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Cost-effectiveness of Japanese encephalitis (JE) immunization in Bali, Indonesia

Wei Liu1, John D Clemens, Komang Kari

  • 1International Vaccine Institute, San 4-8, Bongcheon-7 dong, Kwanak-ku, Seoul 151-818, Republic of Korea.

Vaccine
|July 8, 2008
PubMed

Insights

A live, attenuated Japanese encephalitis (JE) vaccine program in Bali could prevent 54 cases and 5 deaths over 11 years. This immunization strategy is highly cost-effective, saving disability-adjusted life years (DALYs) at a low cost per case and DALY averted.

Area of Science:

  • Epidemiology
  • Public Health
  • Vaccinology

Background:

  • Japanese encephalitis (JE) poses a significant public health risk, particularly in endemic regions like Bali.
  • Understanding the economic impact and effectiveness of vaccination programs is crucial for disease control.

Purpose of the Study:

  • To model the cost-effectiveness of a live, attenuated JE vaccine immunization program in Bali.
  • To estimate the potential impact of JE vaccination on disease incidence, mortality, and disability-adjusted life years (DALYs).

Main Methods:

  • A hypothetical birth cohort of 100,000 newborns in Bali was modeled over 11 years.
  • JE risk was estimated using cumulative incidence data from before vaccine introduction.
  • Data on vaccine efficacy, vaccination, and treatment costs were sourced from published literature and surveys.

Main Results:

  • The modeled immunization program averted an estimated 54 JE cases and 5 deaths.
  • The program saved 1,224 disability-adjusted life years (DALYs).
  • The net cost was USD 700 per JE case averted and USD 31 per DALY saved.

Conclusions:

  • The live, attenuated JE vaccine program is a highly cost-effective intervention for preventing Japanese encephalitis in Bali.
  • Vaccination significantly reduces disease burden, mortality, and disability, offering substantial public health benefits.

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