BACKGROUND AND OBJECTIVES We evaluated the economic impact of routine childhood immunization in the United States, reflecting updated vaccine recommendations and recent data on epidemiology and coverage rates. METHODS An economic model followed the 2017 US birth cohort from birth through death; impact was modeled via a decision tree for each of the vaccines recommended for children by the Advisory Committee on Immunization Practices as of 2017 (with annual influenza vaccine considered in scenario analysis). Using information on historic prevaccine and vaccine-era incidence and disease costs, we calculated disease cases, deaths, disease-related healthcare costs, and productivity losses without and with vaccination, as well as vaccination program costs. We estimated cases and deaths averted because of vaccination, life-years and quality-adjusted life-years gained because of vaccination, incremental costs (2019 US dollars), and the overall benefit-cost ratio (BCR) of routine childhood immunization from the societal and healthcare payer perspectives. RESULTS Over the cohort's lifetime, routine childhood immunization prevented over 17 million cases of disease and 31 000 deaths; 853 000 life years and 892 000 quality-adjusted life-years were gained. Estimated vaccination costs ($8.5 billion) were fully offset by the $63.6 billion disease-related averted costs. Routine childhood immunization was associated with $55.1 billion (BCR of 7.5) and $13.7 billion (BCR of 2.8) in averted costs from a societal and healthcare payer perspective, respectively. CONCLUSIONS In addition to preventing unnecessary morbidity and mortality, routine childhood immunization is cost-saving. Continued maintenance of high vaccination coverage is necessary to ensure sustained clinical and economic benefits of the vaccination program.

中文翻译：

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2017 年美国出生队列中儿童免疫计划的价值。

背景和目标 我们评估了美国常规儿童免疫接种的经济影响，反映了最新的疫苗建议以及流行病学和覆盖率的最新数据。方法 采用 2017 年美国出生队列从出生到死亡的经济模型；截至 2017 年，免疫实践咨询委员会通过决策树对每种疫苗的影响进行建模（情景分析中考虑了年度流感疫苗）。利用历史上的疫苗前和疫苗时代发病率和疾病成本的信息，我们计算了疾病病例、死亡人数、与疾病相关的医疗保健成本、没有和有疫苗接种的生产力损失，以及疫苗接种计划的成本。我们估计了因接种疫苗而避免的病例和死亡，从社会和医疗保健支付者的角度来看，由于疫苗接种、增量成本（2019 美元）以及常规儿童免疫接种的总体收益成本比 (BCR) 而获得的生命年和质量调整生命年。结果 在整个队列的一生中，常规儿童免疫预防了超过 1700 万例疾病和 31000 例死亡；获得了 853 000 生命年和 892 000 质量调整生命年。估计的疫苗接种成本（85 亿美元）被 636 亿美元的疾病相关避免成本完全抵消。从社会和医疗保健支付者的角度来看，常规儿童免疫接种分别与 551 亿美元（BCR 为 7.5）和 137 亿美元（BCR 为 2.8）相关。结论 除了防止不必要的发病率和死亡率外，常规的儿童免疫接种是节省成本的。继续保持高疫苗接种覆盖率对于确保疫苗接种计划的持续临床和经济效益是必要的。