title: An economic evaluation of increased uptake in Q fever vaccination among meat and agricultural industry workers following implementation of the National Q Fever Management Program.
abstract: BACKGROUND
  Q fever is a serious but vaccine-preventable infectious disease that predominantly affects those working in the meat and agricultural industries. In October 2000, the Commonwealth Government introduced the National Q Fever Management Program. This economic evaluation assesses the cost-effectiveness and cost-utility of improved vaccine uptake among meat and agricultural industry workers.
  
  
  METHODS
  Separate analyses were conducted for meat and agricultural industry workers. Clinical and epidemiological data used to create the models were obtained from published sources. Markov modelling was used to estimate the impact of Q fever vaccination uptake on the direct costs and outcomes of Q fever over a 20-year period.
  
  
  RESULTS
  Increasing vaccine uptake from 65% to 100% among meat industry workers results in an incremental cost per life year gained of $20,002, and a cost per QALY of $6,294. Increasing vaccine uptake from zero to 20% among agricultural industry workers results in an incremental cost per life year gained of $24,950, and a cost per QALY of $7,984. Including some indirect costs in the form of Workcover payments results in cost savings for both industry groups.
  
  
  CONCLUSIONS
  The results of this evaluation indicate that public health strategies to enhance the uptake of Q fever vaccine among high-risk workers potentially provides excellent value for the money invested.
authors.affiliation: School of Health Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125. mker@deakin.edu.au
authors.forename: Michelle
authors.initials: M
authors.lastname: Kermode
authors.forename: Karen
authors.initials: K
authors.lastname: Yong
authors.forename: Susan
authors.initials: S
authors.lastname: Hurley
authors.forename: Barrie
authors.initials: B
authors.lastname: Marmion
mesh_terms: D000328:Adult; D000383:Agriculture; D001315:Australia / Q000453:epidemiology; D001428:Bacterial Vaccines / Q000008:administration & dosage / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D016997:Coxiella burnetii / Q000276:immunology*; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008390:Markov Chains; D008462:Meat-Packing Industry; D008875:Middle Aged; D009784:Occupational Diseases / Q000191:economics* / Q000517:prevention & control; D011778:Q Fever / Q000453:epidemiology / Q000517:prevention & control*; D019057:Quality-Adjusted Life Years
chemical_list: D001428:Bacterial Vaccines