rate associated with CMV infection in these patients. Even though the vaccine is predicted to have a lower efficacy in this group, when it is efficacious it may prevent very severe or fatal outcomes; thus, the perceived benefits are judged to be moderately high and the perceived barriers low.

Lay Acceptance Lay perception of the risk of illness caused by CMV is judged to be quite low, primarily because the public is thought to be unfamiliar with the potential for CMV infection and disease. Perception of the severity of disease (e.g., mononucleosis) is judged to be moderate, and perception of the likely benefits of the vaccine is judged to be moderately high, based on the predicted efficacy of the vaccine in preventing disease of moderate severity. Perceived barriers to vaccination are judged to be moderate, based on the relatively high cost of vaccination and the predicted number of required doses (3).

Provider Acceptance Perceptions of the risk and severity of disease caused by CMV are judged to be high because of the high probability of infection over a lifetime and because the illnesses caused by CMV include some that may have severe sequelae. The perceived benefits of the vaccine are judged to be moderately high, based on the predicted efficacy of the vaccine in preventing disease associated with severe outcomes. Perceived barriers are judged to be relatively low because no adverse reactions are expected; the predicted number of required doses (3) may increase perceived barriers slightly.

The scope and purpose of the calculations included below are described in Chapters 4 and 7. These calculations are based on certain simplifying procedures and assumptions that have been judged not to compromise their utility for the purposes of this comparison. The total costs should be taken only as an approximation of the direct cost of this disease.