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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