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Aim: cost-effectiveness assessment and budget impact analysis for 13-valent pneumococcal conjugate vaccine (PCV13) in infant immunization program in Russian Federation. Materials and methods: 10 year modeling with social perspective (direct medical and indirect costs and life expectancy with discounting by 3,5% per year) and population effect based on results of clinical studies, global PCV13 use and Russian epidemiological data has been established. Budget impact has been analyzed without discounting. Direct effect was assessed by influence on pneumococcal meningitis, bacteremia, pneumonia and acute otitis media (AOM) incidence, population effect — by pneumococcal meningitis and hospitalized all-cause pneumonia incidence. Results: Possible PCV13 effectiveness was estimated as 76,6% for invasive pneumococcal diseases (IPD) and 23,7% for hospitalized cases of AOM. Vaccination (per 100 000 vaccinated infants) can prevent 13,8 lethal cases in vaccinated population and 171,1 — in unvaccinated population. Cost-effectiveness ratio for PCV13 is estimated as 32,400 rubles / LYG and 32,400 rubles / QALY. Cost of 1 lethal case prevention is 140 100 rubles, additional cost for 10 years is 111,5 rubles per child. Conclusions: PCV13 mass vaccination of infants in Russian Federation is highly cost-effective and will significantly cut expenses due to pneumococcal diseases treatment.

As it was reported by World Health Organization, the annual number of deaths caused by pneumococci reaches 1,6 million people including 700 thousand of children of 0–5 years old. Pneumococcal meningitis is one of the most severe manifestations of pneumococcal infection. S. pneumoniae keeps one of the leading positions in aetiological structure of bacterial meningitis. Data on serotypes distribution of pneumococci in children of the early age in the Russian Federation are limited. In this study serotypes of pneumococci from pediatric patients with pneumococcal meningitis (children aged 0–7 years, n =35) isolated in 1981–2010 in Moscow were identified. Screening for sensitivity of strains to penicillin was performed, as well as molecular typing by MLST approach. The most frequent serotypes causing pneumococcal meningitis in children aged 0–7 years were 19F, 7F, 14 and 1. Most of MDR-strains were collected in 2007–2009. Among MDR-strains and those demonstrating increased resistance to antibiotics, several new allelic patterns were described.