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people with shigella infection seek the care of a physician and receive medication. See Table A23–1.

VACCINE DEVELOPMENT

The committee assumed that it will take 7 years until licensure of a shigella vaccine and that $240 million needs to be invested. It was assumed that research into the development of a shigella vaccine would lead to increased knowledge of mucosal immunity, which would benefit research and development of many vaccines in the future. Table 4–1 summarizes vaccine development assumptions for all vaccines considered in this report.

VACCINE PROGRAM CONSIDERATIONS

Target Population

For the purposes of the calculations in this report, two scenarios are discussed: a target population of travelers only and a target population of travelers and infants. It is assumed that 90% of infants and 30% of travelers will accept the vaccine.

Vaccine Schedule, Efficacy, and Costs

For the purposes of the calculations in this report, it was estimated that this vaccine would cost $50 per dose and that administration costs would be $10 per dose. Default assumptions of a 3-dose series and 75% effectiveness were accepted. Table 4–1 summarizes vaccine program assumptions for all vaccines considered in this report.

RESULTS

If a vaccine program for Shigella were implemented today and the vaccine were 100% efficacious and utilized by 100% of the target population, the annualized present value of the QALYs gained would be 160. Using committee assumptions of less-than-ideal efficacy and utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the QALYs gained would be 57.

If a vaccine program for Shigella were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the health care costs saved would be $1.7 million.



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