Feng Huangyufei, Zhang Haijun, Ma Chao, Zhang Haonan, Yin Dapeng, Fang Hai
School of Public Health, Peking University, Beijing, 100191, China.
China Center for Health Development Studies, Peking University, Beijing, 100191, China.
Lancet Reg Health West Pac. 2022 Nov 11;32:100639. doi: 10.1016/j.lanwpc.2022.100639. eCollection 2023 Mar.
In China, varicella is the third most frequently reported vaccine-preventable infectious disease after tuberculosis and influenza, and imposes a heavy burden on families and society. To inform future immunization policy, we investigated disease burden of varicella in China and explored cost-effectiveness of different varicella vaccination strategies at national and provincial levels.
A dynamic transmission model was developed to assess disease burden of varicella and the impact of varicella vaccination in China. A cost-effectiveness analysis of three alternative vaccination strategies in China's National Immunization Program (NIP) compared with no vaccination was conducted. Scenario analyses and sensitivity analyses were performed to check the robustness of the results.
It was estimated that 3.35 million new varicella cases occurred in 2019, more than three times of 982 thousand cases officially reported from National Notifiable Infectious Disease Surveillance System (NNIDSS). The under-reported rate was approximately 71%. The economic analysis revealed that from the societal perspective, the incremental cost-effectiveness ratio (ICER) for one dose of varicella vaccination in NIP was US$ 2357 per QALY at the national level and it was cost-effective in 22 of 31 provinces. The ICER for one dose varicella vaccination plus a mass catch-up for unvaccinated children aged 2-11 years old would be US$ -5260 per QALY, cost-saving at the national level. The one dose plus mass catch-up NIP strategy was also cost-saving in 24 of the 31 provinces.
Varicella incident cases were substantially under-reported in China. Varicella vaccination in the NIP could significantly contribute to reducing the burden of varicella disease. From the societal perspective, including varicella vaccination into China's NIP was highly cost-effective at the national level and in most provinces.
Bill & Melinda Gates Foundation.
在中国，水痘是仅次于结核病和流感的第三大最常报告的疫苗可预防传染病，给家庭和社会带来沉重负担。为指导未来的免疫政策，我们调查了中国水痘的疾病负担，并在国家和省级层面探索了不同水痘疫苗接种策略的成本效益。
建立了一个动态传播模型，以评估中国水痘的疾病负担和水痘疫苗接种的影响。对中国国家免疫规划（NIP）中三种替代疫苗接种策略与不接种疫苗进行了成本效益分析。进行了情景分析和敏感性分析，以检验结果的稳健性。
据估计，2019年有335万例新水痘病例发生，是国家法定传染病监测系统（NNIDSS）正式报告的98.2万例的三倍多。漏报率约为71%。经济分析表明，从社会角度看，国家免疫规划中一剂水痘疫苗接种的增量成本效益比（ICER）在国家层面为每获得一个质量调整生命年（QALY）2357美元，在31个省份中的22个省份具有成本效益。一剂水痘疫苗接种加上对2至11岁未接种儿童进行大规模补种的ICER为每QALY -5260美元，在国家层面节省成本。一剂加补种的国家免疫规划策略在31个省份中的24个省份也节省了成本。
中国水痘发病病例存在大量漏报。国家免疫规划中的水痘疫苗接种可显著有助于减轻水痘疾病负担。从社会角度看，将水痘疫苗接种纳入中国国家免疫规划在国家层面和大多数省份都具有很高的成本效益。
比尔及梅琳达·盖茨基金会。
Zotero 插件