The question of whether students entering college should be routinely vaccinated against meningitis B (MenB) infection has been raised for years.
A new study published in the American Journal of Preventive Medicine offers an answer to that query. A computer-generated model developed by Johns Hopkins Medicine researchers supports the concept that providing universal vaccination against meningitis B infection to students entering college might be too costly to justify the number of cases prevented.
On the other hand, the study also suggests that if vaccine developers could significantly lower the price, universal immunization might be worth the expense on college campuses.
For the cost/benefit estimate, the study team determined the cost per quality-adjusted life year (QALY) to be $13.9 million if every entering college student in the United States were vaccinated. The report pointed out that, based on historic expenditures and previous research, society is generally willing to pay $150,000 per QALY.
That means if the vaccine series cost less than $65 versus the average current price of $324, universal vaccination could become feasible, according to the study authors.
“Despite the poor prognosis of MenB infection and the fairly reasonable cost of MenB vaccination, the extreme rarity of this infection even amongst its peak in college-age individuals makes universal vaccination cost-ineffective,” explained lead author Ira Leeds, MD, MBA, a postdoctoral research fellow in the Department of Surgery at the Johns Hopkins University School of Medicine. “Vaccinating 100,000 college students, for example, would prevent less than five cases of MenB. Health care systems and public health programs do not have unlimited funds and such a small benefit makes support of universal vaccination economically untenable, even when accounting for individual, payer and community outbreak costs and productivity lost by society.”
For the computerized “decision tree” algorithm, researchers compared the cost per case averted by universal vaccination of incoming students at a midsize U.S. 4-year college. Those calculations were compared to an informal, “random” vaccination program similar to what this population might do if left to decide on its own whether to vaccinate. Each “student” in the model was assumed to be at equal risk for MenB infection and to be entering college at age 18 years in generally good health.
The researchers emphasized that the vaccine is safe and effective, and that it should remain accessible and an individual option, adding that those at high risk because of compromised immune systems or other preexisting medical conditions definitely should consider receiving the MenB vaccination.
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