Kitano Taito, Onaka Masayuki, Ishihara Mariko, Nishiyama Atsuko, Hashimoto Naoki, Yoshida Sayaka
Department of Pediatrics, Nara Prefecture General Medical Center, Nara City, Japan.
Clin Exp Vaccine Res. 2017 Jul;6(2):120-127. doi: 10.7774/cevr.2017.6.2.120. Epub 2017 Jul 26.
Mumps vaccine has not been included in the routine national immunization program in Japan, leading to low vaccine coverage rates and periodic epidemics approximately every 5 years. Our hospital (a secondary community hospital in Japan) experienced an increased number of mumps-related complications with a nationwide epidemic in 2016. Using previously reported data and mumps-related cases in our hospital, we estimated the cost-effectiveness of routine mumps vaccination in Japan with a static model using current epidemiologic data.
With a decision tree flowchart of mumps infection and adverse events, we estimated the burden of mumps-related complications in our hospital for 5 years, and calculated the current annual national burden. Finally, we compared the current burden and assumptive burden of the stable state after routine vaccination in Japan using a static model.
The cost-benefit ratios with sensitivity analysis were 3.69 (1.08-9.52) and 6.84 (1.51-23.73) in independent inoculation and simultaneous inoculation, respectively, from a social perspective in addition to an annual gain of 9,487 (3,227-14,659) quality adjusted life years.
We contributed additional evidence in terms of cost-effectiveness that routine mumps vaccination should be introduced in Japan with simultaneous inoculation.
腮腺炎疫苗尚未纳入日本国家常规免疫规划，导致疫苗接种率较低，且大约每5年出现一次周期性流行。我院（日本一家二级社区医院）在2016年全国性腮腺炎流行期间，与腮腺炎相关的并发症数量有所增加。利用先前报告的数据和我院的腮腺炎相关病例，我们使用当前的流行病学数据，通过静态模型估计了日本常规接种腮腺炎疫苗的成本效益。
通过腮腺炎感染和不良事件的决策树流程图，我们估计了我院5年中与腮腺炎相关并发症的负担，并计算了当前全国年度负担。最后，我们使用静态模型比较了日本常规接种疫苗后当前的负担和稳定状态下的假设负担。
从社会角度进行敏感性分析，独立接种和同时接种的成本效益比分别为3.69（1.08 - 9.52）和6.84（1.51 - 23.73），此外每年还可获得9487（3227 - 14659）个质量调整生命年。
我们在成本效益方面提供了额外的证据，表明日本应采用同时接种的方式引入常规腮腺炎疫苗。
