Hyer R N, Howell M R, Ryan M A, Gaydos J C
Division of Preventive Medicine, Walter Reed Army Institute of Research, Silver Spring, Maryland 20910-7500, USA.
Am J Trop Med Hyg. 2000 May;62(5):613-8. doi: 10.4269/ajtmh.2000.62.613.
Adenovirus vaccines have controlled acute respiratory disease (ARD) in military recruits since 1971. Vaccine production, however, ceased and new facilities are required. We assessed whether reacquiring and using vaccines in naval recruits is cost-effective. Three policy options were evaluated: no vaccination, seasonal vaccination, and year-round vaccination. Morbidity (outpatient and inpatient), illness costs (medical and lost training), and vaccine program costs (start-up, acquisition, and distribution) were modeled using a decision-analytic method. Results were based on a cohort of 49,079 annual trainees, a winter vaccine-preventable ARD rate of 2.6 cases per 100 person-weeks, a summer incidence rate at 10% of the winter rate, a hospitalization rate of 7.6%, and a production facility costing US$12 million. Compared to no vaccination, seasonal vaccination prevented 4,015 cases and saved $2.8 million per year. Year-round vaccination prevented 4,555 cases and saved $2.6 million. Reacquiring and using adenovirus vaccines seasonally or year-round saves money and averts suffering.
自1971年以来，腺病毒疫苗已控制了新兵中的急性呼吸道疾病（ARD）。然而，疫苗生产已停止，需要新的生产设施。我们评估了在海军新兵中重新获取和使用疫苗是否具有成本效益。评估了三种政策选择：不接种疫苗、季节性接种疫苗和全年接种疫苗。使用决策分析方法对发病率（门诊和住院）、疾病成本（医疗和培训损失）以及疫苗计划成本（启动、采购和分发）进行了建模。结果基于每年49,079名受训人员的队列，冬季疫苗可预防的ARD发病率为每100人周2.6例，夏季发病率为冬季发病率的10%，住院率为7.6%，以及一个成本为1200万美元的生产设施。与不接种疫苗相比，季节性接种疫苗每年预防了4015例病例，节省了280万美元。全年接种疫苗预防了4555例病例，节省了260万美元。季节性或全年重新获取和使用腺病毒疫苗可节省资金并避免痛苦。
