. "Overview of Analytic Approach and Results." Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press, 2000.
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Vaccines for the 21st Century: A Tool for Decisionmaking
Level I
Most favorable
Saves money and QALYs
Level II
More favorable
Costs<$10,000 per QALY saved
Level III
Favorable
Costs>$10,000 and<$100,000 per QALY saved
Level IV
Less favorable
Costs>$100,000 per QALY saved.
Seven candidate vaccines fall into the most favorable (I) category: those with which a vaccination strategy would save money. The Level I candidate vaccines are as follows (in alphabetical order):
cytomegalovirus (CMV) vaccine administered to 12-year-olds,
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),
influenza virus vaccine administered to the general population (once per person every 5 years, or one-fifth of the population per year),
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 candidate vaccines 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):
