Cost-benefit analyses of supplementary measles immunisation in the highly immunized population of New Zealand

D. T.S. Hayman, J. C. Marshall, N. P. French, Tim Carpenter, M. G. Roberts, T. Kiedrzynski

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

As endemic measles is eliminated from countries through increased immunisation, the economic benefits of enhanced immunisation programs may come into question. New Zealand has suffered from outbreaks after measles introductions from abroad and we use it as a model system to understand the benefits of catch up immunisation in highly immunised populations. We provide cost-benefit analyses for measles supplementary immunisation in New Zealand. We model outbreaks based on estimates of the basic reproduction number in the vaccinated population (Rv, the number of secondary infections in a partially immunised population), based on the number of immunologically-naïve people at district and national levels, considering both pre- and post-catch up vaccination scenarios. Our analyses suggest that measles Rv often includes or exceeds one (0.18–3.92) despite high levels of population immunity. We calculate the cost of the first 187 confirmed and probable measles cases in 2014 to be over NZ$1 million (∼US$864,200) due to earnings lost, case management and hospitalization costs. The benefit-cost ratio analyses suggest additional vaccination beyond routine childhood immunisation is economically efficient. Supplemental vaccination-related costs are required to exceed approximately US$66 to US$1877 per person, depending on different scenarios, before supplemental vaccination is economically inefficient. Thus, our analysis suggests additional immunisation beyond childhood programs to target naïve individuals is economically beneficial even when childhood immunisation rates are high.

Original languageEnglish (US)
Pages (from-to)4913-4922
Number of pages10
JournalVaccine
Volume35
Issue number37
DOIs
StatePublished - Sep 5 2017
Externally publishedYes

Fingerprint

Measles
New Zealand
Cost-Benefit Analysis
Immunization
immunization
Vaccination
Population
vaccination
childhood
Costs and Cost Analysis
Disease Outbreaks
Basic Reproduction Number
Immunization Programs
Case Management
Coinfection
Immunity
Hospitalization
Economics
immunity
economics

Keywords

  • Basic reproduction number
  • Cost-benefit analyses
  • Immunisation
  • Measles
  • MMR
  • Vaccine programs

ASJC Scopus subject areas

  • Molecular Medicine
  • Immunology and Microbiology(all)
  • veterinary(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Cost-benefit analyses of supplementary measles immunisation in the highly immunized population of New Zealand. / Hayman, D. T.S.; Marshall, J. C.; French, N. P.; Carpenter, Tim; Roberts, M. G.; Kiedrzynski, T.

In: Vaccine, Vol. 35, No. 37, 05.09.2017, p. 4913-4922.

Research output: Contribution to journalArticle

Hayman, D. T.S. ; Marshall, J. C. ; French, N. P. ; Carpenter, Tim ; Roberts, M. G. ; Kiedrzynski, T. / Cost-benefit analyses of supplementary measles immunisation in the highly immunized population of New Zealand. In: Vaccine. 2017 ; Vol. 35, No. 37. pp. 4913-4922.
@article{c7f2e1051a494d129bcfca204accbab5,
title = "Cost-benefit analyses of supplementary measles immunisation in the highly immunized population of New Zealand",
abstract = "As endemic measles is eliminated from countries through increased immunisation, the economic benefits of enhanced immunisation programs may come into question. New Zealand has suffered from outbreaks after measles introductions from abroad and we use it as a model system to understand the benefits of catch up immunisation in highly immunised populations. We provide cost-benefit analyses for measles supplementary immunisation in New Zealand. We model outbreaks based on estimates of the basic reproduction number in the vaccinated population (Rv, the number of secondary infections in a partially immunised population), based on the number of immunologically-na{\"i}ve people at district and national levels, considering both pre- and post-catch up vaccination scenarios. Our analyses suggest that measles Rv often includes or exceeds one (0.18–3.92) despite high levels of population immunity. We calculate the cost of the first 187 confirmed and probable measles cases in 2014 to be over NZ$1 million (∼US$864,200) due to earnings lost, case management and hospitalization costs. The benefit-cost ratio analyses suggest additional vaccination beyond routine childhood immunisation is economically efficient. Supplemental vaccination-related costs are required to exceed approximately US$66 to US$1877 per person, depending on different scenarios, before supplemental vaccination is economically inefficient. Thus, our analysis suggests additional immunisation beyond childhood programs to target na{\"i}ve individuals is economically beneficial even when childhood immunisation rates are high.",
keywords = "Basic reproduction number, Cost-benefit analyses, Immunisation, Measles, MMR, Vaccine programs",
author = "Hayman, {D. T.S.} and Marshall, {J. C.} and French, {N. P.} and Tim Carpenter and Roberts, {M. G.} and T. Kiedrzynski",
year = "2017",
month = "9",
day = "5",
doi = "10.1016/j.vaccine.2017.07.077",
language = "English (US)",
volume = "35",
pages = "4913--4922",
journal = "Vaccine",
issn = "0264-410X",
publisher = "Elsevier BV",
number = "37",

}

TY - JOUR

T1 - Cost-benefit analyses of supplementary measles immunisation in the highly immunized population of New Zealand

AU - Hayman, D. T.S.

AU - Marshall, J. C.

AU - French, N. P.

AU - Carpenter, Tim

AU - Roberts, M. G.

AU - Kiedrzynski, T.

PY - 2017/9/5

Y1 - 2017/9/5

N2 - As endemic measles is eliminated from countries through increased immunisation, the economic benefits of enhanced immunisation programs may come into question. New Zealand has suffered from outbreaks after measles introductions from abroad and we use it as a model system to understand the benefits of catch up immunisation in highly immunised populations. We provide cost-benefit analyses for measles supplementary immunisation in New Zealand. We model outbreaks based on estimates of the basic reproduction number in the vaccinated population (Rv, the number of secondary infections in a partially immunised population), based on the number of immunologically-naïve people at district and national levels, considering both pre- and post-catch up vaccination scenarios. Our analyses suggest that measles Rv often includes or exceeds one (0.18–3.92) despite high levels of population immunity. We calculate the cost of the first 187 confirmed and probable measles cases in 2014 to be over NZ$1 million (∼US$864,200) due to earnings lost, case management and hospitalization costs. The benefit-cost ratio analyses suggest additional vaccination beyond routine childhood immunisation is economically efficient. Supplemental vaccination-related costs are required to exceed approximately US$66 to US$1877 per person, depending on different scenarios, before supplemental vaccination is economically inefficient. Thus, our analysis suggests additional immunisation beyond childhood programs to target naïve individuals is economically beneficial even when childhood immunisation rates are high.

AB - As endemic measles is eliminated from countries through increased immunisation, the economic benefits of enhanced immunisation programs may come into question. New Zealand has suffered from outbreaks after measles introductions from abroad and we use it as a model system to understand the benefits of catch up immunisation in highly immunised populations. We provide cost-benefit analyses for measles supplementary immunisation in New Zealand. We model outbreaks based on estimates of the basic reproduction number in the vaccinated population (Rv, the number of secondary infections in a partially immunised population), based on the number of immunologically-naïve people at district and national levels, considering both pre- and post-catch up vaccination scenarios. Our analyses suggest that measles Rv often includes or exceeds one (0.18–3.92) despite high levels of population immunity. We calculate the cost of the first 187 confirmed and probable measles cases in 2014 to be over NZ$1 million (∼US$864,200) due to earnings lost, case management and hospitalization costs. The benefit-cost ratio analyses suggest additional vaccination beyond routine childhood immunisation is economically efficient. Supplemental vaccination-related costs are required to exceed approximately US$66 to US$1877 per person, depending on different scenarios, before supplemental vaccination is economically inefficient. Thus, our analysis suggests additional immunisation beyond childhood programs to target naïve individuals is economically beneficial even when childhood immunisation rates are high.

KW - Basic reproduction number

KW - Cost-benefit analyses

KW - Immunisation

KW - Measles

KW - MMR

KW - Vaccine programs

UR - http://www.scopus.com/inward/record.url?scp=85027247373&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027247373&partnerID=8YFLogxK

U2 - 10.1016/j.vaccine.2017.07.077

DO - 10.1016/j.vaccine.2017.07.077

M3 - Article

C2 - 28802754

AN - SCOPUS:85027247373

VL - 35

SP - 4913

EP - 4922

JO - Vaccine

JF - Vaccine

SN - 0264-410X

IS - 37

ER -