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VACCINE PROGRAM CONSIDERATIONS

Target Population

The results of two vaccine strategies will be described. Both strategies involve annual immunization of 2,600,000 high-risk, nonpregnant adults (65 years of age or with specific chronic diseases). Both strategies involve immunization of younger females. One strategy involves annual immunization of pregnant women (approximately 1,630 primiparas). The other strategy involves annual immunization of 1,840,000 12-year-old girls. For the purposes of the calculations in this report, it is assumed that 30% of high-risk adults, 50% of 12-year-old girls, will utilize the vaccine. Additionally, it was assumed that utilization of the vaccine by pregnant women will either be 10% or 90%.

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

Immunization of Pregnant Women and At-Risk Adults

If a vaccine program for group B streptococci 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 37,400. 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 10,200 for 90% utilization by pregnant women and 4,500 for 10% utilization by pregnant women.

If a vaccine program for group B streptococci 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 $630 million. 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 health care costs saved would be $310 million for 90% utilization by pregnant women and $45 million for 10% utilization by pregnant women.

If a vaccine program for group B streptococci were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population,



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