Hinman A R, Koplan J P
Dev Biol Stand. 1985;61:429-37.
Because of continuing debate about the benefits and risks of pertussis immunization, we recently published an analysis of benefits, risks, and costs based on an earlier study carried out in 1979. In the study, a hypothetical cohort of one million children was followed from birth to six years of age without and with a pertussis vaccination program. The study found a benefit: cost ratio of 11.1.: 1 associated with the pertussis vaccination program. Since publication of this study, questions have been raised regarding the result of the model if the observed U.S. age distribution of cases was used rather than the English distribution. In addition, there has recently been a substantial increase in the cost of pertussis vaccine. New data have also become available from the complete British National Childhood Encephalopathy Study. We have made further analyses of the model taking these factors into account. Even in the face of a 90-fold increase in vaccine costs and using "worst case" estimates of the risks of permanent damage associated with vaccine, our model continues to indicate that the benefits of pertussis vaccination outweigh the risks and the economic savings outweigh the costs.
由于关于百日咳免疫接种的益处和风险仍存在争议，我们最近基于1979年进行的一项早期研究发表了一篇关于益处、风险和成本的分析。在该研究中，对一个假设的百万儿童队列从出生到6岁进行了跟踪，一组未接种百日咳疫苗，另一组接种了百日咳疫苗。研究发现，百日咳疫苗接种计划的效益成本比为11.1:1。自这项研究发表以来，有人对该模型的结果提出疑问，即如果使用美国观察到的病例年龄分布而非英国的分布会怎样。此外，最近百日咳疫苗的成本大幅增加。英国全国儿童脑病完整研究也有了新数据。我们在考虑这些因素的情况下对模型进行了进一步分析。即使疫苗成本增加了90倍，并采用与疫苗相关的永久性损伤风险的“最坏情况”估计，我们的模型仍继续表明，百日咳疫苗接种的益处大于风险，经济节省大于成本。
