Cost-effectiveness analysis of reacquiring and using adenovirus types 4 and 7 vaccines in naval recruits

Adenovirus vaccines have controlled acute respiratory disease (ARD) in mili tary recruits since 1971. Vaccine production, however, ceased and new facil ities are required. We assessed whether reacquiring and using vaccines in n aval recruits is cost-effective. Three policy options were evaluated: no va ccination, seasonal vaccination, and year-round vaccination. Morbidity (out patient and inpatient), illness costs (medical and lost training), and vacc ine program costs (start-up, acquisition, and distribution) were modeled us ing a decision-analytic method. Results were based on a cohort of 49,079 an nual trainees, a winter vaccine-preventable ARD rate of 2.6 cases per 100 p erson-weeks, a summer incidence rate at 10% of the winter rate, a hospitali zation rate of 7.6%, and a production facility costing US$12 million. Compa red to no vaccination, seasonal vaccination prevented 4,015 cases and saved $2.8 million per year. Year-round vaccination prevented 4,555 cases and sa ved $2.6 million. Reacquiring and using adenovirus vaccines seasonally or y ear-round saves money and averts suffering.