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Assessing the economics of vaccination for Neisseria meningitidis in industrialized nations: A review and recommendations for further research

Published online by Cambridge University Press:  01 August 2004

Denis Getsios ,
Ingrid Caro ,
Wissam El-Hadi  and
Jaime J. Caro
Denis Getsios
Affiliation:
Caro Research Institute
Ingrid Caro
Affiliation:
Caro Research Institute
Wissam El-Hadi
Affiliation:
Caro Research Institute
Jaime J. Caro
Affiliation:
Caro Research Institute
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Abstract

Objectives: To review the existing health economic literature on meningococcal disease vaccination.

Methods: A Medline search for economic evaluations of vaccination programs for meningococcal disease in developed countries was conducted. All identified studies were reviewed.

Results: Nine published studies were identified examining either mass vaccination during outbreaks or routine vaccination. Although net expenses were estimated in almost all studies, the resulting cost-effectiveness ratios varied widely. Vaccination of college-age students was found to be potentially cost-effective in Australia but not in the United States. With one exception, routine vaccination of children and adolescents in Europe was predicted to be cost-effective. Many simplifying assumptions were made, and important elements were often left out, in particular the potential for reduced transmission of disease.

Conclusions: The methods used and the vaccination strategies vary widely, and results do not provide strong grounds for making conclusions as to whether vaccination is cost-effective. Furthermore, in all instances, transmission of disease, changes in population carriage rates, and outbreaks are either ignored, dealt with using very broad simplifying assumptions, or are not necessarily generalizable to other settings. The analyses provide some insight into the potential cost-effectiveness of vaccination, but more importantly, they highlight areas requiring further study. Economic evaluations based on observed outcomes from recently implemented strategies would be helpful, as would more sophisticated health economic models. The choice of vaccination strategies cannot be based on the results of existing economic analyses.

Keywords

Meningococcal diseaseNeisseria meningitidisCost-effectivenessReviewVaccines
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 20 , Issue 3 , August 2004 , pp. 280 - 288
Copyright
© 2004 Cambridge University Press

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References

Balmer P, Borrow R, Miller E. 2002 Impact of meningococcal C conjugate vaccine in the UK. J Med Microbiol. 51: 717– 722.Google Scholar
Berrón S, De La Fuente L, Martín E, Vásquez JA. 1998 Increasing incidence of meningococcal disease in Spain associated with a new variant of serogroup C. Eur J Clin Microbiol Infect Dis. 17: 85– 89.Google Scholar
Beutels P, Edmunds WJ, Antonanzas F, et al. 2002 Viral Hepatitis Prevention Board. Economic evaluation of vaccination programmes: A consensus statement focusing on viral hepatitis. Pharmacoeconomics. 20: 1– 17.Google Scholar
Bos JM, Rümke HC, Welte R, Postma MJ, Jager JC. 2002 Health economics of a hexavalent meningococcal outer-membrane vesicle vaccine in children: Potential impact of introduction in the Dutch vaccination program. Vaccine. 20: 202– 207.Google Scholar
Bozzette SA, Boer R, Bhatnagar V, et al. 2003 A model for a smallpox-vaccination policy. N Engl J Med. 3: 416– 425.Google Scholar
Brisson M, Edmunds WJ. 2003 Economic evaluation of vaccination programs: The impact of herd immunity. Med Decis Making. 23: 76– 82.Google Scholar
Bruce MG, Rosenstein NE, Capparella JM, et al. 2001 Risk factors for meningococcal disease in college students. JAMA. 286: 688– 693.Google Scholar
Centers for Disease Control and Prevention. 2000 Prevention and control of meningococcal disease and Meningococcal disease and college students: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 49 (No. RR-7): 1– 20.
De Wals P, De Serres G, Niyonsenga T. 2001 Effectiveness of a mass immunization campaign against serogroup C meningococcal disease in Quebec. JAMA. 285: 177– 181.Google Scholar
De Wals P, Dionne M, Douville-Fradet M, et al. 1996 Impact of mass immunization campaign against serogroup C meningococcus in the province of Quebec, Canada. Bull World Health Organ. 74: 407– 411.Google Scholar
De Wals P, Erickson L. 2002 Economic analysis of the 1992-1993 mass immunization campaign against serogroup C meningococcal disease in Quebec. Vaccine. 20: 2840– 2844.Google Scholar
Edmunds WJ, Brisson M, Melegaro A, Gay NJ. 2002 The potential cost-effectiveness of acellular pertussis booster vaccination in England and Wales. Vaccine. 20: 1316– 1330.Google Scholar
Edmunds WJ, Brisson M, Rose JD. 2001 The epidemiology of herpes zoster and potential cost-effectiveness of vaccination in England and Wales. Vaccine. 19: 3076– 3090.Google Scholar
Edmunds WJ, Medley GF, Nokes DJ. 1999 Evaluating the cost-effectiveness of vaccination programmes. A dynamic perspective. Stat Med. 18: 3263– 3282.Google Scholar
Eldabi T, Irani Z, Paul RJ. 2002 A proposed approach for modelling health care systems for understanding. J Manag Med. 16: 170– 187.Google Scholar
Erickson L, De Wals P. 1998 Complications and sequelae of meningococcal disease in Quebec, 1990–1994. Clin Infect Dis. 26: 1159– 1164.Google Scholar
Fine PE. 1993 Herd immunity: History, theory, practice. Epidemiol Re. 15: 265– 302.Google Scholar
Froeschle JE. 1999 Meningococcal disease in college students. Clin Infect Dis. 29: 215– 216.Google Scholar
Grace TW. 2002 The meningococcal vaccine recommendation: What a tangled web we weave. J Am Coll Health. 51: 93– 96.Google Scholar
Harrison LH, Dwyer DM, Maples CT, Billmann L. 1999 Risk of meningococcal infection in college students. JAMA. 281: 1906– 1910.Google Scholar
Hethcote HW. 1988 Optimal ages of vaccination for measles. Math Biosci. 89: 29– 52.Google Scholar
Hethcote HW. 1999 Simulations of pertussis epidemiology in the United States: Effects of adult booster vaccinations. Math Biosci. 158: 47– 73.Google Scholar
Jackson LA, Schuchat A, Reeves MW, Wenger JD. 1995 Serogroup C meningococcal outbreaks in the United States: An emerging threat. JAMA. 273: 383– 389.Google Scholar
Jackson LA, Schuchat A, Gorsky RD, Wenger JD. 1995 Should college students be vaccinated against meningococcal disease? A cost-benefit analysis. Am J Public Health. 85: 843– 845.Google Scholar
Jackson LA, Wenger JD. 1993 Laboratory-based surveillance for meningococcal disease in selected areas, United States, 1988–1991. MMWR CDC Surveill Summ. 42 (SS–2): 21– 30.Google Scholar
Johannesson M. 1996 The willingness to pay for health changes, the human capital approach and the external costs. Health Policy. 36: 231– 244.Google Scholar
Kelleher JA, Raebel MA. 2002 Meningococcal vaccine use in college students. Ann Pharmacother. 36: 1776– 1784.Google Scholar
Kirsch EA, Barton RP, Kitchen L, Giroir BP. 1996 Pathophysiology, treatment and outcome of meningococcemia: A review and recent experience. Pediatr Infect Dis J. 15: 967– 979.Google Scholar
Koopmanschap MA, Rutten FF. 1997 A practical guide for calculating indirect costs of disease. Pharmacoeconomics. 10: 46– 466.Google Scholar
Krause G, Blackmore C, Wiersma S, et al. 2002 Mass vaccination campaign following community outbreak of meningococcal disease. Emerg Infect Dis. 8: 1398– 1403.Google Scholar
Lieu TA, Cochi SL, Black SB, et al. 1994 Cost-effectiveness of a routine varicella vaccination program for US children. JAM. 271: 375– 381.Google Scholar
Liljas B. 1998 How to calculate indirect costs in economic evaluations. Pharmacoeconomics. 13: 1– 7.Google Scholar
Maiden MCJ, Stuart JM, 2002 for the UK Meningococcal Carriage Group. Carriage of serogroup C meningococci 1 year after meningococcal C conjugate polysaccharide vaccination. Lancet. 359: 1829– 1830.Google Scholar
Miller E, Salisbury D, Ramsay M. 2002 Planning, registration, and implementation of an immunization campaign against meningococcal serogroup C disease in the UK: A success story. Vaccine. 20: S58– S67.Google Scholar
Neal KR, Nguyen-Van-Tam J, Monk P, et al. 1999 Invasive meningococcal disease among universities providing relatively large amounts of catered hall accommodation. Epidemiol Infect. 122: 351– 357.Google Scholar
Nelson SJ, Charlett A, Orr HJ, et al. 2001 Risk factors for meningococcal disease in university halls of residence. Epidemiol Infect. 126: 211– 217.Google Scholar
Oostenbrink R, Oostenbrink JB, Moons KGM, et al. 2002 Cost-utility analysis of patient care in children with meningeal signs. Int J Technol Assess Health Care. 18: 485– 496.Google Scholar
Osterholm MT. 2001 How to vaccinate 30,000 people in three days: Realities of outbreak management. Public Health Rep. 116 (Suppl 2): 74– 78.Google Scholar
Pereiró I, Díez-Domingo J, Morant A, et al., 2001 and the Group for the Study of Invasive Diseases. Epidemiological pattern of meningococcal disease in Valencia, Spain. Impact of mass immunization campaign with meningococcal C polysaccharide vaccine. Scand J Infect Dis. 33: 581– 584.Google Scholar
Ramsay ME, Andrews NJ, Trotter CL, Kaczmarski EB, Miller E. 2003 Herd immunity from meningococcal serogroup C conjugate vaccination in England: Database analysis. BMJ. 326: 365– 366.Google Scholar
Ramsay ME, Andrews N, Kaczmarski EB, Miller E. 2001 Efficacy of meningococcal serogroup C conjugate vaccine in teenagers and toddlers in England. Lancet. 357: 195– 196.Google Scholar
Rosenstein NE, Perkins BA, Stephens DS, et al. 1999 The changing epidemiology of meningococcal disease in the United States, 1992-1996. J Infect Dis. 180: 1894– 1901.Google Scholar
Rosenstein NE, Perkins BA, Stephens DS, Popovic T, Hughes JM. 2001 Meningococcal disease. N Engl J Med. 344: 1378– 1388.Google Scholar
Round A, Palmer S. 1999 Should we be doing more to prevent meningococcal infection in school age children? How can we decide? J Public Health Med. 21: 8– 13.Google Scholar
Salleras L, Domínguez A, Cardeñosa N. 2003 Impact of mass vaccination with polysaccharide conjugate vaccine against serogroup C meningococcal disease in Spain. Vaccine. 21: 725– 728.Google Scholar
Salleras L, Domínguez A, Prats G, Parron I, Muñ;oz P. 2001 Dramatic decline of serogroup C meningococcal disease incidence in Catalonia (Spain) 24 months after a mass vaccination programme of children and young people. J Epidemiol Community Health. 55: 283– 287.Google Scholar
Scott RD Jr, Meltzer MI, Erickson LJ, De Wals P, Rosenstein NE. 2002 Vaccinating first-year college students living in dormitories for meningococcal disease. An economic analysis. Am J Prev Med. 23: 98– 105.Google Scholar
Skull SA, Butler JRG, Robinson P, Carnie J. 2001 Should programmes for community-level meningococcal vaccination be considered in Australia? An economic evaluation. Int J Epidemiol. 30: 571– 578.Google Scholar
Skull SA, Butler JRG. 2001 Meningococcal vaccination for adolescents? An economic evaluation in Victoria. J Paediatr Child Health. 37: S28– S33.Google Scholar
Trotter C, Borrow R, Andrews N, Miller E. 2003 Seroprevalence of meningococcal serogroup C bactericidal antibody in England and Wales in the pre-vaccination era. Vaccine. 21: 1094– 1098.Google Scholar
Trotter CL, Edmunds WJ. 2002 Modelling cost-effectiveness of meningococcal serogroup C conjugate vaccination campaign in England and Wales. BMJ. 324: 1– 6.Google Scholar
Trotter CL, Ramsay ME, Kaczmarski EB. 2002 Meningococcal serogroup C conjugate vaccination in England and Wales: Coverage and initial impact of the campaign. Commun Dis Public Health. 5: 220– 225.Google Scholar
Whalen CM, Hockin JC, Ryan A, Ashton F. 1995 The changing epidemiology of invasive meningococcal disease in Canada 1985 through 1992. JAMA. 273: 390– 394.Google Scholar
World Health Organization. Control of epidemic meningococcal diseas. WHO practical guidelines. 2nd ed. Available at: http://www.who.int/emc-documents/meningitis/whoemcbac983c.html. Accessed: February 11, 2003.