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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Donald S. Shepard, PhD, Schneider Institute for Health Policy, Heller School, Brandeis University, MS 035, 415 South Street, Waltham, MA 02454-9110, 781-736-3975, Shepard@Brandeis.edu, Jose A. Suaya, MD, MPH, Heller School, Brandeis University, 415 South St., MS 035, Waltham, MA 02454-9110, and Scott Halstead, MD, Rockefeller Foundation, 5824 Edson Lane, Rockville, MD 20852.
The health burden of dengue is enormous, particularly in Southeast Asia. That region, with a population of 529 million persons, experiences about 6 million clinical cases of dengue annually, of which 380,000 progress to dengue hemorrhagic fever (DHF) and 3,000 are fatal. A scientifically feasible vaccine, of which several types are now in late stages of development, would resolve much of this burden. This study had two objectives: (1) to estimate the health benefits of administering dengue vaccination to annual childhood cohorts in SE Asia; and (2) to determine the annual cost of the proposed strategy. We performed a cost-effectiveness analysis using a societal perspective for evaluating costs and benefits, comparing the vaccination of 85% of the cohort of children born in SE Asia who would had reached age 15 months during 2001 against no vaccination. We assumed that two doses of the vaccine would be 95% efficacious against dengue infection over the recipient's lifetime. Using a sensitivity analysis, we found that DHF incidence and cost per dose of vaccine were the most critical factors. Five dollars per dose, a plausible price, would generate annual revenues of $123 million for the producer. The cost-effectiveness ratio was $389 per DALY gained, a result within the range of most major public health programs analyzed by the World Bank. As vaccination would likely provide decades of protection, it is potentially less expensive than vector control, which must be repeated annually. As a result, vaccination appears to be both a scientifically and economically feasible tool to control the heavy health and economic burden of dengue.
Learning Objectives:
Keywords: Immunizations, International Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.