Economic evaluation of universal BCG vaccination of Japanese infants

Mahbubur Rahman, Miho Sekimoto, Isamu Takamatsu, Kenji Hira, Takuro Shimbo, Kyoichiro Toyoshima, Tsuguya Fukui

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background. The international controversy surrounding the use and effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine and the low incidence of tuberculosis (TB) among Japanese children prompted this study. Methods. We compared 'universal BCG vaccination' with 'no vaccination at all' using a cost-effectiveness analysis. The study population was a hypothetical cohort comprising a total of 1.2 million infants born in 1996 at locations all over Japan. A model was developed to calculate the number of TB cases prevented by the vaccination programme. Assuming 40-80% overall vaccine efficacy (64-86% for TB-meningitis) and 10 years of protection, we calculated the cost and number of immunizations required to prevent one child from developing TB, the total number of TB cases averted by vaccination and total costs required for the programme. Results. Based on an assumption of flexible vaccine efficacy (40-80%), we estimated that 111-542 TB cases including 10-27 of TB-meningitis would be prevented during the 10 years after BCG vaccination among the cohort of infants born in 1996. About US$35 950-175 862 or 2125-10 399 immunizations would be required to prevent one child from developing TB. Sensitivity analyses covering a wide duration of protection, incidence of TB, vaccine coverage and discount rate, revealed that other than vaccine efficacy, the cost of preventing a single case of TB is highly sensitive to the duration of BCG protection and TB incidence. Conclusion. The cost per case of TB prevented is heavily dependent on vaccine efficacy and the duration of protection, and is high compared with the cost of treating one child who has developed TB.

Original languageEnglish (US)
Pages (from-to)380-385
Number of pages6
JournalInternational Journal of Epidemiology
Volume30
Issue number2
StatePublished - 2001
Externally publishedYes

Fingerprint

Bacillus
Cost-Benefit Analysis
Vaccination
Tuberculosis
Costs and Cost Analysis
Vaccines
Meningeal Tuberculosis
Immunization
Incidence
Tuberculosis Vaccines
BCG Vaccine
Japan

Keywords

  • Bacillus Calmette-Guérin (BCG)
  • Cost-effectiveness analysis
  • Japan
  • Tuberculosis
  • Vaccine

ASJC Scopus subject areas

  • Epidemiology

Cite this

Rahman, M., Sekimoto, M., Takamatsu, I., Hira, K., Shimbo, T., Toyoshima, K., & Fukui, T. (2001). Economic evaluation of universal BCG vaccination of Japanese infants. International Journal of Epidemiology, 30(2), 380-385.

Economic evaluation of universal BCG vaccination of Japanese infants. / Rahman, Mahbubur; Sekimoto, Miho; Takamatsu, Isamu; Hira, Kenji; Shimbo, Takuro; Toyoshima, Kyoichiro; Fukui, Tsuguya.

In: International Journal of Epidemiology, Vol. 30, No. 2, 2001, p. 380-385.

Research output: Contribution to journalArticle

Rahman, M, Sekimoto, M, Takamatsu, I, Hira, K, Shimbo, T, Toyoshima, K & Fukui, T 2001, 'Economic evaluation of universal BCG vaccination of Japanese infants', International Journal of Epidemiology, vol. 30, no. 2, pp. 380-385.
Rahman M, Sekimoto M, Takamatsu I, Hira K, Shimbo T, Toyoshima K et al. Economic evaluation of universal BCG vaccination of Japanese infants. International Journal of Epidemiology. 2001;30(2):380-385.
Rahman, Mahbubur ; Sekimoto, Miho ; Takamatsu, Isamu ; Hira, Kenji ; Shimbo, Takuro ; Toyoshima, Kyoichiro ; Fukui, Tsuguya. / Economic evaluation of universal BCG vaccination of Japanese infants. In: International Journal of Epidemiology. 2001 ; Vol. 30, No. 2. pp. 380-385.
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AU - Fukui, Tsuguya

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