The risks, costs, and benefits of possible future global policies for managing polioviruses.

Abstract:

OBJECTIVES:We assessed the costs, risks, and benefits of possible future major policy decisions on vaccination, surveillance, response plans, and containment following global eradication of wild polioviruses. METHODS:We developed a decision analytic model to estimate the incremental cost-effectiveness ratios and net benefits of risk management options for polio for the 20-year period and stratified the world according to income level to capture important variability between nations. RESULTS:For low-, lower-middle-, and upper-middle-income groups currently using oral poliovirus vaccine (OPV), we found that after successful eradication of wild polioviruses, OPV cessation would save both costs and lives when compared with continued use of OPV without supplemental immunization activities. We found cost-effectiveness ratios for switching from OPV to inactivated poliovirus vaccine to be higher (i.e., less desirable) than other health investment opportunities, depending on the actual inactivated poliovirus vaccine costs and assumptions about whether supplemental immunization activities with OPV would continue. CONCLUSIONS:Eradication promises billions of dollars of net benefits, although global health policy leaders face difficult choices about future policies. Until successful eradication and coordination of posteradication policies, health authorities should continue routine polio vaccination and supplemental immunization activities.

journal_name

Am J Public Health

authors

Thompson KM,Tebbens RJ,Pallansch MA,Kew OM,Sutter RW,Aylward RB,Watkins M,Gary HE Jr,Alexander J,Jafari H,Cochi SL

doi

10.2105/AJPH.2007.122192

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

1322-30

issue

7

eissn

0090-0036

issn

1541-0048

pii

AJPH.2007.122192

journal_volume

98

pub_type

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