The Risks, Costs, and Benefits of Possible Future Global Policies for Managing Polioviruses
- 1 July 2008
- journal article
- Published by American Public Health Association in American Journal of Public Health
- Vol. 98 (7), 1322-1330
- https://doi.org/10.2105/ajph.2007.122192
Abstract
Objectives. We assessed the costs, risks, and benefits of possible future major policy decisions on vaccination, surveillance, response plans, and containment following global eradication of wild polioviruses. Methods. We developed a decision analytic model to estimate the incremental cost-effectiveness ratios and net benefits of risk management options for polio for the 20-year period and stratified the world according to income level to capture important variability between nations. Results. For low-, lower-middle-, and upper-middle-income groups currently using oral poliovirus vaccine (OPV), we found that after successful eradication of wild polioviruses, OPV cessation would save both costs and lives when compared with continued use of OPV without supplemental immunization activities. We found cost-effectiveness ratios for switching from OPV to inactivated poliovirus vaccine to be higher (i.e., less desirable) than other health investment opportunities, depending on the actual inactivated poliovirus vaccine costs and assumptions about whether supplemental immunization activities with OPV would continue. Conclusions. Eradication promises billions of dollars of net benefits, although global health policy leaders face difficult choices about future policies. Until successful eradication and coordination of posteradication policies, health authorities should continue routine polio vaccination and supplemental immunization activities.Keywords
This publication has 52 references indexed in Scilit:
- Uncertainty and Sensitivity Analyses of a Decision Analytic Model for Posteradication Polio Risk ManagementRisk Analysis, 2008
- The Costs of Future Polio Risk Management PoliciesRisk Analysis, 2006
- Risk Management in a Polio‐Free WorldRisk Analysis, 2006
- Retrospective Cost‐Effectiveness Analyses for Polio Vaccination in the United StatesRisk Analysis, 2006
- The cost-effectiveness of alternative polio immunization policies in South AfricaVaccine, 2006
- A Dynamic Model of Poliomyelitis Outbreaks: Learning from the Past to Help Inform the FutureAmerican Journal of Epidemiology, 2005
- "Endgame" Issues for the Global Polio Eradication InitiativeClinical Infectious Diseases, 2002
- Cost-effectiveness analysis of changing from live oral poliovirus vaccine to inactivated poliovirus vaccine in AustraliaAustralian and New Zealand Journal of Public Health, 2001
- Eradication of Wild Poliovirus from the Americas: Wild Poliovirus Surveillance-Laboratory IssuesThe Journal of Infectious Diseases, 1997
- Poliovirus Surveillance: Building the Global Polio Laboratory NetworkThe Journal of Infectious Diseases, 1997