AN ECONOMIC-EVALUATION OF VARICELLA VACCINE FOR PEDIATRIC LIVER AND KIDNEY-TRANSPLANT RECIPIENTS

To evaluate the potential benefit of varicella vaccine for pediatric l iver and kidney transplant patients, we determined the consequences of varicella susceptibility for a cohort of susceptible children (n = 44 ) who received transplants between July 1986 and June 1990 at the Hosp ital for Sick Children, Toronto. Costs of these consequences were comp ared with costs with a hypothetical varicella vaccination program in p lace. The median follow-up was 11.4 months (range, 2-50 months). Total costs in Canadian dollars to the health service without a program wer e for varicella-related hospital stay ($135,675) and varicella-zoster immune globulin ($4,322). Costs to parents were for lost time ($13,590 ) and transport ($414). Assuming a vaccine cost of $30/dose and a 90% vaccine efficacy, a pretransplantation vaccination program would have cost $16,205 and saved $3,132/child ($304 for families and $2,828 for the health service) during the study period. Varicella vaccination pri or to solid organ transplantation should reduce morbidity in pediatric recipients and provide considerable savings for families and the heal th system.