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August 17, 2005

Varicella Vaccine, Cost-effectiveness Analyses, and Vaccination Policy

Author Affiliations

Author Affiliations: Child Health Evaluation and Research Unit, Division of General Pediatrics, Division of General Internal Medicine, and the Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor.

JAMA. 2005;294(7):845-846. doi:10.1001/jama.294.7.845

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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