Cost Effectiveness of Meningococcal Serogroup B Vaccination in College-Aged Young Adults

Abstract

Introduction: Neisseria meningitidis serogroup B is the most common form of meningococcal infection in young adults in the U.S. Vaccines have recently become available, but it is not clear that the benefits outweigh the costs. The purpose of this study was to assess cost effectiveness and determine potentially favorable conditions for universal vaccination. Methods: Costs and benefits of universal vaccination at college entry versus no universal vaccination with an outbreak response were estimated in 2018 in the context of a mid-sized U.S.based 4-year college from both a health sector and a societal perspective. Probability, cost, and utility data were obtained from the published literature. Costs (2015 U.S.$) and benefits were discounted at 3%. One-way and multivariable probabilistic sensitivity analyses were performed including variations in the specific vaccine used. Further testing of the model's parameters at extremes was used to identify favorable conditions for universal vaccination.

Choosing a Mass Immunization Program against Meningococcal B

“…A recent study showed that the incremental cost per quality-adjusted life year gained with universal meningococcal B vaccination approached nearly $14 million, as compared with the usual willingness-to-pay benchmark threshold of $150,000 per quality-adjusted life year. 12 The second reason that only targeted immunization during an outbreak is preferable is supported by the study by Marshall et al published in this issue of the Journal. 6 Investigators from Australia immunized more than 20,000 15-to-18-year-old students with two doses of meningococcal B vaccines and showed that vaccination was not associated with a reduction in carriage -a finding that contrasts with the effect of the conjugate vaccines targeting serogroups A, C, W, and Y, which prevent colonization.…”

Canadian Association of Gastroenterology Clinical Practice Guideline for Immunizations in Patients With Inflammatory Bowel Disease (IBD)—Part 2: Inactivated Vaccines

“…Childhood vaccination would be cost-effective in areas with a high incidence of meningococcal disease. In contrast, universal meningococcal serogroup B vaccine was not shown to be cost-effective in infants or college-aged young adults ( 137 , 138 ).…”

“…This analysis assessed vaccination during an outbreak of IMD among men who have sex with men with or without human immunodeficiency virus infection. A 2018 analysis, found that universal serogroup B vaccination was not cost-effective in college-aged young adults ( 138 ). The incidence of IMD in Canada was estimated at 0.55 cases per 100,000 persons per years (2006–2011), with the greatest risk being in infants under 1 year of age ( 140 ).…”

Epidemiological impact and cost-effectiveness of universal meningitis b vaccination among college students prior to college entry

“…Though a recently published cost-utility analysis (CUA) by Leeds et al [ 7 ] reported that universal vaccination at college entry is not cost-effective, it did not estimate the number and severity of outbreaks reduced through vaccination or the cost-effectiveness of the intervention in outbreak-only scenarios. Other cost-effectiveness studies have been limited to pediatric populations in the UK [ 8 – 11 ], Germany [ 12 ], and non-comparable lower-income settings, such as the meningitis belt in Africa [ 13 – 15 ].…”