White C C, Koplan J P, Orenstein W A
Am J Public Health. 1985 Jul;75(7):739-44. doi: 10.2105/ajph.75.7.739.
For a single year, 1983, we compared the actual and estimated morbidity, mortality, and costs attributable to measles, mumps, and rubella with having or not having a childhood immunization program using the combined measles-mumps-rubella (MMR) vaccine. Without an immunization program, an estimated 3,325,000 cases of measles would occur as compared to 2,872 actual cases in 1983 with a program. Instead of an expected 1.5 million rubella cases annually, there were only 3,816 actual cases. Mumps cases were lowered from an expected 2.1 million to 32,850 actual cases. Comparable reductions in disease-associated complications, sequelae, and deaths are gained with an immunization program. Without a vaccination program, disease costs would have been almost $1.4 billion. Based on the actual incidence of disease in 1983, costs were estimated to be approximately +14.5 million. Expenditures for immunization, including vaccine administration costs and the costs associated with vaccine reactions, totaled $96 million. The resulting benefit-cost ratio for the MMR immunization program is approximately 14:1. The savings realized due to the use of combination rather than single antigen vaccine total nearly $60 million.
在1983年这一年，我们比较了麻疹、腮腺炎和风疹的实际发病、死亡情况以及相关成本，这些情况是基于是否开展了使用联合麻疹-腮腺炎-风疹（MMR）疫苗的儿童免疫规划。如果没有免疫规划，预计会出现332.5万例麻疹病例，而在1983年开展了免疫规划的情况下，实际病例为2872例。风疹病例每年预期为150万例，实际只有3816例。腮腺炎病例从预期的210万例降至实际的32850例。免疫规划还使与疾病相关的并发症、后遗症和死亡人数得到了相应减少。如果没有疫苗接种规划，疾病成本将接近14亿美元。根据1983年疾病的实际发病率估算，成本约为1450万美元。免疫接种的支出，包括疫苗接种费用和与疫苗反应相关的费用，总计9600万美元。MMR免疫规划的效益成本比约为14:1。由于使用联合疫苗而非单一抗原疫苗而节省的费用总计近6000万美元。
