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Vaccines for the 21st Century: A Tool for Decisionmaking
rheumatoid arthritis therapeutic vaccine,
Group B streptococcus vaccine to be well-incorporated into routine prenatal care and administered to women during first pregnancy and to high-risk adults (at age 65 years and to people less than age 65 years with serious, chronic health conditions), and
Streptococcus pneumoniae vaccine to be given to infants and to 65-year-olds.
Nine candidate vaccines fall into the more favorable (II) category: those with which a vaccination strategy would incur small costs (less than $10,000) for each QALY gained. The Level II vaccine candidates are as follows (in alphabetical order):
chlamydia vaccine to be administered to 12-year-olds,
Helicobacter pylori vaccine to be administered to infants,
hepatitis C virus vaccine to be administered to infants,
herpes simplex virus vaccine to be administered to 12-year-olds,
human papillomavirus vaccine to be administered to 12-year-olds,
melanoma therapeutic vaccine,
Mycobacterium tuberculosis vaccine to be administered to high-risk populations,
Neisseria gonorrhea vaccine to be administered to 12-year-olds, and
respiratory syncytial virus vaccine to be administered to infants and to 12-year-old females.
Four candidate vaccines fall into the favorable (III) category: those with which a vaccination strategy would incur moderate costs (more than $10,000 but less than $100,000) per QALY gained. The Level III vaccine candidates are as follows (in alphabetical order):
parainfluenza virus vaccine to be given to infants and to women in their first pregnancy,
rotavirus vaccine to be given to infants,
Group A streptococcus vaccine to be given to infants, and
Group B streptococcus vaccine to be given to high-risk adults and to either 12-year-old females or to women during first pregnancy (low utilization).
Seven candidate vaccines fall into the less favorable (IV) category: those with which a vaccination strategy would incur significant costs (more than $100,000 and up to well more than $1 million) per QALY gained. The Level IV vaccine candidates are as follows (in alphabetical order):
Borrelia burgdorferi vaccine to be given to resident infants born in and immigrants of any age to geographically defined high-risk areas,
