钩端螺旋体外膜疫苗大规模预防接种可行性评价

Evaluation on Feasibility of Comprehensive Use of the Leptospiral Outer Membrane Vaccine

钩端螺旋体 (钩体 )外膜疫苗的免疫效果和保护率比较理想 ,但经济学研究结果显示其各年龄组的成本效益指标均 <1,预防 1例病人费用均多于人均疾病的经济负担 ,成本效果指标均 >0 ,说明钩体外膜疫苗的接种未取得较好的经济效益 ,免疫预防钩体病需投入额外的卫生资源。从灵敏度分析结果显示 ,如发病率提高或人均医疗费用增加将使某些成年人的成本效益和成本效果指标达到或接近正向指标。灵敏度分析结果也提示 ,在目前的社会经济条件下 ,作为主要面向农民的钩体外膜疫苗要想取得较好的经济效益和效果 ,则必须从进一步提高疫苗质量 ,延长钩体外膜疫苗的保护期或增加保护型别 ,同时降低钩体疫苗的价格。另外 ,疾病预防控制 (卫生防疫 )机构要有针对性的使用钩体外膜疫苗 。

The protective efficacy of leptospiral outer membrane vaccine is comparatively satisfactory,but the result of economic evaluation showed that the benefit-cost ratio(BCR) in every age group was all less than 1,the cost of preventing one case in every age group was all bigger than the disease burden of everyone,the cost effective ratio (CER) of every age group was all bigger than 0 This meant that the inoculation of leptospiral outer membrane vaccine did not get positive economic results,and it would need more health resource to prevent leptospiral disease The sensitivity analysis showed that if the morbidity or the therapy cost of leptospiral increased,the economic results in some adult groups could be positive The sensitivity analysis results also suggested that if we want to get the positive economic results of the vaccine facing the farmers,we should cut down the price,improve the quality and prolong the protective time of the vaccine or increase the protective serotypes It is also suggested that the preventive organization should use the vaccine more carefully,such as inoculating the vaccine in adults in the high risk areas,or inoculating the vaccine to those who will join fighting flood before the flood coming