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Editorial |

Varicella Vaccine, Cost-effectiveness Analyses, and Vaccination Policy

Matthew M. Davis, MD, MAPP
JAMA. 2005;294(7):845-846. doi:10.1001/jama.294.7.845.
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Has varicella vaccination been as cost-effective as anticipated when it was universally recommended for children 10 years ago? The answer is complicated and illuminates an evolving controversy regarding the role of cost-effectiveness analyses in deliberations over national vaccine recommendations.

In 1994, Lieu and colleagues1 estimated the cost-effectiveness of a universal childhood varicella vaccination program. Projecting a national vaccination rate of 97% by the sixth year of the program, they estimated a 94% reduction in varicella incidence, accompanied by an 89% reduction in direct medical costs. Accounting as well for reductions in the quantity of parents’ and other adults’ lost work time attributable to varicella (ie, the “indirect” benefits of vaccination), Lieu et al projected that a varicella vaccination program would save more than $5 for every $1 spent.1

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