Cost-benefit analyses of supplementary measles immunisation in the highly immunized population of New Zealand
| Autor: | T. Kiedrzynski, Tim E. Carpenter, Jonathan C. Marshall, Mick G. Roberts, Nigel P. French, David T. S. Hayman |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Cost-Benefit Analysis Secondary infection 030106 microbiology Population Measles Herd immunity 03 medical and health sciences 0302 clinical medicine Environmental health Humans Medicine 030212 general & internal medicine education education.field_of_study General Veterinary General Immunology and Microbiology Immunization Programs business.industry Vaccination Public Health Environmental and Occupational Health Outbreak medicine.disease Infectious Diseases Immunology Molecular Medicine Immunization Cost benefit business Basic reproduction number New Zealand |
| Zdroj: | Vaccine. 35:4913-4922 |
| ISSN: | 0264-410X |
| Popis: | As endemic measles is eliminated from countries through increased immunisation, the economic benefits of enhanced immunisation programs may come into question. New Zealand has suffered from outbreaks after measles introductions from abroad and we use it as a model system to understand the benefits of catch up immunisation in highly immunised populations. We provide cost-benefit analyses for measles supplementary immunisation in New Zealand. We model outbreaks based on estimates of the basic reproduction number in the vaccinated population (Rv, the number of secondary infections in a partially immunised population), based on the number of immunologically-naive people at district and national levels, considering both pre- and post-catch up vaccination scenarios. Our analyses suggest that measles Rv often includes or exceeds one (0.18-3.92) despite high levels of population immunity. We calculate the cost of the first 187 confirmed and probable measles cases in 2014 to be over NZ$1 million (∼US$864,200) due to earnings lost, case management and hospitalization costs. The benefit-cost ratio analyses suggest additional vaccination beyond routine childhood immunisation is economically efficient. Supplemental vaccination-related costs are required to exceed approximately US$66 to US$1877 per person, depending on different scenarios, before supplemental vaccination is economically inefficient. Thus, our analysis suggests additional immunisation beyond childhood programs to target naive individuals is economically beneficial even when childhood immunisation rates are high. |
| Databáze: | OpenAIRE |
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