Ismael R. Ortega-Sanchez1, Martin I. Meltzer
2, Colin W. Shepard
2, Elizabeth R. Zell
2, Mark L. Messonnier
1, Oleg Bilukha
2, Xinzhi Zhang
2, David S. Stephens
3, and Nancy Rosenstein
2. (1) National Immunization Program/ ESD/ OD, Centers for Disease Control and Prevention, 1600 Clifton Road NE, M/S E-61, Atlanta, GA, USA, (2) National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, USA, (3) National Center for Infectious Diseases, Centers for Disease Control and Prevention & Emory University, 1600 Clifton Road NE, M/S C-09, Atlanta, GA, USA
BACKGROUND:
The US Food and Drug Administration is considering approval of a quadrivalent meningococcal conjugate vaccine (MCV-4). A one-time catch-up vaccination campaign in 11-17 year-olds, followed by routine annual immunization of each 11 year old cohort could take full advantage of vaccine benefits, but cost and feasibility issues are unresolved.
OBJECTIVE:
To analyze the effectiveness and cost-effectiveness of a catch-up campaign with MCV-4 in 11-17 year-olds.
METHOD:
We built a probabilistic model of disease burden and economic impacts for a 10 year period with and without an adolescent catch-up program. US age- and serogroup-specific surveillance data on incidence and case fatality rates were used, as were hypothetical age-specific reductions in attack rates in the unvaccinated. After projecting medical, indirect and program costs, we estimated costs per case averted, death prevented and life-year saved (LYS). Sensitivity analyses were conducted.
RESULT:
With herd immunity effects equivalent to recent experience in the United Kingdom, catch-up vaccination of healthy adolescents added to a routine program would prevent 5,263 cases in a 10-year period -- a 32% reduction. Excluding program costs, the catch-up would save $338 million in medical and public response costs and $591 million in time off work, long term disability and premature death. At a cost of $83 per vaccinee, catch-up would cost society $532,000 per case averted, $5.9 million per death prevented, and $138,000 per LYS. A 20% reduction in herd immunity effects would increase the cost per LYS by $21,000; a $30 decrease in the average cost of vaccination would decrease the cost per LYS by $55,000. Targeting highly endemic counties decreased the cost per LYS by two-thirds.
CONCLUSION:
Catch-up vaccination of adolescents can have a substantial impact on disease burden and costs. Compared with routine vaccination of each 11 year old cohort, catch-up vaccination could cost twice as much per LYS.
LEARNING OBJECTIVES:
Meningococcal conjugate vaccine, Adolescent, Cost-effectiveness, Catch-up, Herd immunity
See more of Break — Exhibit/Poster Viewing (Access Poster Abstracts Here)
See more of The 39th National Immunization Conference (NIC)
