Heesoo Joo1, Brian Maskery2, Tarissa Mitchell2, Andrew Leidner3, Alexander Klosovsky4, Michelle Weinberg2. 1. Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: hjoo@cdc.gov. 2. Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA. 3. Berry Technology Solutions, Immunization Services Division, Centers for Disease Control and Prevention, Atlanta, GA, USA. 4. International Organization for Migration, Washington D.C., USA.
Abstract
BACKGROUND: Vaccination Program for US-bound Refugees (VPR) currently provides one or two doses of some age-specific Advisory Committee on Immunization Practices (ACIP)-recommended vaccines to US-bound refugees prior to departure. METHODS: We quantified and compared the full vaccination costs for refugees using two scenarios: (1) the baseline of no VPR and (2) the current situation with VPR. Under the first scenario, refugees would be fully vaccinated after arrival in the United States. For the second scenario, refugees would receive one or two doses of selected vaccines before departure and complete the recommended vaccination schedule after arrival in the United States. We evaluated costs for the full vaccination schedule and for the subset of vaccines provided by VPR by four age-stratified groups; all costs were reported in 2015 US dollars. We performed one-way and probabilistic sensitivity analyses and break-even analyses to evaluate the robustness of results. RESULTS: Vaccination costs with the VPR scenario were lower than costs of the scenario without the VPR for refugees in all examined age groups. Net cost savings per person associated with the VPR were ranged from $225.93 with estimated Refugee Medical Assistance (RMA) or Medicaid payments for domestic costs to $498.42 with estimated private sector payments. Limiting the analyses to only the vaccines included in VPR, the average costs per person were 56% less for the VPR scenario with RMA/Medicaid payments. Net cost savings with the VPR scenario were sensitive to inputs for vaccination costs, domestic vaccine coverage rates, and revaccination rates, but the VPR scenario was cost savings across a range of plausible parameter estimates. CONCLUSIONS: VPR is a cost-saving program that would also reduce the risk of refugees arriving while infected with a vaccine preventable disease. Published by Elsevier Ltd.
BACKGROUND: Vaccination Program for US-bound Refugees (VPR) currently provides one or two doses of some age-specific Advisory Committee on Immunization Practices (ACIP)-recommended vaccines to US-bound refugees prior to departure. METHODS: We quantified and compared the full vaccination costs for refugees using two scenarios: (1) the baseline of no VPR and (2) the current situation with VPR. Under the first scenario, refugees would be fully vaccinated after arrival in the United States. For the second scenario, refugees would receive one or two doses of selected vaccines before departure and complete the recommended vaccination schedule after arrival in the United States. We evaluated costs for the full vaccination schedule and for the subset of vaccines provided by VPR by four age-stratified groups; all costs were reported in 2015 US dollars. We performed one-way and probabilistic sensitivity analyses and break-even analyses to evaluate the robustness of results. RESULTS: Vaccination costs with the VPR scenario were lower than costs of the scenario without the VPR for refugees in all examined age groups. Net cost savings per person associated with the VPR were ranged from $225.93 with estimated Refugee Medical Assistance (RMA) or Medicaid payments for domestic costs to $498.42 with estimated private sector payments. Limiting the analyses to only the vaccines included in VPR, the average costs per person were 56% less for the VPR scenario with RMA/Medicaid payments. Net cost savings with the VPR scenario were sensitive to inputs for vaccination costs, domestic vaccine coverage rates, and revaccination rates, but the VPR scenario was cost savings across a range of plausible parameter estimates. CONCLUSIONS: VPR is a cost-saving program that would also reduce the risk of refugees arriving while infected with a vaccine preventable disease. Published by Elsevier Ltd.
Authors: Margaret S Coleman; Heather M Burke; Bethany L Welstead; Tarissa Mitchell; Eboni M Taylor; Dmitry Shapovalov; Brian A Maskery; Heesoo Joo; Michelle Weinberg Journal: Hum Vaccin Immunother Date: 2017-01-09 Impact factor: 3.452
Authors: Clelia Pezzi; Audrey McCulloch; Heesoo Joo; Jennifer Cochran; Laura Smock; Ellen Frerich; Blain Mamo; Kailey Urban; Stephen Hughes; Colleen Payton; Kevin Scott; Brian Maskery; Deborah Lee Journal: Vaccine Date: 2018-02-01 Impact factor: 3.641
Authors: Charles Hui; Jessica Dunn; Rachael Morton; Lukas P Staub; Anh Tran; Sally Hargreaves; Christina Greenaway; Beverly Ann Biggs; Robin Christensen; Kevin Pottie Journal: Int J Environ Res Public Health Date: 2018-09-20 Impact factor: 3.390