Clin Exp Vaccine Res.  2017 Jul;6(2):120-127. 10.7774/cevr.2017.6.2.120.

Static model simulation for routine mumps vaccination in Japan: with a result of mumps-related complications in a Japanese community hospital

Affiliations
  • 1Department of Pediatrics, Nara Prefecture General Medical Center, Nara City, Japan. taito.kitano0110@gmail.com

Abstract

PURPOSE
Mumps vaccine has not been included in the routine national immunization program in Japan, leading to low vaccine coverage rates and periodic epidemics approximately every 5 years. Our hospital (a secondary community hospital in Japan) experienced an increased number of mumps-related complications with a nationwide epidemic in 2016. Using previously reported data and mumps-related cases in our hospital, we estimated the cost-effectiveness of routine mumps vaccination in Japan with a static model using current epidemiologic data.
MATERIALS AND METHODS
With a decision tree flowchart of mumps infection and adverse events, we estimated the burden of mumps-related complications in our hospital for 5 years, and calculated the current annual national burden. Finally, we compared the current burden and assumptive burden of the stable state after routine vaccination in Japan using a static model.
RESULTS
The cost-benefit ratios with sensitivity analysis were 3.69 (1.08-9.52) and 6.84 (1.51-23.73) in independent inoculation and simultaneous inoculation, respectively, from a social perspective in addition to an annual gain of 9,487 (3,227-14,659) quality adjusted life years.
CONCLUSION
We contributed additional evidence in terms of cost-effectiveness that routine mumps vaccination should be introduced in Japan with simultaneous inoculation.

Keyword

Mumps vaccine; Immunization program; Cost-benefit analysis; Quality adjusted life years

MeSH Terms

Asian Continental Ancestry Group*
Cost-Benefit Analysis
Decision Trees
Hospitals, Community*
Humans
Immunization Programs
Japan*
Mumps Vaccine
Mumps*
Quality-Adjusted Life Years
Software Design
Vaccination*
Mumps Vaccine

Figure

  • Fig. 1 Decision tree flowchart of mumps infection and adverse events due to vaccination.

  • Fig. 2 Mumps-related complication cases in Nara Prefecture General Medical Center (2012-2016) and estimated overall number of patients in Japan. The overall number of patients in Japan was estimated using Japanese epidemiologic data.

  • Fig. 3 Sensitivity analysis. The figure plots worst and best scenarios for each parameter of vaccine cost (4,000 to 8,000 per dose), vaccine coverage rate (80%, 70% to 99%, and 99% for first and second doses, respectively), reduction rate of patients after routinization (70% to 99.9%), burden of each complication of natural infection (-50% to +50%), and incidence of adverse events after vaccination (-50% to +50%). JPY, Japanese Yen.


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