National Center for Immunization and Respiratory Diseases, and.
Pediatrics. 2014 Apr;133(4):577-85. doi: 10.1542/peds.2013-0698. Epub 2014 Mar 3.
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.
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.
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.
From both direct cost and societal perspectives, vaccinating children as recommended with these vaccines results in substantial cost savings.
评估 2009 年美国常规儿童免疫计划的经济影响，包括白喉和破伤风类毒素、无细胞百日咳、b 型流感嗜血杆菌结合疫苗、灭活脊髓灰质炎疫苗、麻疹/腮腺炎/风疹、乙型肝炎、水痘、7 价肺炎球菌结合疫苗、甲型肝炎和轮状病毒疫苗；流感疫苗未包括在内。
使用基于人群的疫苗接种覆盖率、已发表的疫苗效力、疫苗接种前疾病发病率的历史数据以及 2005 年至 2009 年报告的疾病发病率，进行决策分析。使用直接成本和社会（直接和间接成本）视角估计成本。项目成本包括疫苗、管理、疫苗相关不良事件以及父母旅行和工作时间损失。所有成本均按 2009 年美元进行了通胀调整，未来的所有成本和收益均按 3%的年贴现率贴现。对 2009 年美国出生的 4261494 名婴儿的假设队列进行了终生随访。计算了常规儿童免疫接种的净现值（净储蓄）和效益成本比。
分析表明，2009 年美国出生队列成员的常规儿童免疫接种将预防约 42000 例早期死亡和 2000 万例疾病，直接成本净节省 135 亿美元，总社会成本净节省 688 亿美元。常规儿童疫苗接种的直接和社会效益成本比分别为 3.0 和 10.1。
从直接成本和社会角度来看，按照建议为儿童接种这些疫苗可带来巨大的成本节约。
