Review: The average cost of measles cases and adverse events following vaccination in industrialised countries
Filed under: Article Reviews, Vaccine Science, Vaccine/Disease Analysis
One of our readers posted a comment asking us: “Can you tease out some facts in this study?” We think we could probably write several papers discussing the issues surrounding this study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC128813/ but we will provide a brief summary because a study such as this isn’t worth spending an inordinate amount of time on.
We are going to make a few opening caveats:
1) Some of us believe that measles might be the only vaccine that is justifiable on a large population basis and that is only because there is some evidence that measles can have a relatively high (still low on an absolute basis) rate of serious side effects in some populations.
2) Cost justification studies (such as this) are usually based on a house of cards, and are only as good as the data that underlies the layers of assumptions made in the model.
3) Cost justification studies that are used to support mass vaccination mandates almost invariably turn out to be wrong due to underestimating the cost of the vaccine program and side-effects and overestimating the effectiveness of the vaccines.
4) These studies are often misleading because they are usually sensitive to a few key assumptions and they normalize everything to a dollar value. Here is a sample problem with normalizing everything to a dollar value: let us imagine we have two different vaccines that we want to give to 1 million people. In the testing, 50% of the people suffered 3 days of mild illness causing missed work with no long term effects from vaccine A. 1 person died from vaccine B with no one else suffering any ill effects. The cost of vaccine A would be far higher in almost any financial model, and yet clearly we would much rather fall mildly ill for 3 days rather than risk a 1 in a million chance of dying.
This particular study is interesting in that it is not actually performing a cost comparison or justification. It is only trying to set the cost of a measles case and the cost of a measles vaccine reaction. In order to judge the likelihood of bias in a study, a quick check on the authors reveals that although there are no direct conflicts of interest declared, several of them work for organizations which were desperate to defend the MMR vaccine in the wake of the Wakefield papers from around that time period. There is nothing wrong with that, but it provides context for the timing, content, and potential bias’ of the study. Read more
Vaccination with the full CDC-endorsed schedule of vaccines is presented as our absolute best choice to protect and nurture the health of our precious children. Vaccines are believed to be so important that they are mandated , subsidized , and protected by a special court .
Recently, we published an article  that discussed the widely promoted claim that vaccines save society billions of dollar every year. Are there other measures that could save society a few billion bucks, and significantly reduce infant and child mortality, morbidity, and related health costs?
In April 2010, Pediatrics published an article, The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis . This analysis was a review of some of the findings contained in an exceptionally comprehensive report  that was published in 2007 by the Agency for Healthcare Research and Quality (AHRQ). The Pediatrics paper determined that if:
“90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess of 911 deaths, nearly all of which would be infants…”
Almost 1,000 excess infant deaths every year, and a cumulative total of $130 billion in costs in 10 years. Low breastfeeding rates in the US should obviously be cause for serious concern. Note that the authors only considered three diseases, none of which are communicable or have vaccines available; necrotizing enterocolitis, otitis media, and gastroenteritis. Pediatrics did not publish new evidence, but simply analyzed data contained in the AHRQ report, which cited numerous studies favoring breastfeeding. Read more