Economics of cardiac adverse events after smallpox vaccination: lessons from the 2003 US Vaccination Program.
ABSTRACT Of >39,000 civilian public health responders vaccinated against smallpox in 2003, 203 reported cardiovascular adverse events (CAEs). An association exists between the US vaccinia strain and myocarditis and/or pericarditis ("myo/pericarditis" [MP]). Other associations are inconclusive. We used surveillance and follow-up survey data of CAE case patients to estimate the resources used during the 2003 smallpox vaccination program and used a probabilistic model to estimate the potential costs of CAEs in a mass vaccination campaign. For every million adult vaccinees, 3001 CAEs (including 351 MP cases) would occur, with >92% in revaccinees. CAEs would require a median of 5934 outpatient visits, 1786 emergency department visits, 533 days in general wards, 132 days in intensive care units, 5484 cardiac enzymes tests, 3504 electrocardiograms, 3049 chemistry tests, 2828 complete blood counts, and 1444 transthoracic echocardiograms, among other procedures. CAEs would reduce productivity (15,969 work days lost) and cost $11 per vaccinee. In a mass vaccination campaign, the care of a sizable number of CAEs would be resource intensive.
SourceAvailable from: Robert Martin Jacobson[Show abstract] [Hide abstract]
ABSTRACT: Besides natural disasters and naturally occurring novel infectious diseases, nothing potentially threatens the health and stability of nations and health systems as much as the devastating threat and unfathomability of bioterrorism. Other than attempts at political solutions and interdictive attempts, only antimicrobials and vaccines offer possible means for protection. Of these, vaccines offer the most immediate and definitive of preventive solutions. Limiting the development and use of vaccines however are social, political, ethical, and economic considerations, and this article will provide a brief exploration of each of these issues and the intersection with the need for such vaccines. In this article we define bioterrorism as the deliberate use of naturally occurring or bioengineered microorganisms in order to cause harm to people, animals, or plants.Vaccine 11/2009; 27 Suppl 4:D23-7. DOI:10.1016/j.vaccine.2009.08.054 · 3.49 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: The following introduction describes the context in which the national smallpox vaccination program was implemented and highlights the significance of the key policy, programmatic, or scientific challenges, observations, and lessons learned that are presented in the articles that follow within this supplement to Clinical Infectious Diseases. Although the execution of this national program posed multiple complex and varied challenges, the focus of this supplement is on vaccine-associated adverse events and vaccine safety.Clinical Infectious Diseases 04/2008; 46 Suppl 3:S153-6. DOI:10.1086/524379 · 9.42 Impact Factor