Vaccines for the 21st Century A Tool for Decisionmaking (2000) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-10
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as part of its planning for the fixture. The committee developed a quantitative model that could be used by decisionmakers to prioritize the development of vaccines against a number of disparate infectious diseases considered significant threats to public health.
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Furthermore, although some of the vaccines included in the study are intended to treat illness, most will be used in the more familiar role of preventing disease. The committee adopted a cost-effectiveness approach that makes it possible to compare potential new vaccines on the basis of their anticipated impact on morbidity and mortality and on the basis of the costs for health care, use of the vaccine, and vaccine development.
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Furthermore, the analysis does not address the allocation of resources between vaccine development and the development and use of other forms of prevention or treatment. Although priority setting and resource allocation can be informed by economic analyses, they require value judgments that cannot be captured by a cost-effectiveness model.
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charged with prioritizing vaccine development and vaccination program implementation should use as an aid in that prioritization process a model, such as that developed for this report, that is quantitative and relatively unbiased toward a specific vaccine candidate. Such a model should use standardly accepted data and techniques such as measures of health impact, and discounting.
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That is, use of some of the candidate vaccines would save money while also saving QALYs and some of the candidate vaccination strategies would incur costs for each QALY gained. The four groups are: Level I Most Favorable Level II More Favorable Level III Favorable Level IV Less Favorable Saves money and QALYs Costs < $10,000 per QALY saved Costs > $10,000 and < $100,000 per QALY saved Costs > $100,000 per QALY saved.
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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,
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This also will require a health care milieu that is more capable than it is now of routine vaccination at puberty. Factors such as health beliefs, health care practices, performance measurements for health plans, and school entry laws have contributed to relatively successful childhood immunization efforts.
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Vaccine delivery poses significant barriers to effective prevention and control of infectious disease. Children in the United States can receive up to 6 different vaccines (adding up to a maximum of 32 antigens, 6 visits to a health care provider, and 16 injections)
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This false sense of security strikes individuals, communities, health care providers, and policymakers. It is not until the system fails and illness surges (such as with antibiotic resistance, nosocomial infections, the measles outbreaks that occurred in the late 1980s, or food-borne illness)
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