Paediatric vaccination: the hidden costs

PharmacoEconomics & Outcomes News 285 - 21 Oct 2000

Paediatric vaccination: the hiddencosts

The hidden costs of paediatric vaccination aresubstantial, report investigators from KaiserPermanente, Oakland, California, and the Centers forDisease Control and Prevention, Atlanta, Georgia, US.

The investigators performed a cross-sectional surveyof 1657 caregivers of paediatric patients aged 1–8months who received vaccines at Northern CaliforniaKaiser Permanente between April and June 1997.*;† Theresults indicated that caregivers incur considerablepsychological and economic costs when their childrenreceive multiple injections during a single clinic visit orexperience adverse effects due to vaccination.

Multiple shots bring a cost . . .Caregivers reported that they would be willing to pay

a median of $US25 (1997 values) to reduce the numberof simultaneous injections that their charges wouldreceive from 4 to 3, or from 3 to 2, while still providingthe same level of disease protection. Caregivers saidthey would be willing to pay a median of $US50 toreduce the number of simultaneous injections from 2 to1.

If 4 injections had been due at a single clinic visit, 55%of caregivers indicated that they would have preferred <4 injections to be given at the first visit, and for theremaining injections to be given at a follow-up visit. Eachfollow-up visit had an estimated work-loss cost of$US30.

. . . as do adverse effects73% of caregivers reported that their charges

experienced ≥ 1 adverse event, mostly fussiness (46%),injection-site pain (35%) and fever (31%). Parentsreported that they would have been willing to pay amedian of $US50 to avoid these symptoms.Furthermore, vaccination-related adverse effectsincurred a total mean cost of $US7.70 per vaccinationvisit: $US2.91 in costs for clinic visits or telephone callsto advice nurses; $US4.05 in work-loss costs; and$US0.74 in direct nonmedical costs due to familiesrequiring transportation, parking or extra babysitting.* Data were collected by telephone interview 2 weeks after paediatricvaccination.† The vaccines included: diphtheria, tetanus, pertussis andHaemophilus influenzae type b vaccine (1269 injections); hepatitis Bvirus vaccine (1172); pneumococcal conjugate vaccine (< 639);diphtheria, tetanus and acellular pertussis vaccine (388); Haemophilusinfluenzae type b vaccine (383); inactivated poliovirus vaccine (266);and measles, mumps and rubella vaccine (2).

Lieu TA, et al. The hidden costs of infant vaccination. Vaccine 19: 33-41, 15 Aug2000 800846225

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PharmacoEconomics & Outcomes News 21 Oct 2000 No. 2851173-5503/10/0285-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved