Meghani Mehreen, Pike Jamison, Tippins Ashley, Leidner Andrew J
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Rep. 2025 Jan-Feb;140(1):48-56. doi: 10.1177/00333549241249672. Epub 2024 Jun 4.
The Federated States of Micronesia (FSM) experience periodic outbreaks of vaccine-preventable diseases. Our objective was to assess the cost-effectiveness of routine outreach and catch-up campaign strategies for increasing vaccination coverage for the measles, mumps, and rubella (MMR) vaccine among children aged 12 months through 6 years in Chuuk, FSM.
We used a cost-effectiveness model to assess 4 MMR vaccination strategies from a public health perspective: routine outreach conducted 4 times per year (quarterly routine outreach), routine outreach conducted 2 times per year (biannual routine outreach), catch-up campaigns conducted once per year (annual catch-up campaign), and catch-up campaigns conducted every 2 years with quarterly routine outreach in non-catch-up campaign years (status quo). We calculated costs and outcomes during a 5-year model horizon and summarized results as incremental cost-effectiveness ratios. We analyzed the following public health outcomes: additional protected person-month (PPM), doses administered and protected people (ie, a child who completed a 2-dose MMR series). We conducted 1-way sensitivity analyses to evaluate the stability of incremental cost-effectiveness ratios and to identify influential model inputs.
Among the 4 MMR vaccination strategies, quarterly routine outreach was the most effective and most expensive strategy, and biannual routine outreach was the least expensive and least effective strategy. Quarterly routine outreach (vs status quo) yielded approximately an additional 7001 PPMs and 132 vaccine doses administered, with incremental costs of about $4 per PPM, $193 per dose administered, and $123 per protected person.
Routine outreach and catch-up campaign vaccination strategies can be important interventions to improve health in Chuuk, FSM. More frequent routine outreach events could improve MMR coverage and reduce the likelihood of outbreaks of vaccine-preventable diseases such as measles and mumps.
密克罗尼西亚联邦（FSM）定期爆发可通过疫苗预防的疾病。我们的目标是评估常规外展和补种活动策略在提高FSM楚克州12个月至6岁儿童麻疹、腮腺炎和风疹（MMR）疫苗接种覆盖率方面的成本效益。
我们从公共卫生角度使用成本效益模型评估4种MMR疫苗接种策略：每年开展4次常规外展（季度常规外展）、每年开展2次常规外展（半年常规外展）、每年开展1次补种活动（年度补种活动）以及在非补种活动年份每2年开展1次补种活动并进行季度常规外展（现状）。我们计算了5年模型期内的成本和结果，并将结果总结为增量成本效益比。我们分析了以下公共卫生结果：额外的受保护人月数（PPM）、接种剂量和受保护人数（即完成2剂MMR系列接种的儿童）。我们进行了单因素敏感性分析，以评估增量成本效益比的稳定性，并确定有影响力的模型输入。
在4种MMR疫苗接种策略中，季度常规外展是最有效且成本最高的策略，半年常规外展是成本最低且效果最差的策略。季度常规外展（与现状相比）大约产生了额外7001个PPM和132剂疫苗接种，增量成本约为每PPM 4美元、每剂接种193美元和每受保护人123美元。
常规外展和补种活动疫苗接种策略可能是改善FSM楚克州健康状况的重要干预措施。更频繁的常规外展活动可以提高MMR疫苗接种覆盖率，并降低麻疹和腮腺炎等可通过疫苗预防疾病爆发的可能性。
