Table 4.
Cost-benefit analyses of vaccination programs in the general population
| First author [Reference] | Stray-Pedersen [[25]] | White [[26]] | Hatzandrieu [[27]] | Schoenbaum [[24]] |
|---|---|---|---|---|
| Country |
Norway |
USA |
USA |
USA |
| Year |
1982 |
1985 |
1994 |
1976 |
| WB income group |
High |
High |
High |
High |
| Comparators |
1. Vaccinate infant girls |
1. Rubella vaccination |
1. Rubella vaccination |
1. Vaccinate all 2-yr-olds |
| |
2. Vaccinate pubertal girls |
2. MMR vaccination |
2. MMR vaccination |
2. Vaccinate all 6-yr-olds |
| |
|
|
|
3. Vaccinate all 12-yr-olds |
| |
|
|
|
4. Vaccinate 2-yr-olds and 12-yr-olds |
| Perspective |
Societal |
Societal |
Societal |
Societal |
| Cost components measured |
Vaccine; immunization; serology; CRS treatment (including special care; indirect costs (lost productivity and premature mortality) |
Vaccine; immunization; physician visits; hospitalization; supportive care; special schooling; institutionalization; indirect costs (lost wages, lost lifetime earnings due to retardation or death) |
Vaccine; immunization; physician visits; hospitalization; supportive care; special schooling; institutionalization; indirect costs (lost wages, lost lifetime earnings due to retardation or death) |
Vaccine; immunization; OP care; hospitalization; CRS treatment and care; indirect costs (lost lifetime earnings) |
| Method of cost estimation |
Micro-costing (for vaccination and treatment; expected lifetime earnings (for indirect costs) |
Micro-costing (for direct costs; expected lifetime earnings (for indirect costs) |
Micro-costing (for direct costs; expected lifetime earnings (for indirect costs) |
Micro-costing (for direct costs; expected lifetime earnings (for indirect costs) |
| Method of benefits estimation |
Averted costs |
Averted costs |
Averted costs |
Averted costs |
| Time period for costs and benefits |
Lifetime |
Lifetime |
Lifetime |
Lifetime |
| Discounting (Rate) |
Yes (7%) |
Yes (10%) |
Yes (10%) |
Yes (6%) |
| Results—Benefit-cost ratio |
1. 5 |
1. 7.7 |
1. 11.1 |
1. 8 |
| |
2. 11 |
2. 14.4 |
2. 21.3 |
2. 9 |
| |
|
|
|
3. 27 |
| |
|
|
|
4. 8 |
| Stated conclusion |
Vaccination of pubertal girls preferable |
Routine MMR vaccine program was cost-effective |
Routine MMR vaccine program was cost-effective |
Vaccination at 12 years better than vaccination at other ages |
| Sponsor | NR | CDC* | CDC* | NR |
*Not explicitly reported but inferred.
WB, World Bank; NR, Not Reported; NA, Not Applicable; CDC, US Centers for Disease Control and Prevention.