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Cost-benefit analysis of routine mumps and rubella vaccination for Israeli infants
S A Berger1, G M Ginsberg, P E Slater
1Department of Microbiology, Ichilov Hospital, Tel Aviv Medical Center, Israel.
Insights
Implementing routine mumps-rubella vaccination for 1-year-olds in Israel could significantly reduce disease cases and costs. The projected benefits strongly support the nationwide vaccination program initiated in 1989.
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- Mumps vaccine was not routinely administered in Israel until January 1989.
- Rubella immunization was previously restricted to adolescent girls.
- This study evaluates the impact of combined mumps-rubella vaccination.
Purpose of the Study:
- To assess the projected impact of a combined mumps-rubella vaccination program.
- To analyze the benefit-to-cost ratio of routine mumps-rubella vaccination.
- To evaluate the economic implications, including laboratory testing costs.
Main Methods:
- A cohort of 1-year-old children was followed for 13 years.
- Assumptions included 90% compliance and 95% vaccine efficacy.
- Projected reductions in clinical cases and cost-benefit analyses were performed.
Main Results:
- Projected reductions: 4,144 mumps cases, 3,109 rubella cases, 13 encephalitis cases, and 1 thrombocytopenia case.
- Anticipated benefit-to-cost ratio: 1.17–1.77, potentially higher than 5.85 due to under-reporting.
- Annual savings of approximately $2,750 in laboratory testing costs.
Conclusions:
- The combined mumps-rubella vaccination program is projected to be highly beneficial.
- Economic analysis, including reduced lab costs and adjusted for under-reporting, supports the program.
- Results justify the nationwide routine vaccination initiative started in January 1989.
Abstract:
Until January 1989, mumps vaccine was not routinely administered in Israel, and rubella immunization was restricted to adolescent girls. The theoretical effect of combined mumps-rubella vaccination was applied to a population consisting of a cohort of 1-year-old children followed for 13 years. Assuming 90% compliance and 95% vaccine efficacy, projected clinical cases of mumps, rubella, encephalitis and thrombocytopenia would be reduced by 4,144; 3,109; 13; and 1 respectively. We anticipate a benefit to cost ratio of between 1.17 and 1.77 for the program. Since only 10-20% of cases are reported, the true benefit to cost ratio is likely to be at least 5.85. The benefit to cost ratio based on health service benefits alone is between 0.34 and 0.52; however, after adjusting for under-reporting, benefits are expected to exceed costs. Expenditures for laboratory testing, a factor not previously considered in such an analysis, would be reduced by approximately $2,750 per year. These results justify the initiation in January 1989 of nationwide routine vaccination.