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Cost analysis of post-polio certification immunization policies.

Nalinee Sangrujee1, Victor M Cáceres, Stephen L Cochi

  • 1Centers for Disease Control and Prevention, National Immunization Program, 1600 Clifton Rd., MS-E05, Atlanta, GA 30333, USA. Nsangrujee@cdc.gov

Bulletin of the World Health Organization
|April 27, 2004
PubMed
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The least expensive post-polio immunization policy involves stopping oral poliovirus vaccine (OPV) and using inactivated poliovirus vaccine (IPV) optionally. Switching to universal IPV becomes cost-effective if IPV prices decrease, but risks of polio resurgence remain.

Area of Science:

  • Public Health
  • Vaccinology
  • Health Economics

Background:

  • Global polio eradication efforts are nearing completion, necessitating strategic planning for post-certification immunization policies.
  • Current policies involve oral poliovirus vaccine (OPV), which carries a risk of vaccine-associated paralytic poliomyelitis (VAPP).

Purpose of the Study:

  • To estimate the financial costs of different post-polio certification immunization strategies.
  • To inform policymakers by providing cost analyses for various vaccine policies.

Main Methods:

  • Analysis of three global policy options: continued OPV, OPV cessation with optional inactivated poliovirus vaccine (IPV), and OPV cessation with universal IPV.
  • Estimation of financial costs, VAPP cases, and outbreak response capacity costs from 2005-20.

Related Experiment Videos

  • Assumptions on immunization policy decisions by low-, middle-, and high-income countries.

    • Main Results:

    • OPV cessation with optional IPV was the least costly option at an estimated US$ 20,412 million.
    • Continued OPV use resulted in the highest number of VAPP cases.
    • OPV cessation with universal IPV had the highest financial costs but the fewest VAPP cases. A reduced IPV price of US$ 0.50/dose for low-income countries made this option cost-neutral compared to continued OPV.

    Conclusions:

    • Vaccine price and coverage rates significantly influence the global costs of post-polio immunization.
    • The break-even price for switching to IPV is US$ 0.50 per dose, excluding costs associated with OPV-derived poliovirus cases.
    • Risk assessments for polio re-emergence are critical for future policy decisions beyond financial considerations.