Table 2.
Cost-Effectiveness of Typhoid Vaccination Strategies
| Strategy | Year 1 Vaccination Costs (USD Millions) | 10-Year Cumulative Vaccination Costs (USD Millions) | Discounted Cumulative Costs (Societal, USD Millions) | Discounted Cumulative DALYs Averted (Relative to Status Quo, Millions) | Incremental Cumulative Costs (Societal, USD Millions) | Incremental Cumulative DALYs Averted (Millions) | ICERs (Societal) |
| Campaign urban only and routine all | 271 | 700 | 1315 | 1.488 | … | … | Lowest-cost |
| Campaign and routine urban only | 236 | 383 | 1317 | 1.330 | Dominated | ||
| School urban only and routine all | 312 | 776 | 1367 | 1.474 | Dominated | ||
| School and routine urban only | 277 | 460 | 1369 | 1.317 | Dominated | ||
| Campaign and routine all | 794 | 1222 | 1530 | 1.719 | 214.5 | 0.231 | $929/DALY averted |
| School-based and routine all | 928 | 1482 | 1658 | 1.701 | Dominated | ||
| Routine all | 56 | 485 | 1761 | 1.061 | Dominated | ||
| Routine urban only | 21 | 168 | 1771 | 0.899 | Dominated | ||
| Status quo | 7 | 39 | 3125 | … | Dominated |
ICERs are shown as incremental cumulative discounted costs per incremental cumulative discounted DALYs averted, compared to the next-highest-cost nondominated strategy. Status quo vaccine costs are nonzero because of the low levels of vaccination under the status quo observed in surveillance data.
Abbreviations: DALY, disability-adjusted life-year; ICER, incremental cost-effectiveness ratio; USD, United States dollars.