Using recently published information, we examined the experience of a hypothetical cohort of 1 million children followed up from birth to 6 years of age without and with a pertussis vaccination program. Costs associated with death or lost wages were not estimated. A vaccination program reaching 90% of children would reduce disease incidence and disease-related costs by 90%. Taking into account costs associated with vaccine and vaccine reactions, the costs are reduced 82%. The ratio of overall costs without a program to those with a program is 5.7:1. The benefit-cost ratio is 11.1:1. Because we did not include indirect costs, this is a conservative estimate. Until improved vaccines are available, continued use of our present vaccines, with careful attention to possible contraindications, seems the only prudent course to follow.
Hinman AR, Koplan JP. Pertussis and Pertussis VaccineReanalysis of Benefits, Risks, and Costs. JAMA. 1984;251(23):3109-3113. doi:10.1001/jama.1984.03340470035022