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Benefits, risks and costs of immunization for measles, mumps and rubella
Insights
The childhood immunization program using the measles-mumps-rubella (MMR) vaccine significantly reduced disease cases and costs in 1983. This program demonstrated a substantial benefit-cost ratio, highlighting the value of widespread vaccination.
Area of Science:
- Public Health
- Epidemiology
- Vaccinology
Background:
- Measles, mumps, and rubella (MMR) pose significant public health risks, including morbidity, mortality, and substantial economic costs.
- Childhood immunization programs are crucial for controlling vaccine-preventable diseases.
- The introduction and widespread use of the combined MMR vaccine have transformed the landscape of pediatric infectious diseases.
Purpose of the Study:
- To compare the actual and estimated morbidity, mortality, and costs associated with measles, mumps, and rubella in 1983.
- To evaluate the impact of a childhood immunization program utilizing the combined MMR vaccine versus no program.
- To determine the benefit-cost ratio of the MMR immunization program.
Main Methods:
- Retrospective analysis comparing actual disease incidence in 1983 with a childhood immunization program against estimated incidence without such a program.
- Calculation of disease-related morbidity, mortality, and economic costs under both scenarios.
- Assessment of immunization program expenditures, including vaccine administration and reaction costs.
Main Results:
- An immunization program drastically reduced measles cases from an estimated 3,325,000 to 2,872, rubella from 1.5 million to 3,816, and mumps from 2.1 million to 32,850.
- Significant reductions in disease complications, sequelae, and deaths were observed with the immunization program.
- Without the program, disease costs were estimated at nearly $1.4 billion; with the program, costs were approximately $14.5 million, with immunization expenditures totaling $96 million.
Conclusions:
- The MMR immunization program in 1983 yielded substantial public health benefits by dramatically reducing disease incidence and associated complications.
- The program demonstrated a highly favorable economic impact, with estimated savings of nearly $1.4 billion against program costs of $96 million.
- The benefit-cost ratio for the MMR immunization program was approximately 14:1, underscoring its significant value and efficiency. Use of the combination vaccine resulted in savings of nearly $60 million.
Abstract:
For a single year, 1983, we compared the actual and estimated morbidity, mortality, and costs attributable to measles, mumps, and rubella with having or not having a childhood immunization program using the combined measles-mumps-rubella (MMR) vaccine. Without an immunization program, an estimated 3,325,000 cases of measles would occur as compared to 2,872 actual cases in 1983 with a program. Instead of an expected 1.5 million rubella cases annually, there were only 3,816 actual cases. Mumps cases were lowered from an expected 2.1 million to 32,850 actual cases. Comparable reductions in disease-associated complications, sequelae, and deaths are gained with an immunization program. Without a vaccination program, disease costs would have been almost $1.4 billion. Based on the actual incidence of disease in 1983, costs were estimated to be approximately +14.5 million. Expenditures for immunization, including vaccine administration costs and the costs associated with vaccine reactions, totaled $96 million. The resulting benefit-cost ratio for the MMR immunization program is approximately 14:1. The savings realized due to the use of combination rather than single antigen vaccine total nearly $60 million.