs of shingles
      Among patients with acute episodes of shingles, average expenditures ranged from $112 to $287 per episode of outpatient care, $73 to $180 per antiviral treatment, and $3,221 to $7,206 per…  
    • Flu costs US $16.3 billion in lost earnings each year
      Lost productivity and loss of life due to influenza amounts to $16.3 billion of lost earnings annually.  
    • >1/2 of flu’s economic burden from people 65+
      An estimated 64% of the total economic burden of influenza comes from those over 65 years old.  
    • Medical expenses for Medicare patients with pneumonia higher
      Medicare patients hospitalized for pneumonia have medical expenses—during the hospitalization and for a year afterwards—that are $15,682 higher than in Medicare patients without pneumonia.  
    • Cost of hospital-treated pneumonia in Medicare patients
      Hospital-treated pneumonia in Medicare patients cost at least $7 billion in 2010.  
    • Cost of pneumonia and flu more than $40 billion in 2005
      In 2005, pneumonia and influenza combined cost the U.S. $40.2 billion—$34.2 in direct costs and $6 billion in indirect mortality costs.  
    • Shingles pain occurs in ~50% of cases in older adults
      Complications of shingles—including postherpetic neuralgia (PHN)—occur in almost 50 percent of older persons with the disease.  
    • Shingles causes >50,000 hospitalizations each year
      Shingles causes around 50,000 to 60,000 hospitalizations each year in the United States.  
    • Increase in flu mortality between 1970 and 1990
      Mortality from influenza increased from between 7,000 and 32,000 annual deaths in the 1970s, to between 36,000 and 72,000 annual deaths in the 1990s.  
    • Flu fatality rates in long-term care facilities
      Case-fatality rates from influenza in residents of long-term care facilities range from 10% to 20%.  
    • Influenza-associated deaths
      The annual number of influenza-associated deaths from respiratory and circulatory cases varies widely from year-to-year, ranging from an estimated 3,349 to 48,614.  
    • Lost productivity and healthcare visits due to flu
      In one year (1995), influenza was responsible for more than: 200 million days of restricted activity 100 million days of bed disability 75 million work absenteeisms 22 million health care provider visits  
    • Healthcare use due to flu
      In the U.S. influenza epidemics lead to around: • 600,000 life years lost • 3 million hospitalized days • 30 million outpatient visits  
    • Hospitalization rate from flu epidemics
      Every influenza epidemic, between 55,000 and 431,000 Americans are hospitalized, with a mean annual hospitalization rate of 226,000.  
    • Mortality rate from hospital-acquired pneumonia
      The mortality rate for hospital-acquired pneumonia ranges from 38% to more than 70%.  
    • In 1998, community-acquired pneumonia was 6th leading cause of death
      Community-acquired pneumonia is the sixth leading cause of death in the U.S. and the number-one cause of death from infection.  
    • Pneumonia killed ~50,000 people in 2010
      In 2010, pneumonia killed around 50,000 Americans.  
    • 1 in 4 inpatient pneumonia hospitalizations due to HAIs
      In one study, one in four inpatient pneumonia hospitalizations were from health-care-associated pneumonia.  
    • Hospitalizations due to pneumonia
      Community-acquired pneumonia is responsible for 350,000 – 620,000 hospitalizations each year in Americans age 65 and older.  
    • Increased rate of hospitalization from shingles
      Hospitalization rates for shingles are 75 times higher in people over 85 than those younger than 30.  
    • 1 in 2 people who live to 85 will get shingles
      Around 1 in 2 people who live to be 85 will get shingles.  
    • Death rate from pneumonia and flu rises significantly with age
      The death rate from pneumonia and influenza is close to 130 times higher in people age 85 and older, compared to people ages 45 to 54. This increased risk due…  
    • Medicare hospitalization rates from pneumonia
      Elderly Medicare patients are hospitalized with community-acquired pneumonia at a rate of 18.3 per 1000, compared to 4 per 1000 in younger populations.  
    • Pneumonia in people age 85+
      In the U.S., 1 in every 20 individuals age 85 and older will have a new episode of community-acquired pneumonia each year.  
    • >900,000 cases of pneumonia each year
      Each year, more than 900,000 cases of community-acquired pneumonia are estimated to occur in seniors in the U.S.  
    • 1 in 3 people will develop shingles
      An estimated 1 in 3 people will develop shingles in their lifetime.  
    • ~1 million Americans get shingles each year
      Around 1 million Americans get herpes zoster (shingles) each year.  
    • Flu rates in long-term care facilities
      Residents of long-term care facilities are particularly vulnerable to influenza, with rates of illness that range as high as 25% to 60%.  
    • Every year 5 to 20% of US population gets the flu
      Every year around 5% to 20% of the U.S. population gets influenza.  
    • Annual incidence of pneumonia in Medicare population
      In Medicare beneficiaries, the average cumulative annual incidence of any type of pneumonia was 47.4 per 1,000 from 2005 to 2007.  
    • Pneumonia in nursing home residents
      Every year an estimated 2.3% of nursing home residents acquire pneumonia—more than 33,000 residents.  
    • 5 to 10 million Americans get pneumonia each year
      Between 5 and 10 million Americans get pneumonia each year.  
    • Lost work due to shingles
      Shingles patients lose an average 129 hours of work per episode.  
    • Annual cost of shingles
      Shingles cost ~$1 billion in indirect and direct medical expenses each year.  
    • Lost productivity due to flu
      During flu season, in working adults ages 50 to 64 years old, flu-like illness is responsible for 45% of workdays lost and 49% of low-productivity days.  
    • Annual cost of flu
      The annual direct and indirect cost of flu in the U.S. is more than $87 billion.  
    • Higher hospitalization costs due to pneumonia
      Medicare beneficiaries hospitalized for pneumonia have $15,682 higher expenses than those without the infection.  
    • Physician visits due to infectious diseases
      1 in 4 physician visits are due to infectious diseases.  
    • Infectious diseases 15% of all healthcare expenditures
      The annual direct & indirect medical cost of infectious diseases is $120 million, 15% of all U.S. healthcare expenditures.  
    • Tremendous impact of flu epidemics
      Flu epidemics in the U.S. lead to approximately: 600,000 life years lost 3,000,000 days of hospitalization 30,000,000 outpatient visits 48,000 deaths  
    • Pneumonia leading cause of death and infection
      Community-acquired pneumonia was the #6 cause of death and the #1 cause of death from infection in the U.S. in 2003.  
    • Pneumonia is the 5th most frequent cause of hospitalization in the US
      Pneumonia is the 5th most frequent cause of hospitalization in the U.S.  
    • Postherpetic neuralgia in shingles
      Complications, including postherpetic neuralgia (PHN) occur in ~50% of older persons with shingles.  
    • Mortality from vaccine-preventable diseases
      Vaccine-preventable diseases or their complications account for 50,000 to 90,000 adult deaths in the U.S. each year.  
    • Infectious diseases lead to hospitalization
      Number of infectious disease cases that lead to hospitalization every year: Pneumonia >1.1 million Shingles 50,000 to 60,000 Influenza 55,000 to 431,000  
    • Hospitalization rates in shingles patients rises with age
      Hospitalization rates for people with shingles are 75 times higher for people age 85+ than for those under the age of 30.  
    • Hospitalizations from flu increase with age
      People age 65+ account for 50% of flu hospitalizations.  
    • Mortality rates from flu and pneumonia rise significantly with age
      Death rate from pneumonia and flu is 130x higher for ages 85+ compared with people ages 45 to 54. This increased risk due to age is higher than that seen…  
    • 1 in 20 age 85+ will have pneumonia
      Every year 1 in 20 Americans age 85+ will have an episode of community-acquired pneumonia.  
    • High odds of shingles after age 85
      Around 1 in 2 who live to be 85 will get shingles.  
    • 5 – 20% of the U.S. population gets the flu each year
      Between 5% and 20% of the U.S. population gets the flu each year.  
    • Annual pneumonia, flu, and shingles cases
      Approximate annual number of new cases of leading infectious diseases in US: Pneumonia – 5 to 10 million Influenza – 35 to 50 million Herpes zoster (shingles) – 1 million