title: Relative cost-effectiveness of a norovirus vaccine in the deployed military setting compared to a vaccine against Campylobacter sp., ETEC, and Shigella sp.
abstract: Norovirus (NoV) has been identified as a significant cause of acute gastrointestinal illness among deployed military troops. We conducted a cost-effectiveness analysis for the use of a NoV vaccine in the military using a previously developed model that evaluated vaccines for ETEC, Campylobacter, and Shigella for prevention of non-outbreak associated travelers' diarrhea. Under conservative assumptions, acquisition of a NoV vaccine by the Department of Defense is estimated to result in a cost-effectiveness ratio per duty day lost to illness (CERDDL) of $1344 compared to a CERDDL of $776, $800, and $1275 for ETEC, Campylobacter sp., and Shigella sp., respectively compared to current management strategies. The absolute value of avoiding a duty day lost is likely to vary under different scenarios, and further study is needed to evaluate how improved diagnostics and prevention of outbreaks may impact the relative value of this vaccine. Overall, this study demonstrates the utility of a previously established evidence-based decision tool for prioritization of vaccine acquisition in an important target population.
authors.affiliation: Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, United States.
authors.forename: Aaron
authors.initials: A
authors.lastname: Tallant
authors.affiliation: Naval Medical Research Center, Silver Spring, MD, United States.
authors.forename: Chad K
authors.initials: CK
authors.lastname: Porter
authors.affiliation: Naval Health Research Center, San Diego, CA, United States.
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Putnam
authors.affiliation: Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
authors.forename: David R
authors.initials: DR
authors.lastname: Tribble
authors.affiliation: Enteric Diseases Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, United States.
authors.forename: Tomoko I
authors.initials: TI
authors.lastname: Hooper
authors.affiliation: Enteric Diseases Department, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, United States. Electronic address: mark.riddle@med.navy.mil.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Riddle
mesh_terms: D001428:Bacterial Vaccines / Q000191:economics* / Q000627:therapeutic use; D017250:Caliciviridae Infections / Q000517:prevention & control; D002167:Campylobacter; D002169:Campylobacter Infections / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D004405:Dysentery, Bacillary / Q000517:prevention & control; D054307:Enterotoxigenic Escherichia coli; D004927:Escherichia coli Infections / Q000517:prevention & control; D006801:Humans; D017589:Immunization Programs / Q000191:economics; D008889:Military Personnel; D018803:Models, Economic; D029322:Norovirus; D012760:Shigella; D014765:Viral Vaccines / Q000191:economics* / Q000627:therapeutic use
chemical_list: D001428:Bacterial Vaccines; D014765:Viral Vaccines
keywords: Economic analysis; Military; Norovirus