{"id":5972,"date":"2026-10-19T09:48:16","date_gmt":"2026-10-19T09:48:16","guid":{"rendered":"https:\/\/phd.hi.is\/doktorsvorn\/doktorsvorn-i-laeknavisindum-elias-saebjorn-eythorsson\/"},"modified":"2026-10-19T09:48:16","modified_gmt":"2026-10-19T09:48:16","slug":"doktorsvorn-i-laeknavisindum-elias-saebjorn-eythorsson","status":"publish","type":"phd_defence","link":"https:\/\/phd.hi.is\/en\/doktorsvorn\/doktorsvorn-i-laeknavisindum-elias-saebjorn-eythorsson\/","title":{"rendered":"Doktorsv\u00f6rn \u00ed l\u00e6knav\u00edsindum – El\u00edas S\u00e6bj\u00f6rn Ey\u00fe\u00f3rsson"},"content":{"rendered":"
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Mi\u00f0vikudaginn 5. j\u00fan\u00ed ver El\u00edas S\u00e6bj\u00f6rn Ey\u00fe\u00f3rsson doktorsritger\u00f0 s\u00edna \u00ed l\u00e6knav\u00edsindum vi\u00f0 L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands. Ritger\u00f0in ber heiti\u00f0: L\u00fd\u00f0grundu\u00f0 \u00e1hrif 10-gilds samtengds pneum\u00f3kokkab\u00f3luefnis \u00e1 notkun heilbrig\u00f0is\u00fej\u00f3nustu og kostna\u00f0. The population impact and cost-effectiveness of the 10-valent pneumococcal conjugate vaccine in Iceland<\/strong>.<\/p>\n

Andm\u00e6lendur eru dr. Daniel M Weinberger, d\u00f3sent vi\u00f0 Yale University, Bandar\u00edkjunum, og<\/p>\n

Dr. Arto Palmu, ranns\u00f3knastj\u00f3ri vi\u00f0 Nat. Institute for Health and Welfare, Finnlandi.<\/p>\n

Umsj\u00f3narkennari og lei\u00f0beinandi var dr. \u00c1sgeir Haraldsson, pr\u00f3fessor vi\u00f0 l\u00e6knadeild.<\/p>\n

Auk hans s\u00e1tu \u00ed doktorsnefnd dr. Birgir Hrafnkelsson, pr\u00f3fessor vi\u00f0 Raunv\u00edsindadeild, Karl G. Kristinsson, pr\u00f3fessor vi\u00f0 L\u00e6knadeild, Helga Erlendsd\u00f3ttir, a\u00f0junkt vi\u00f0 L\u00e6knadeild, og Tinna Laufey \u00c1sgeirsd\u00f3ttir, pr\u00f3fessor vi\u00f0 Hagfr\u00e6\u00f0ideild.<\/p>\n

Run\u00f3lfur P\u00e1lsson pr\u00f3fessor vi\u00f0 L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands, stj\u00f3rnar ath\u00f6fninni sem fer fram \u00ed Ver\u00f6ld-H\u00fasi Vigd\u00edsar VHV-023, kl. 13:00.<\/p>\n

\u00c1grip af ranns\u00f3kn<\/strong><\/p>\n

Streptococcus pneumoniae eru hluti af e\u00f0lilegri \u00f6rverufl\u00f3ru nefkoks flestra barna, en einnig algengur sj\u00fakd\u00f3msvaldur. Algengustu birtingarmyndir pneum\u00f3kokkas\u00fdkinga eru mi\u00f0eyrnab\u00f3lgur og lungnab\u00f3lgur, en \u00fe\u00e6r valda einnig heilahimnub\u00f3lgu og bl\u00f3\u00f0s\u00fdkingum.\u00a0 \u00cd apr\u00edl 2011 var 10-gilda samtengda pneum\u00f3kokkab\u00f3luefni\u00f0 innleitt \u00ed ungbarnab\u00f3lusetningar \u00e1 \u00cdslandi.<\/p>\n

Markmi\u00f0 ranns\u00f3knarinnar var a\u00f0 meta l\u00fd\u00f0grundu\u00f0 \u00e1hrif innlei\u00f0ingar 10-gilda samtengda pneum\u00f3kokkab\u00f3luefnisins \u00e1 \u00cdslandi. Einstaklingsg\u00f6gnum var safna\u00f0 \u00far fimm l\u00fd\u00f0grundu\u00f0um gagnagrunnum og sj\u00fakraskr\u00e1m Landsp\u00edtala H\u00e1sk\u00f3lasj\u00fakrah\u00fass fr\u00e1 1. jan\u00faar 2005 til 31. desember 2017.<\/p>\n

Fj\u00f3rar ferilsranns\u00f3knir voru framkv\u00e6mdar sem fylgdu eftir f\u00e6\u00f0ingar\u00e1rg\u00f6ngum 2005-2015. S\u00fa fyrsta fylgdi \u00f6llum b\u00f6rnum fr\u00e1 f\u00e6\u00f0ingu til 36 m\u00e1na\u00f0a aldurs me\u00f0 tilliti til koma \u00e1 heilsug\u00e6slu vegna mi\u00f0eyrnab\u00f3lgu og s\u00fdndi fram \u00e1 22% f\u00e6kkun eftir upphaf b\u00f3lusetninga. \u00d6nnur ferilranns\u00f3knin fylgdi b\u00f6rnum me\u00f0 tilliti til allra s\u00fdklalyfja\u00e1v\u00edsana og leiddi \u00ed lj\u00f3s 5,8% f\u00e6kkun. \u00deri\u00f0ja ferilranns\u00f3knin mat t\u00ed\u00f0ni r\u00f6r\u00edsetninga. H\u00fan fylgdi b\u00f6rnum eftir til 60 m\u00e1na\u00f0a aldurs og s\u00fdndi fram \u00e1 \u00f3markt\u00e6ka aukningu \u00e1 r\u00f6r\u00edsetningum, \u00fer\u00e1tt fyrir innlei\u00f0ingu b\u00f3luefnisins. Fj\u00f3r\u00f0a ranns\u00f3knin sko\u00f0a\u00f0i sj\u00fakrah\u00fasinnlagnir vegna \u00f6ndunarf\u00e6ras\u00fdkinga. H\u00fan bar saman b\u00f3lusetta \u00e1rganga vi\u00f0 \u00f3b\u00f3lusetta og s\u00fdndi fram \u00e1 20% f\u00e6kkun \u00e1 innl\u00f6gnum vegna lungnab\u00f3lgu. Loks s\u00fdndi l\u00fd\u00f0grundu\u00f0 ranns\u00f3kn sem t\u00f3k til allra aldursh\u00f3pa fram \u00e1 hjar\u00f0\u00f3n\u00e6mi og kostna\u00f0arvirkni b\u00f3luefnisins. A\u00f0 teknu tilliti til sparna\u00f0ar vegna f\u00e6rri s\u00fdkinga spara\u00f0i b\u00f3luefni\u00f0 7,463,176 Bandar\u00edkjadala \u00e1 fyrstu fimm \u00e1rum eftir innlei\u00f0ingu \u00feess.<\/p>\n

Ranns\u00f3knirnar sem \u00feessi ritger\u00f0 er bygg\u00f0 \u00e1 s\u00fdndu fram \u00e1 gr\u00ed\u00f0arlegan samf\u00e9lagslegan \u00e1bata af innlei\u00f0ingu pneum\u00f3kokkab\u00f3luefnisins \u00e1 \u00cdslandi. Innlei\u00f0ingin olli f\u00e6kkun \u00e1 l\u00e6knisheims\u00f3knum, sj\u00fakrah\u00fasinnl\u00f6gnum og s\u00fdklalyfja\u00e1v\u00edsunum hj\u00e1 b\u00f6rnum og hjar\u00f0\u00f3n\u00e6mi mynda\u00f0ist hj\u00e1 fullor\u00f0num. Innlei\u00f0ing b\u00f3luefnisins leiddi af s\u00e9r sparna\u00f0 frekar en kostna\u00f0.\u00a0<\/strong><\/p>\n

Abstract<\/strong><\/p>\n

Streptococcus pneumoniae is both a commensal bacterium in the upper respiratory tract of humans, and a common pathogen. The infectious manifestations of pneumococci span a range from benign to serious; from acute otitis media (AOM) that often resolves without intervention, to sepsis and meningitis which invariably require hospitalization. In April of 2011, the 10-valent pneumococcal Haemophilus influenzae Protein D conjugate vaccine (PHiD-CV10) was introduced in Iceland.<\/p>\n

The aim of the study was to evaluate the impact of PHiD-CV10 introduction in Iceland. Individual level data were obtained from five population-based registries and Landspitali University Hospital\u2018s patient registry for the period from 1 January 2005 to 31 December 2017.<\/p>\n

Four cohort studies followed 11 Icelandic birth-cohorts 2005-2015. The first such study followed children from birth to 36 months of age with regards to primary care visits for AOM, and revealed a 22% reduction. The second cohort study followed observed outpatient antimicrobial prescriptions and demonstrated a 5.8% reduction. The third cohort study evaluated tympanostomy procedures. It followed children from birth to 60 months of age and revealed a non-significant increase in procedures, despite the introduction of PHiD-CV10. The fourth cohort study examined the hazard of hospitalization for respiratory and invasive infections. It compared vaccine eligible cohorts to vaccine non-eligible cohorts and found a 20% reduction in pneumonia hospitalizations. Finally, a population-based study that included all age-groups, revealed strong evidence of herd effect. After taking into account costs avoided because of prevented disease cases, the introduction of PHiD-CV10 was found to have saved 7,463,176 United States Dollars in the first five years of the program.<\/p>\n

The studies that comprise this thesis showed a large societal impact of PHiD-CV10 introduction; visits, antimicrobial prescriptions and hospitalizations of children decreased, and indirect protection was observed in adults. The vaccination program was cost-saving from both the health sector and societal perspectives.<\/p>\n

Um doktorsefni\u00f0<\/strong><\/p>\n

El\u00edas S\u00e6bj\u00f6rn Ey\u00fe\u00f3rsson lauk st\u00fadentspr\u00f3fi af n\u00e1tt\u00farufr\u00e6\u00f0ibraut Menntask\u00f3lans \u00ed Reykjav\u00edk \u00e1ri\u00f0 2009. Hann hlaut bakkal\u00e1rgr\u00e1\u00f0u \u00ed l\u00e6knisfr\u00e6\u00f0i fr\u00e1 H\u00e1sk\u00f3la \u00cdslands \u00e1ri\u00f0 2012 og lauk emb\u00e6ttispr\u00f3fi \u00ed l\u00e6knisfr\u00e6\u00f0i fr\u00e1 sama sk\u00f3la \u00e1ri\u00f0 2016. \u00a0Hann stundar s\u00e9rn\u00e1m \u00ed almennum lyfl\u00e6kningum vi\u00f0 Landsp\u00edtala H\u00e1sk\u00f3lasj\u00fakrah\u00fas. Foreldrar El\u00edasar eru Ey\u00fe\u00f3r Haraldsson og Andrea Haraldsson. Hann \u00e1 tv\u00f6 b\u00f6rn me\u00f0 k\u00e6rustu sinni, Krist\u00ednu Lilju Sigur\u00f0ard\u00f3ttur, \u00feau Breka Fannar 5 \u00e1ra og st\u00falku 1 m\u00e1na\u00f0ar.<\/p>\n

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