Valutazione economica della vaccinazione antimorbillo-parotite-rosolia in relazione al livello di copertura vaccinale.

Objectives: To evaluate the cost-benefit ratio of measles-mumps-rubella vaccination in two Italian areas with different immunisation coverages. Design: On the basis of the epidemiologic patterns of the three diseases and vaccination were estimated. A hypothetical 5-years vaccination program for children between 2 and 6 years of age was designed for the two regions. Setting: Piemonte and Puglia regions from 1995 to 1999, with a MMR immunization coverage of 60% and 40%, respectively. Main outcome measures and results: The variation of the cost-benefit ratio of vaccination was related to immunization coverage (and residual morbidity), cost of the disease (especially indirect costs), efficacy of the vaccine. The ratio was >1 when coverage was moderate (40%) with high morbidity and low costs of the disease; with a 60% coverage a ratio of 0.70-0.90 was achieved. Conclusions: The analysis showed that the cost-benefit ratio is affected by several factors that can vary within the regional situations. While the cost of a prevented case can be low, public health strategies should also consider the cost of residual cases, which can be high when immunisation coverage or vaccine efficacy is low.