Article ID: | iaor20053192 |
Country: | United States |
Volume: | 16 |
Issue: | 19 |
Start Page Number: | 1885 |
End Page Number: | 1897 |
Publication Date: | Nov 1998 |
Journal: | Vaccine |
Authors: | Jacobson Sheldon H., Sewell Edward C., Weniger Bruce G., Chen R.T., Deuson R., Livengood J.R., Orenstein W.A. |
Keywords: | vaccination |
The biotechnology revolution is producing a growing bounty of new vaccines which pose difficult choices in selecting among many products. Some major public and private purchasers of vaccine may offer individual physicians and clinics their choice in assembling vaccine inventories. Others might purchase only a limited stock of products that would satisfactorily immunize a typical child. In either case, current vaccine selection decisions are based principally on purchase price alone without systematic consideration of other factors of fiscal consequence. As a potential tool for decision making, we developed an economic algorithm for vaccine selection that would minimize the overall costs of disease control through immunization by considering: (1) purchase price, (2) number of doses needed, (3) preparation time, (4) route of administration, (5) cold storage needs, (6) shelf life, (7) earliest age of full immunity, (8) adverse events frequency, and (9) efficacy of protection. To demonstrate the algorithm, variables (1) to (4) above were incorporated into a pilot binary-integer linear programming model that satisfied the recommended immunization schedule for diphtheria, tetanus, pertussis,