Meningococcal vaccine use in college students

Immunizations for the college student: a campus perspective of an outbreak and national and international considerations

Although vaccine-preventable diseases have declined to record-low levels in the United States, infectious disease "epidemics" on college campuses continue. A large student body with variable immunization status makes a college campus fertile ground for the spread of communicable diseases. The presence of international students and an increasingly large number of students traveling abroad make it essential that individuals charged with defining and instituting health-related policies for the university have knowledge about health issues occurring in foreign countries as well. Several safe and effective vaccines are available that offer protection to young adults from a variety of infectious diseases in the United States. Because vaccine-preventable diseases can cause both human and economic problems for colleges and universities, administrators should take steps to assure that the students on college campuses benefit from these vaccines.

Assessing the economics of vaccination forNeisseria meningitidisin industrialized nations: A review and recommendations for further research

Objectives:To review the existing health economic literature on meningococcal disease vaccination.

Methods:A Medline search for economic evaluations of vaccination programs for meningococcal disease in developed countries was conducted. All identified studies were reviewed.

Results:Nine published studies were identified examining either mass vaccination during outbreaks or routine vaccination. Although net expenses were estimated in almost all studies, the resulting cost-effectiveness ratios varied widely. Vaccination of college-age students was found to be potentially cost-effective in Australia but not in the United States. With one exception, routine vaccination of children and adolescents in Europe was predicted to be cost-effective. Many simplifying assumptions were made, and important elements were often left out, in particular the potential for reduced transmission of disease.

Conclusions:The methods used and the vaccination strategies vary widely, and results do not provide strong grounds for making conclusions as to whether vaccination is cost-effective. Furthermore, in all instances, transmission of disease, changes in population carriage rates, and outbreaks are either ignored, dealt with using very broad simplifying assumptions, or are not necessarily generalizable to other settings. The analyses provide some insight into the potential cost-effectiveness of vaccination, but more importantly, they highlight areas requiring further study. Economic evaluations based on observed outcomes from recently implemented strategies would be helpful, as would more sophisticated health economic models. The choice of vaccination strategies cannot be based on the results of existing economic analyses.

Should university students be vaccinated against meningococcal disease in Canada?

OBJECTIVE

To evaluate the benefit and costs of vaccination of university students against invasive meningococcal disease (IMD) in Canada.

METHODS

Published studies were reviewed and a simulation model was used.

RESULTS

IMD risk seems to be of low magnitude, but consequences can be dramatic. Over a 10-year period, IMD risk reduction would be slightly greater using a monovalent C conjugate vaccine than a quadrivalent polysaccharide vaccine. From a societal perspective, costs per quality-adjusted life-years gained would be between $135,000 and $698,000, according to epidemiological scenarios and with vaccine purchase prices between $35 and $50 per dose.

CONCLUSIONS

Economic indices exceed proposed criteria for cost effective public health programs, but from the perspective of students and parents, the cost of vaccination might be worth the benefit.