Cost-benefit ratio of tick-borne encephalitis vaccination of French troopsbased in Kosovo

Background: French military troops based in Kosovo are exposed to Tick-Born e Encephalitis (TBE) biorisk. An efficacious vaccine is available to preven t this disease, burdened by high morbidity and mortality. The epidemiologic features of TBE in Kosovo are unprecise. To help the French Department of Defense to make a decision about immunization against TEE, we performed a c ost-benefit analysis. Methods: By a Bayes' analysis decision, we have estimated the net benefits for a three-injection vaccine program versus absence of vaccination, for al l French military troops based in Kosovo. Time expectancy was 4 years. Thro ugh the review of several medical reports, we have estimated the useful par ameters for this study: morbidity incidence rate, mortality rate, sequelae rate, efficacy vaccine and side effects. We have chosen as initial hypothes is a sere-conversion rare of 1,080 per 100,000 men-by-year. Human life was valorized in francs, by calculating the allowance paid by Department of Def ense to the family in case of death or for sequelae. Results: Net benefits arised to 2.17 millions of francs. The vaccine progra m cost was 25.0 millions of francs. 140 cases of encephalitis viruses were saved by vaccination. Nevertheless a sensibility analysis has shown that re sults are well reliable with TEE incidence rate. Conclusion: The break even point being close to the incidence rate of the i nitial assumption, the decision to vaccine all French military troops depen ds at the same time on a better knowledge of the incidence of the disease i n Kosovo, but also of the number of potentially avoided cases of tick-borne encephalitis and of the programs of vaccination concerning this disease of the other countries forming the United Nations Organization forces.