title: An economic analysis of the universal varicella vaccination program in the United States.
abstract: Frequent varicella outbreaks with sizable impact on the US public health system have continued to occur despite the success of the country's 1-dose varicella vaccination program. The Advisory Committee on Immunization Practices recently recommended adding a routine second dose of varicella vaccine and weighed economic projections as well as public health goals in their deliberations. This decision-tree-based analysis was conducted to evaluate the economic impact of the projected 2-dose varicella vaccination program as well as the existing 1-dose program. The analysis used population-based vaccination coverage and disease incidence data to make projections for a hypothetical US birth cohort of 4,100,000 infants born in 2006. Compared with no vaccination, both the 1-dose program (societal benefit-cost ratio [BCR], 4.37) and 2-dose program (BCR, 2.73) were estimated to be cost saving from the societal perspective. Compared with the 1-dose program, the incremental second dose was not cost saving (societal incremental BCR, 0.56). The incremental cost-effectiveness ratio for the second dose was $343 per case prevented, or approximately $109,000 per quality-adjusted life-year saved, and these results were sensitive to assumptions about vaccine effectiveness and prices.
authors.affiliation: National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia, USA. faz1@cdc.gov
authors.forename: Fangjun
authors.initials: F
authors.lastname: Zhou
authors.forename: Ismael R
authors.initials: IR
authors.lastname: Ortega-Sanchez
authors.forename: Dalya
authors.initials: D
authors.lastname: Guris
authors.forename: Abigail
authors.initials: A
authors.lastname: Shefer
authors.forename: Tracy
authors.initials: T
authors.lastname: Lieu
authors.forename: Jane F
authors.initials: JF
authors.lastname: Seward
mesh_terms: D000293:Adolescent; D000328:Adult; D002644:Chickenpox / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000008:administration & dosage* / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004196:Disease Outbreaks / Q000191:economics / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007223:Infant; D032541:Mass Vaccination / Q000191:economics*; D015397:Program Evaluation; D014481:United States / Q000453:epidemiology
chemical_list: D019433:Chickenpox Vaccine