Cost-benefit analysis of tetanus prophylaxis by a mathematical model.

A mathematical model has been developed which allows estimation of the epidemiological and economic effects of different tetanus vaccination strategies. The model was used to simulate the epidemiology of tetanus in Italy from 1955 to 1982, and then applied to a district of Tuscany by utilizing data obtained from a seroepidemiological survey carried out in the same area. For this district we simulated vaccination programmes designed to reach, within 1 or 10 years, coverages of 60 or 90% of the population aged over 10 years who had not been exposed to the neonatal vaccination programme. The most effective strategy, from both the epidemiological and economic point of view, seems to be 90% coverage reached in 1 year's time. Benefits would be increased by improving the reliability of vaccinal anamnesis.