title: A cost-utility analysis of antenatal screening to prevent congenital rubella syndrome.
abstract: In low vaccination coverage regions (LVR) in The Netherlands people often reject participation in the National Immunization Programme for religious reasons. During a rubella epidemic in 2004-2005, 32 pregnant women were notified with rubella, and 11 babies were born with defects related to maternal infection. This study presents a cost-utility analysis of a screening and vaccination programme for rubella focusing on three scenarios: (1) screening non-vaccinated pregnant women in LVR; (2) screening all pregnant women in LVR; (3) screening all non-vaccinated pregnant women in The Netherlands (including pregnant first-generation non-Western immigrant women). Cost-utility was estimated over a 16-year period which included two rubella outbreaks. Observed complications from the 2004-2005 epidemic were used to estimate average cost savings and quality-adjusted life-years (QALY) gained. The programme would be cost-effective (euro1100/QALY gained) when assuming an acceptability of vaccination of 20% in women belonging to orthodox protestant risk groups.
authors.affiliation: RIVM-Centre for Infectious Disease Control, Epidemiology and Surveillance Unit, Bilthoven, The Netherlands. anna.lugner@rivm.nl
authors.forename: A K
authors.initials: AK
authors.lastname: Lugnér
authors.forename: L
authors.initials: L
authors.lastname: Mollema
authors.forename: W L M
authors.initials: WL
authors.lastname: Ruijs
authors.forename: S J M
authors.initials: SJ
authors.lastname: Hahné
mesh_terms: D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D004196:Disease Outbreaks / Q000191:economics / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D005843:Geography; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008403:Mass Screening / Q000191:economics / Q000706:statistics & numerical data; D032541:Mass Vaccination / Q000191:economics* / Q000706:statistics & numerical data; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000191:economics*; D019057:Quality-Adjusted Life Years; D012410:Rubella Syndrome, Congenital / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D012411:Rubella Vaccine
chemical_list: D012411:Rubella Vaccine