A benefit-cost analysis of a childhood varicella vaccination programme.

We examined the expected experience of normal individuals from a hypothetical birth cohort of 3.5 million persons followed from birth to their 30th birthday without and with a varicella vaccination programme. We assumed that one dose of vaccine would be given to 15-month-old children along with the measles, mumps and rubella vaccination to avoid a separate administration cost. It was also assumed that 90% of children would be vaccinated, that vaccine efficacy would be 90%, and that vaccine-induced immunity would be lifelong. Finally, it was assumed that the programme would have no effect on either the incidence rate or severity of zoster. For both disease and vaccine, we measured the direct medical costs and home care costs (i.e., costs associated with lost work time by someone other than the patient). Costs associated with death or forgone wages to the patient were not estimated. The reduction in costs would be 66% with a net savings of $262,050,392. The benefit:cost ratio would be 6.9:1. If the major assumptions in this analysis hold true, there may be substantial financial benefits from vaccinating all children against varicella.