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Assessing the Effectiveness and Cost-Benefit of Test-and-Vaccinate Policy for Supplementary Vaccination against Rubella with Limited Doses

Author

Listed:
  • Masaya M. Saito

    (The Institute of Statistical Mathematics, 10-3 Midori-cho, Tachikawa, Tokyo 190-8562, Japan
    Core Research for Evolutional Science and Technology (CREST), Japan Science and Technology Agency, 4-1-8 Honcho, Kawaguchi, Saitama 332-0012, Japan)

  • Keisuke Ejima

    (Institute of Industrial Science, The University of Tokyo, Tokyo 153-8505, Japan
    School of Public Health, Indiana University Bloomington, 1025 E 7th St #111, Bloomington, IN 47405, USA)

  • Ryo Kinoshita

    (Core Research for Evolutional Science and Technology (CREST), Japan Science and Technology Agency, 4-1-8 Honcho, Kawaguchi, Saitama 332-0012, Japan
    Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-9638, Japan)

  • Hiroshi Nishiura

    (Core Research for Evolutional Science and Technology (CREST), Japan Science and Technology Agency, 4-1-8 Honcho, Kawaguchi, Saitama 332-0012, Japan
    Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Kita-ku, Sapporo, Hokkaido 060-9638, Japan)

Abstract

Elevating herd immunity level against rubella is essential to prevent congenital rubella syndrome (CRS). Insufficient vaccination coverage left susceptible pockets among adults in Japan, and the outbreak of rubella from 2012 to 2013 resulted in 45 observed CRS cases. Given a limited stock of rubella-containing vaccine (RCV) available, the Japanese government recommended healthcare providers to prioritize vaccination to those confirmed with low level of immunity, or to those likely to transmit to pregnant women. Although a test-and-vaccinate policy could potentially help reduce the use of the limited stockpile of vaccines, by selectively elevating herd immunity, the cost of serological testing is generally high and comparable to the vaccine itself. Here, we aimed to examine whether random vaccination would be more cost-beneficial than the test-and-vaccinate strategy. A mathematical model was employed to evaluate the vaccination policy implemented in 2012–2013, quantifying the benefit-to-cost ratio to achieve herd immunity. The modelling exercise demonstrated that, while the test-and-vaccinate strategy can efficiently achieve herd immunity when stockpiles of RCV are limited, random vaccination would be a more cost-beneficial strategy. As long as the herd immunity acts as the goal of vaccination, our findings apply to future supplementary immunization strategy.

Suggested Citation

  • Masaya M. Saito & Keisuke Ejima & Ryo Kinoshita & Hiroshi Nishiura, 2018. "Assessing the Effectiveness and Cost-Benefit of Test-and-Vaccinate Policy for Supplementary Vaccination against Rubella with Limited Doses," IJERPH, MDPI, vol. 15(4), pages 1-12, March.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:4:p:572-:d:137586
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    References listed on IDEAS

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    1. Carol Y. Lin, 2008. "Modeling Infectious Diseases in Humans and Animals by KEELING, M. J. and ROHANI, P," Biometrics, The International Biometric Society, vol. 64(3), pages 993-993, September.
    2. Pedro Plans, 2010. "Prevalence of Antibodies Associated with Herd Immunity: A New Indicator to Evaluate the Establishment of Herd Immunity and to Decide Immunization Strategies," Medical Decision Making, , vol. 30(4), pages 438-443, July.
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    Cited by:

    1. Kazuki Shimizu & Ayaka Teshima & Hiromi Mase, 2020. "Measles and Rubella during COVID-19 Pandemic: Future Challenges in Japan," IJERPH, MDPI, vol. 18(1), pages 1-11, December.
    2. Taishi Kayano & Hyojung Lee & Hiroshi Nishiura, 2019. "Modelling a Supplementary Vaccination Program of Rubella Using the 2012–2013 Epidemic Data in Japan," IJERPH, MDPI, vol. 16(8), pages 1-11, April.

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