Vaccine sleight of hand

July 18, 2010 by
Filed under: Opinion, Parents' Pages 

Every Child by Two proclaims that vaccines save money! Lots and lots of money!

Childhood Vaccines Save Lives and Money

But then, on the side of their web-page, is a link to a graphic illustration of the rising costs of childhood vaccination.

Looks like they want it both ways: “vaccines save billions” by reducing health care costs, preventing hospitalizations and doctor visits; BUT  “the newer vaccines are more expensive and we need to put a lot more tax dollars into vaccination programs.”

If the numbers with respect to “dollars saved” were solid and existed across the entire vaccine program, the argument would be a good one. Upon further scrutiny, it looks like they are pulling a bait and switch. They put forward some old numbers based on the less expensive vaccines combined with some inflated statistics for predicted epidemics (see the “33,000 deaths prevented” link above for our detailed analysis of these numbers), then slide right past the huge increase in the number and cost of vaccines in the current U.S. schedule.

On top of this, some of the newer vaccines are aimed at illnesses which are of low incidence or fairly mild in most children.  For example, Hepatitis B is very severe, but it isn’t common among infants born in the U.S. On the other side, chickenpox is usually a minor illness, although common. The chickenpox vaccine cost benefit justification actually depended on a monetary estimate of the cost of parental time lost from work. Some convoluted bookkeeping methods would be needed to demonstrate that universal vaccination with ALL of the vaccines on the current schedule results in overall health care savings. There is certainly no sign of these savings in the escalating cost of health insurance in the U.S.

The tipping point on the economic justification for vaccination probably occurred when the chickenpox vaccine was first added to the schedule.

The recently released varicella vaccine is effective and cost-effective. Routine immunization with one dose of varicella vaccine is now indicated for all children 12 months to 18 months of age. (emphasis added)

and this:

It is estimated that it would save $0.90/dollar spent and $5.40/dollar spent from payers’ and society’s perspectives, respectively. Thus varicella vaccination is cost-beneficial only when considered from a societal perspective. (emphasis added)

However, within just a few years (2006) vaccinated children were coming down with chickenpox in significant numbers:

The implementation of a routine childhood varicella vaccination program in the United States in 1995 has resulted in a dramatic decline in varicella morbidity and mortality. Although disease incidence has decreased, outbreaks of varicella continue to be reported, increasingly in highly vaccinated populations.

The answer was to recommend a booster in 2007.  How can you claim that the chickenpox vaccine is economically sound when the original numbers were marginal and then the price of the vaccine rises AND  the cost is doubled by the addition of a booster shot?  The same analysis could probably be carried out on several of the newer vaccines, and on some of the older vaccines where more doses have been added (and prices have been rising).

Here are the current costs for the overall childhood schedule, roughly pulled together. Because of combination vaccines, there are many different paths through the childhood schedule and total expense will vary depending on the choice of vaccine. Since we used the CDC price list [1], it  is probably worth noting that these costs are probably lower than the prices charged by doctor’s offices and clinics.

Childhood Vaccine Schedule and Costs

0-6 years of age [2]

Hepatitis B x 3 doses @ 43.56 = 130.58
Rotavirus x 3 doses @ 69.59 = 208.68
DTaP x 5 doses @ 23.05 = 115.25
Hib x 4 doses @ 22.77 = 91.08
Prevnar 13 x 4 doses * @ 108.75 = 435.00
IPV x 4 doses @ 24.70 = 98.80
Influenza x 6 doses * @ 11.00 = 66.00
MMR x 2 doses @ 48.31 = 96.62
Varicella x 2 doses @ 80.58 = 161.16
Hepatitis A x 2 doses @ 30.30 = 60.62

Grand Total for the first 6 years of childhood vaccines: $1,463.79
Notes: Children who have already received 4 doses of Prevnar 7 “should” receive a dose of Prevnar 13. The first round of Influenza vaccine involves two doses about 1 month apart. Do we count the first two doses as one or two?

7-18 years of age [2]

TDap x 1 dose @ 37.55 = 37.55

HPV

x 3 doses @ 130.27 = 390.81

MCV

x 1 dose @ 103.41 = 103.41

Influenza

x 12 doses @ 11.00 = 132.00

Hepatitis B

x 2 doses @ 23.20 = 46.40

Grand Total for older childhood and teen vaccines: $710.17

Total for the full schedule of childhood vaccines: $2173.96

Just in! Another dose of MCV has been added to the schedule ($103.41) upping the older children’s schedule to $813.58 and the total schedule to $2,277.37.

It never ends, two doses of Menactra may be added to the schedule, following approval by the FDA (April 2011). This adds 212.98 to the 0-6 schedule, bringing it up to $1,676.77 and the complete schedule goes up to $2,386.94, which is fairly impressive, I think, for an operation which is supposed to be just breaking even. Multiply this by millions of children every year…

We should also note that last year there were either one, or two extra doses of the flu vaccine required for the H1N1 pandemic. For 2009-10, therefore, add $22 to the total.

When you visit a doctor’s office or clinic, there are usually co-pays or administrative costs which boost the total. Of course it is rare for the parent to directly pay the fees–the high price of childhood vaccines hits us indirectly through medical insurance rate hikes and higher taxes.

Time for Every Child by Two to update their arithmetic.

[1] http://www.cdc.gov/vaccines/programs/vfc/cdc-vac-price-list.htm

[2] Vaccine schedules from the CDC: 0-6 and 7-18

Comments

7 Comments on Vaccine sleight of hand

  1. Autism on Wed, 21st Jul 2010 6:03 am
  2. Your Child is worth $2173.96 to Vaccine Makers…

    Inside Vaccines did the math. And don’t miss where they mention that the chicken pox vaccine has actually…

  3. admin on Thu, 22nd Jul 2010 5:55 am
  4. Peter on Fri, 23rd Jul 2010 1:38 am
  5. German vaccination critics published a paper about TETANUS- LIES, with some historical-medical investigation on the illness, symptoms and vaccination.

    They found out that science has not delivered enough evidence for a connection between bacteria and the illness in human organism and but there is enough evidence to question the vaccination and related “protection”.

    http://www.impfkritik.de/pressespiegel/2010071601.htm

    I think it is worth to check it with IV-eyes.

  6. admin on Fri, 23rd Jul 2010 5:54 am
  7. We will look into it. Since we are mostly americans, you do realize that we are not bilingual…

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  8. admin on Sat, 7th Aug 2010 3:12 pm
  9. admin on Sun, 14th Aug 2011 6:13 pm
  10. The saving money bit is getting weaker and weaker. From NPR:
    At an ACIP meeting in February, CDC director Thomas Frieden told members that his agency now spends more than $3.5 billion a year on vaccines for children. And he made it clear that he’s frustrated by the rising costs.

    “Most newer products and new formulations of old products have come at substantially higher prices,” Frieden said. “And we’ve also seen prices rising after initial federal contracts were set and prices failing to fall when vaccine schedules are compressed or a second vaccine manufacturer enters the market. These are not things we would expect under normal economic conditions.”

    http://www.npr.org/2011/07/20/138474107/rising-costs-complicate-vaccine-guidelines

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