Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Jl. PB Sudirman, Denpasar, Bali 80232, Indonesia.
Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Jl. PB Sudirman, Denpasar, Bali 80232, Indonesia.
Vaccine. 2023 Nov 13;41(47):6930-6940. doi: 10.1016/j.vaccine.2023.10.007. Epub 2023 Oct 21.
The incidence of Japanese Encephalitis (JE) in Bali Province remains high, and is one among the highest in Indonesia. The Indonesian Government initiated the JE vaccination campaign followed by a JE vaccine introduction program in Bali Province in 2018. The JE vaccination program then has been fully integrated into the provincial routine immunization program since 2019. We conducted a retrospective economic analysis of JE vaccination program in Bali Province, Indonesia; considering multiple vaccination strategies.
We conducted a cost-effectiveness analysis using a decision analytic model comparing two vaccination strategies with no vaccination from the societal and government perspectives. These vaccination strategies were: (1) JE vaccination campaign and introduction program, and (2) a routine JE vaccination program. We compared costs and outcomes for three hypothetical cohorts of 100,000 children followed from birth to the age of 10 years, with impacts measured throughout the child's life-time. We measured the economic consequences as costs per case, per death, and per disability-adjusted life year (DALY) averted.
A routine JE immunization program was the most cost-effective strategy with a cost per DALYs averted of US$ 212.59 and US$ 94.09 from the government and societal perspectives respectively. In contrast, costs per DALYs averted through the JE vaccination campaign and introduction strategy was US$ 1,473.53 and US$ 1,224.20 from the government and societal perspectives respectively.
Both JE vaccination strategies are cost-effective but they are not cost-saving when compared to no immunization program.
巴厘省的日本脑炎（JE）发病率仍然很高，是印度尼西亚发病率最高的地区之一。印度尼西亚政府于 2018 年在巴厘省启动了 JE 疫苗接种运动，并随后推出了 JE 疫苗接种计划。自 2019 年以来，JE 疫苗接种计划已完全纳入该省的常规免疫规划。我们对印度尼西亚巴厘省的 JE 疫苗接种计划进行了回顾性经济分析；考虑了多种疫苗接种策略。
我们从社会和政府的角度，使用决策分析模型，对两种疫苗接种策略（1：JE 疫苗接种运动和引入计划；2：常规 JE 疫苗接种计划）与不接种疫苗的情况进行了成本效益分析。我们比较了三个假想的 10 万人队列的成本和结果，这些队列从出生到 10 岁进行跟踪，其影响贯穿儿童的整个生命周期。我们以每例病例、每例死亡和每例残疾调整生命年（DALY）的成本来衡量经济后果。
常规 JE 免疫接种计划是最具成本效益的策略，从政府和社会的角度来看，每例 DALY 的成本分别为 212.59 美元和 94.09 美元。相比之下，通过 JE 疫苗接种运动和引入策略，每例 DALY 的成本分别为政府和社会的 1473.53 美元和 1224.20 美元。
这两种 JE 疫苗接种策略都是具有成本效益的，但与不接种疫苗相比，它们并不能节省成本。
