2013-2020年青岛市适龄儿童水痘疫苗免费接种策略实施期间成本-效益分析

Cost-benefit analysis on free varicella vaccination strategy for children in Qingdao city from 2013 to 2020

目的评估2013-2020年青岛市适龄儿童水痘疫苗免费接种策略实施期间的成本-效益。方法通过山东省预防接种信息系统收集2013年7月1日-2020年12月31日青岛市水痘疫苗接种数据;通过水痘患病儿童的专项调查,获得水痘病例经济负担数据。分为两个免疫策略阶段,第一阶段为2013年7月1日-2016年6月30日,对2012年7月1日以后出生的满1周岁儿童免费接种一剂次水痘疫苗;第二阶段为2016年7月1日-2020年12月31日,为在第一阶段的基础上,对2012年7月1日以后出生的满4周岁儿童免费接种第二剂次水痘疫苗。根据青岛市免费水痘疫苗接种数据和接种成本,测算不同免疫策略阶段接种成本;通过专项调查,获得水痘病例经济负担数据;再结合以上数据计算不同免疫策略阶段成本效果比和成本效益比。结果两个阶段中接种一剂次和接种两剂次的接种成本分别为0.75亿元和0.46亿元;水痘门诊病例占96.30%,人均经济负担2895.53元;仅接种一剂次的成本效果比为0.89∶1,成本效益比为23.52∶1;接种两剂次的成本效果比为0.94∶1,成本效益比25.89∶1。结论青岛市适龄儿童两剂次水痘疫苗接种的经济效益及社会效益均优于一剂次接种。

Objective To evaluate the cost-effectiveness of the free varicella vaccination strategy for school-age children in Qingdao city from 2013 to 2020.Methods Data on varicella vaccination in Qingdao city were collected from July 1,2013-December 31,2020 through the Shandong Province Preventive Vaccination Information System;data on the economic burden of varicella cases were obtained through a special survey of varicella-affected children.It was divided into two immunization strategy phases,the first phase was from July 1,2013 to June 30,2016,and one dose of varicella vaccine was given free of charge to children who were born after July 1,2012 and reached 1 year of age.The second phase was July 1,2016-December 31,2020,based on the first phase,the second dose of varicella vaccine was given free of charge to children who were born after July 1,2012 and had reached the age of 4 years.According to the vaccination data and cost of free varicella vaccine in Qingdao city,the vaccination cost of different immunization strategies was calculated.Data on economic burden of varicella cases were collected through special surveys.The cost-effectiveness ratio and cost-benefit ratio of different immunization strategies were calculated based on the above data.Results The cost of one dose and two doses in the two phases were 75 million yuan and 46 million yuan,respectively.The outpatient cases of varicella accounted for 96.30%,and the average economic burden was 2895.53 yuan per person.The cost-effectiveness ratio of one dose was 0.89∶1,and the cost-benefit ratio was 23.52∶1.The cost-effectiveness ratio of two doses was 0.94∶1,and the cost-benefit ratio was 25.89∶1.Conclusion Two-dose varicella vaccination is superior to one-dose vaccination in both economic and social benefits.