Epidemiology and Infection

Economic evaluation of options for measles vaccination strategy in a hypothetical Western European country

Ph. BEUTELS a1c1 and N. J. GAY a2
a1 Centre for the Evaluation of Vaccination, Department of Epidemiology and Community Medicine, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
a2 Immunisation Division, Communicable Disease Surveillance Centre, Public Health Laboratory Service, London, UK


In this study an analysis was made of economic costs and medical effects (by cost-effectiveness and cost–benefit analysis) associated with measles vaccination in a hypothetical Western European country. We analysed ten vaccination options in terms of past and future vaccination coverage. We show that several of the proposed strategies for improving measles vaccination coverage are preferable to maintaining the existing policies, regardless of past coverage and the viewpoint of the analysis. For society, very high coverage (95%) two-dose vaccination is most optimal, irrespective of past vaccination coverage. The addition of a one-time campaign (to reduce susceptibility in (pre-)adolescent age groups) to such a high coverage two-dose vaccination programme is cost-saving to the health-care payer and to society when coverage in the past was low ([less-than-or-eq, slant]70%). Even when coverage in the past was high (90%) for more than a decade, this ‘maximum strategy’ could be implemented at an acceptable cost to the health-care payer (incremental direct costs per discounted life-year gained <€30000), and at net savings to society.

(Accepted October 31 2002)

c1 Author for correspondence.