Cost-Benefit Analysis of a Chlamydia trachomatis Vaccine Program in Adolescent Girls in the United States

J Pediatric Infect Dis Soc. 2018 Dec 3;7(4):296-302. doi: 10.1093/jpids/pix072.

Abstract

Background: With >1.4 million cases in the United States reported to the Centers for Disease Control and Prevention in 2012, Chlamydia trachomatis infection is a major public health concern. We examined the impact of a C trachomatis vaccination program using a decision-analysis model to estimate the effects of vaccination on C trachomatis-associated costs and morbidity.

Methods: We developed a Markov model considering a cohort of 2158117 US females aged 9 to 26 years. Morbidity, death, and healthcare-associated costs associated with chlamydial infection of mothers and fetuses/neonates were calculated over a 17-year time frame. We developed 2 major comparison arms, namely, a C trachomatis vaccination program and no C trachomatis vaccination program. Base-case efficacy and coverage were set to those of human papillomavirus in the United States with all variables, including efficacy and coverage, ranged in sensitivity analyses.

Results: On the basis of a base-case analysis, a vaccination program would cost an estimated $710 million for a cohort of 2158117 women over a 17-year period, an increase of $41 million over having no vaccination program. A vaccination program would prevent 34000 cases of C trachomatis infection and 5976 cases of pelvic inflammatory disease.

Conclusions: A C trachomatis vaccination program results in increased cost to the healthcare system but averts significant morbidity and death.

MeSH terms

  • Adolescent
  • Adult
  • Bacterial Vaccines / economics*
  • Bacterial Vaccines / therapeutic use*
  • Child
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / prevention & control*
  • Chlamydia Infections / transmission
  • Chlamydia trachomatis*
  • Cost-Benefit Analysis*
  • Decision Support Techniques*
  • Decision Trees
  • Female
  • Health Care Costs
  • Humans
  • Markov Chains
  • Mass Vaccination / economics*
  • Monte Carlo Method
  • United States / epidemiology
  • Young Adult

Substances

  • Bacterial Vaccines