KEYWORDS:
immunization, combination vaccines, labor costs

BACKGROUND:
Combination vaccine use may reduce provider vaccination costs. A new combination vaccine, DTaP-HepB-IPV, is expected to become available in the US in late 2002/early 2003.

OBJECTIVE:
To estimate the effects of DTaP-HepB-IPV vaccine on costs incurred by pediatricians and family practitioners/general practitioners (FP/GPs) in vaccinating children during the first year of life.

METHOD:
We examined vaccination records of 520 children from 24 centers and developed a model to predict use of DTaP-HepB-IPV vaccine. Results from the model were used to estimate the number of 1-,2-,3-,4-,5-, and 6-injection visits per child. A time-motion study was performed in 5 pediatric centers to measure labor and supplies used at vaccination visits with different numbers of injections.

RESULT:
300 vaccination visits were observed in the time-motion study. Number of injections predicted labor time for preparation, administration, and record updating, but not vaccine information dissemination and consent. Each additional injection was estimated to add 57 seconds labor time per visit. In the model, DTaP-HepB-IPV vaccine use was estimated to require 0.34 and 0.14 fewer vaccination visits per patient of pediatricians and FP/GPs, respectively, and obtain a reduction of 0.4 and 0.7 (p<.0001) average injections per vaccination visit, respectively. Using DTaP-HepB-IPV vaccine is estimated to result in a total cost reduction in the first year of life of $0.76 and $2.04 per patient, for pediatricians and FP/GPs, respectively.

CONCLUSION:
DTaP-HepB-IPV vaccine use is expected to reduce provider's vaccination costs.

LEARNING OBJECTIVES:
To understand the effects of DTaP-HepB-IPV vaccine use on clinic vaccination costs.