title: Cost-effectiveness of Chlamydia vaccination programs for young women.
abstract: We explored potential cost-effectiveness of a chlamydia vaccine for young women in the United States by using a compartmental heterosexual transmission model. We tracked health outcomes (acute infections and sequelae measured in quality-adjusted life-years [QALYs]) and determined incremental cost-effectiveness ratios (ICERs) over a 50-year analytic horizon. We assessed vaccination of 14-year-old girls and catch-up vaccination for 15-24-year-old women in the context of an existing chlamydia screening program and assumed 2 prevaccination prevalences of 3.2% by main analysis and 3.7% by additional analysis. Estimated ICERs of vaccinating 14-year-old girls were $35,300/QALY by main analysis and $16,200/QALY by additional analysis compared with only screening. Catch-up vaccination for 15-24-year-old women resulted in estimated ICERs of $53,200/QALY by main analysis and $26,300/QALY by additional analysis. The ICER was most sensitive to prevaccination prevalence for women, followed by cost of vaccination, duration of vaccine-conferred immunity, and vaccine efficacy. Our results suggest that a successful chlamydia vaccine could be cost-effective.
authors.forename: Kwame
authors.initials: K
authors.lastname: Owusu-Edusei
authors.forename: Harrell W
authors.initials: HW
authors.lastname: Chesson
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Gift
authors.forename: Robert C
authors.initials: RC
authors.lastname: Brunham
authors.forename: Gail
authors.initials: G
authors.lastname: Bolan
mesh_terms: D000293:Adolescent; D000328:Adult; D001428:Bacterial Vaccines / Q000276:immunology*; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care; D011159:Population Surveillance; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D014481:United States / Q000453:epidemiology; D014611:Vaccination; D055815:Young Adult
chemical_list: D001428:Bacterial Vaccines
keywords: Chlamydia trachomatis; annual screening; bacteria; chlamydia; chlamydia vaccination; chlamydial infections; cost-effectiveness; vaccinations programs; vaccine; young women