Program on Health, Work and Productivity, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts (Dr Rogers), Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina (Dr Bunn III), and Program on Health, Work and Productivity, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts (Dr Lerner).
J Occup Environ Med. 2019 Jan;61(1):16-20. doi: 10.1097/JOM.0000000000001474.
Methods for assessing the costs and benefits of administering vaccines to international business/occupational travelers, assignees, and expatriates have neglected the impact of health and treatment on work productivity. The research objective is to evaluate the benefit to cost ratio of the Japanese encephalitis (JE) vaccine for international business/occupational travelers to Asia and other endemic areas incorporating a health and productivity approach.
Costs and benefits were estimated using actuarial methods with data obtained from secondary sources describing prevalence of infection risk and health outcomes, and business traveler demographic and travel characteristics. Results assumed 2018 salaries and prices, with employee time valued according to total compensation.
Risks contracting JE vary widely on the basis of length of trip, season, and destination. The productivity benefits of vaccinating a traveler outweigh the vaccination costs for those staying 30 days or longer in endemic areas during one or more transmission seasons ($2009 vs $750 per traveler), and for business travelers to endemic areas during the transmission season with outdoor activities for the average 2-week/15.4-day international business trip ($502 to $815 vs $500). Vaccination costs outweigh the productivity benefits for short-term travelers who remain in urban areas or travel outside of the transmission season ($10 vs $500).
JE Vaccination for business travelers in the active transmission season has a net benefit under certain conditions that are not commonly considered risky, such as average-length trips to peri-urban areas, in situations where contracting disease would result in significant business disruption, or when multiple trips are anticipated over several years.
评估向国际商务/职业旅行者、外派人员和侨民接种疫苗的成本和收益的方法忽略了健康和治疗对工作生产力的影响。本研究旨在评估纳入健康和生产力方法后，为亚洲和其他流行地区的国际商务/职业旅行者接种乙型脑炎（JE）疫苗的成本效益比。
使用精算方法估算成本和收益，数据来自描述感染风险和健康结果以及商务旅行者人口统计学和旅行特征的二手资料。结果假设 2018 年的工资和价格，根据总薪酬计算员工时间价值。
旅行者感染 JE 的风险因旅行时间、季节和目的地的不同而有很大差异。对于在一个或多个传播季节在流行地区停留 30 天或更长时间的旅行者（每位旅行者 2009 美元对 750 美元），以及对于在传播季节有户外活动的平均 2 周/15.4 天国际商务旅行的流行地区的商务旅行者（502 美元至 815 美元对 500 美元），接种疫苗的收益超过了接种成本。对于在城市地区停留或在传播季节以外旅行的短期旅行者（10 美元对 500 美元），接种疫苗的成本超过了其生产力收益。
在某些情况下，如到城市周边地区的平均旅行时间、感染疾病会导致重大业务中断的情况，或在未来几年预期进行多次旅行的情况下，在流行季节为商务旅行者接种 JE 疫苗具有净收益，这些情况通常不被认为是有风险的。
