KEYWORDS:
immunization, vaccines, costs

BACKGROUND:
A new combination vaccine, DTaP-HepB-IPV, is expected to become available in the US in late 2002/early 2003.

OBJECTIVE:
To estimate DTaP-HepB-IPV effects on coverage rates, number of vaccine injections and vaccination visits, and societal costs.

METHOD:
A natural history model was developed comparing children receiving currently available vaccines (controls) with children receiving currently available vaccines and DTaP-HepB-IPV. Records from age 0-12 months were obtained for children born during July 2000-June 2001. DTaP-HepB-IPV vaccine use was predicted by applying decision rules to each control to selectively substitute DTaP-HepB-IPV for component vaccines in compliance with ACIP minimum age and interval criteria. We incorporated predictions of DTaP-HepB-IPV effects on use of HepB birth dose and other HepB-containing combination vaccines among children of HBsAG(-) mothers.

RESULT:
24 centers reviewed 595 records of pediatrician and family practitioner/general practitioner (FP/GP) patients. 7 were excluded for receiving no vaccines and 68 for receiving ³ invalid dose. 256 pediatrician and 264 FP/GP patients were analyzed. The coverage rate at age 5 months among DTaP-HepB-IPV patients of pediatricians was increased for ³ HepB dose (p<.05), and among DTaP-HepB-IPV patients of pediatricans and FP/GPs for ³ HepB and ³ IPV doses at ages 7 and 12 months (p<.01). Injections per child were decreased among DTaP-HepB-IPV patients of pediatricians and FP/GPs by 2.7 and 2.6 (p<.0001), respectively, as were vaccination visits, by 0.3 and 0.7 (p<.0001). Vaccination costs were reduced by $25 per pediatrician and $30 per FP/GP patient.

CONCLUSION:
DTaP-HepB-IPV vaccine is expected to improve coverage rates in the first year of life, and reduce vaccine injections, vaccination visits, and cost.

LEARNING OBJECTIVES:
To understand DTaP-HepB-IPV's epidemiological and economic effects.