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Angela R. Wateska
University of Pittsburgh
Supply chainImmunologyVaccinationPopulationMedicine
36Publications
16H-index
735Citations
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Publications 38
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#1Angela R. Wateska (University of Pittsburgh)H-Index: 16
#2Mary Patricia Nowalk (University of Pittsburgh)H-Index: 36
Last. Kenneth J. Smith (University of Pittsburgh)H-Index: 30
view all 7 authors...
Introduction Recommending both the conjugate and polysaccharide pneumococcal vaccines to all U.S. seniors may have little public health impact and be economically unreasonable. Public health impact and cost-effectiveness of using both vaccines in all adults aged ≥65 years were estimated compared with an alternative strategy (omitting pneumococcal conjugate vaccine in the nonimmunocompromised) and with the newly revised recommendation (giving or omitting conjugate vaccine based on patient–physici...
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#1Angela R. Wateska (University of Pittsburgh)H-Index: 16
#2Mary Patricia Nowalk (University of Pittsburgh)H-Index: 36
Last. Kenneth J. Smith (University of Pittsburgh)H-Index: 30
view all 7 authors...
BACKGROUND/OBJECTIVES: Recently revised vaccination recommendations for US adults, aged 65 years and older, include both 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), with PCV13 now recommended for immunocompetent older people based on shared decision making. The public health impact and cost-effectiveness of this recommendation or of pneumococcal vaccine uptake improvement interventions are unclear. DESIGN: Markov decision analysis....
Source
#1Angela R. Wateska (University of Pittsburgh)H-Index: 16
#2Mary Patricia Nowalk (University of Pittsburgh)H-Index: 36
Last. Kenneth J. Smith (University of Pittsburgh)H-Index: 30
view all 7 authors...
In US adults aged < 65 years, pneumococcal vaccination is recommended when high-risk conditions are present, but vaccine uptake is low. Additionally, there are race-based differences in illness risk and vaccination rates. The cost-effectiveness of programs to improve vaccine uptake or of alternative vaccination policies to increase protection is unclear. A decision analysis compared, in US black and general population cohorts aged 50 years, the public health impact and cost-effectiveness of pneu...
1 CitationsSource
#1Mary Patricia Nowalk (University of Pittsburgh)H-Index: 36
#2Angela R. Wateska (University of Pittsburgh)H-Index: 16
Last. Kenneth J. Smith (University of Pittsburgh)H-Index: 30
view all 7 authors...
Abstract Background Racial disparities in U.S. adult pneumococcal vaccination rates persist despite reduced barriers to access. Consequently, racial and ethnic minorities experience pneumococcal disease at higher rates than whites. This study examined prevalence of high-risk conditions and pneumococcal hospitalizations among U.S. black and non-black populations aged ≥50 years. Methods National Health Interview Survey, National Center for Health Statistics and National Inpatient Sample data were ...
2 CitationsSource
#1Angela R. Wateska (University of Pittsburgh)H-Index: 16
#2Mary Patricia Nowalk (University of Pittsburgh)H-Index: 36
Last. Kenneth J. Smith (University of Pittsburgh)H-Index: 30
view all 7 authors...
ABSTRACTIn the U.S., pneumococcal polysaccharide vaccine (PPSV23) uptake among high-risk adults aged <65 years is consistently low and improvement is needed. One barrier to improved vaccine coverage is the complexity of the adult vaccination schedule. This exploratory analysis compared the cost-effectiveness of strategies to increase pneumococcal vaccine uptake in high-risk adults aged 50–64 years. We used a Markov model to compare strategies for non-immunocompromised 50–64 year olds: 1) current...
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#1Kenneth J. Smith (University of Pittsburgh)H-Index: 30
#3Mary Patricia Nowalk (University of Pittsburgh)H-Index: 36
Last. Richard K. Zimmerman (University of Pittsburgh)H-Index: 37
view all 7 authors...
Introduction Tradeoffs exist between efforts to increase influenza vaccine uptake, including early season vaccination, and potential decreased vaccine effectiveness if protection wanes during influenza season. U.S. older adults increasingly receive vaccination before October. Influenza illness peaks vary from December to April. Methods A Markov model compared influenza likelihood in older adults with (1) status quo vaccination (August–May) to maximize vaccine uptake or (2) vaccination compressed...
Source
#1Angela R. Wateska (University of Pittsburgh)H-Index: 16
#2Mary Patricia Nowalk (University of Pittsburgh)H-Index: 36
Last. Kenneth J. Smith (University of Pittsburgh)H-Index: 30
view all 7 authors...
Abstract Background Changing pneumococcal disease epidemiology due to childhood vaccination has prompted re-examination of US adult pneumococcal vaccination policies, as have considerations of greater pneumococcal disease incidence and higher prevalence of conditions that increase risk in underserved minority populations. Prior analyses suggest routine pneumococcal vaccination at age 50 could be considered, which could disproportionately benefit underserved populations. Methods A Markov cohort m...
1 CitationsSource
#2Angela R. Wateska (University of Pittsburgh)H-Index: 16
#3Mary Patricia Nowalk (University of Pittsburgh)H-Index: 36
Last. Kenneth J. Smith (University of Pittsburgh)H-Index: 30
view all 7 authors...
Background and Objectives: Universal" vaccines that could have multistrain and multiyear effectiveness are being developed. Their potential cost-effectiveness in geriatric populations is unknown. Research Design and Methods: A Markov model estimated effects of a theoretical universal influenza vaccine compared with available seasonal vaccines in hypothetical cohorts of U.S. 65+-year olds followed over a 5-year time horizon to capture potential multiyear protection. Outcomes included costs per qu...
Source
#1Angela R. Wateska (University of Pittsburgh)H-Index: 16
#2Mary Patricia Nowalk (University of Pittsburgh)H-Index: 36
Last. Chyongchiou J. Lin (University of Pittsburgh)H-Index: 14
view all 5 authors...
Adults aged 18–64 years with comorbid conditions are at high risk for complications of certain vaccine-preventable diseases, including influenza and pneumococcal disease. The 4 Pillars™ Practice Transformation Program (4 Pillars Program) increases uptake of pneumococcal polysaccharide vaccine, influenza vaccine and tetanus-diphtheria-acellular pertussis vaccine by 5–10% among adults with high-risk medical conditions, but its cost-effectiveness is unknown. A decision tree model estimated the cost...
3 CitationsSource
#1Jonathan M. Raviotta (University of Pittsburgh)H-Index: 8
#2Kenneth J. Smith (University of Pittsburgh)H-Index: 30
Last. Richard K. Zimmerman (University of Pittsburgh)H-Index: 37
view all 8 authors...
Abstract Purpose High-dose trivalent inactivated influenza vaccine (HD-IIV3) or recombinant trivalent influenza vaccine (RIV) may increase influenza vaccine effectiveness (VE) in adults with conditions that place them at high risk for influenza complications. This analysis models the public health impact and cost-effectiveness (CE) of these vaccines for 50–64 year-olds. Methods Markov model CE analysis compared 5 strategies in 50–64 year-olds: no vaccination; only standard-dose IIV3 offered (SD-...
3 CitationsSource
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