An Economic Analysis of Mumps Vaccination in Fiji: Static Model Simulation of Routine Measles-Mumps-Rubella (MMR) Vaccination Instead of Current Measles-Rubella (MR) Vaccination.

Chunghyeon Oh,Damin Jun,Eric Rafai,Seungman Cha,Yinseo Cho

doi:10.3390/ijerph19031861

Abstract

Mumps remains endemic in Fiji, with 7802 cases reported between 2016 and 2018. The introduction of mumps vaccination has been discouraged due to perceptions of mumps as a self-limited disease and the perceived high cost of mumps vaccines. We estimated the benefits and costs of introducing a mumps vaccination program in Fiji. First, we estimated the burden of mumps and mumps-related complications in Fiji based on the reported cases in the Fiji National Notifiable Disease Surveillance System between 2016 and 2018. We then developed a static simulation model with stable mumps herd immunity after routine measles–mumps–rubella (MMR) vaccination. Finally, we compared the estimated economic burden of mumps with current MR vaccination and the assumptive burden of the stable-state simulation model after routine MMR vaccination. The benefit–cost ratios (BCRs) were 2.65 from the taxpayer view and 3.00 from the societal view. A probabilistic sensitivity analysis indicated that the 1st and 99th percentiles of BCRs were 1.4 and 5.2 from the taxpayer’s perspective and 1.5 and 6.1 from the societal perspective. From both the taxpayer and societal perspectives, the probability of BCRs greater than 1.0 was 100%. A routine MMR program has value for money from both the taxpayer and societal perspectives. MMR vaccination should be urgently introduced in Fiji.

Highlights

We developed a static simulation model with stable mumps herd immunity state developed a static simulation model with stable mumps herd immunity state after after routine MMR vaccination
Our research shows that a two-dose regular MMR immunization program would be worthwhile in Fiji in terms of the benefit–cost ratio
Considerable benefits were suggested in many other countries such as Austria (3.6), the USA (7.4), Israel (5.9) and Japan (5.9) [17,18,35]

Summary

Introduction

Mumps is a viral infection in humans that primarily affects the salivary glands. The majority of mumps cases can be cured naturally without receiving specific treatment, some cases have severe complications such as aseptic meningitis, encephalitis, and hearing loss [1,2]. As of December 2018, the mumps vaccine is on the routine immunization schedule in 122 countries [3]. Immunization has dramatically reduced the incidence of mumps [4–9]. Mumps outbreaks have been reported every 3 to 5 years, with case counts ranging from 100 to 1000 per 100,000 population, in countries without regular mumps vaccination programs [4]. A country with no routine mumps vaccination program, has seen cyclic mumps outbreaks in recent years. From October 2016 through September 2017, more than

Objectives

Methods

Results

Conclusion