title: Economic evaluation of the routine childhood immunization program in the United States, 2009.
abstract: OBJECTIVE
  To evaluate the economic impact of the 2009 routine US childhood immunization schedule, including diphtheria and tetanus toxoids and acellular pertussis, Haemophilus influenzae type b conjugate, inactivated poliovirus, measles/mumps/rubella, hepatitis B, varicella, 7-valent pneumococcal conjugate, hepatitis A, and rotavirus vaccines; influenza vaccine was not included.
  
  
  METHODS
  Decision analysis was conducted using population-based vaccination coverage, published vaccine efficacies, historical data on disease incidence before vaccination, and disease incidence reported during 2005 to 2009. Costs were estimated using the direct cost and societal (direct and indirect costs) perspectives. Program costs included vaccine, administration, vaccine-associated adverse events, and parent travel and work time lost. All costs were inflated to 2009 dollars, and all costs and benefits in the future were discounted at a 3% annual rate. A hypothetical 2009 US birth cohort of 4,261,494 infants over their lifetime was followed up from birth through death. Net present value (net savings) and benefit-cost ratios of routine childhood immunization were calculated.
  
  
  RESULTS
  Analyses showed that routine childhood immunization among members of the 2009 US birth cohort will prevent ∼42,000 early deaths and 20 million cases of disease, with net savings of $13.5 billion in direct costs and $68.8 billion in total societal costs, respectively. The direct and societal benefit-cost ratios for routine childhood vaccination with these 9 vaccines were 3.0 and 10.1.
  
  
  CONCLUSIONS
  From both direct cost and societal perspectives, vaccinating children as recommended with these vaccines results in substantial cost savings.
authors.affiliation: National Center for Immunization and Respiratory Diseases, and.
authors.forename: Fangjun
authors.initials: F
authors.lastname: Zhou
authors.forename: Abigail
authors.initials: A
authors.lastname: Shefer
authors.forename: Jay
authors.initials: J
authors.lastname: Wenger
authors.forename: Mark
authors.initials: M
authors.lastname: Messonnier
authors.forename: Li Yan
authors.initials: LY
authors.lastname: Wang
authors.forename: Adriana
authors.initials: A
authors.lastname: Lopez
authors.forename: Matthew
authors.initials: M
authors.lastname: Moore
authors.forename: Trudy V
authors.initials: TV
authors.lastname: Murphy
authors.forename: Margaret
authors.initials: M
authors.lastname: Cortese
authors.forename: Lance
authors.initials: L
authors.lastname: Rodewald
mesh_terms: D002648:Child; D017281:Cost of Illness; D003663:Decision Trees; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D015233:Models, Statistical; D014481:United States
keywords: 7-valent pneumococcal conjugate vaccine (PCV7); Haemophilus influenzae type b conjugate vaccine (Hib); benefit-cost analysis; diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP); hepatitis A vaccine (HepA); hepatitis B vaccine (HepB); inactivated poliovirus vaccine (IPV); measles/mumps/rubella vaccine (MMR); net savings; rotavirus vaccine (Rota); tetanus and diphtheria toxoids vaccine (Td); varicella vaccine (VAR)