Abstract
To ascertain the economic feasibility of a pediatric tetravalent dengue vaccine, we developed and calibrated a cost-effectiveness model of vaccinating children at 15 months in Southeast Asia and Panama using a societal perspective. We assumed that full immunization would require two doses. In Southeast Asia, the gross cost per vaccinee would be US $8.28. Due to projected savings in dengue treatment, the net cost per capita would be 89% below the gross cost. The cost per disability adjusted life year (DALY) saved by a pediatric vaccine would be $50, making the potential vaccine highly cost-effective. In Panama, where we assumed a higher price per dose ($5), the gross cost per vaccinee would be $19.70 for infants and $26.70 in a catch up program for adults. As projected treatment costs are higher, however, averaging $154.27 when discounted to the time of vaccination, the estimated cost offsets would be 178% of vaccination costs for infants and 138% for adults. Thus the dengue vaccination appears to be cost saving under our most likely assumptions. Many uncertainties remain, however, until more epidemiological and economic data are obtained and vaccine development proceeds further.