Static model simulation for routine mumps vaccination in Japan: with a result of mumps-related complications in a Japanese community hospital

Abstract

PurposeMumps vaccine has not been included in the routine national immunization program in Japan, leading to low vaccine coverage rates and periodic epidemics approximately every 5 years. Our hospital (a secondary community hospital in Japan) experienced an increased number of mumps-related complications with a nationwide epidemic in 2016. Using previously reported data and mumps-related cases in our hospital, we estimated the cost-effectiveness of routine mumps vaccination in Japan with a static model using current epidemiologic data.Materials and MethodsWith a decision tree flowchart of mumps infection and adverse events, we estimated the burden of mumps-related complications in our hospital for 5 years, and calculated the current annual national burden. Finally, we compared the current burden and assumptive burden of the stable state after routine vaccination in Japan using a static model.ResultsThe cost-benefit ratios with sensitivity analysis were 3.69 (1.08-9.52) and 6.84 (1.51-23.73) in independent inoculation and simultaneous inoculation, respectively, from a social perspective in addition to an annual gain of 9,487 (3,227-14,659) quality adjusted life years.ConclusionWe contributed additional evidence in terms of cost-effectiveness that routine mumps vaccination should be introduced in Japan with simultaneous inoculation.

Dynamic transmission model of routine mumps vaccination in Japan

“…In the current programme, parents pay approximately 6000 JPY per each mumps vaccine for their children, which has led to low national coverage rate of the mumps vaccine (30–40% for the first dose) [ 4 ]. Because of that, the annual number of mumps infection in Japan is estimated to be from 400 000 to 1 500 000 with inconsequential number of mumps-induced complications such as meningitis, encephalitis, hearing loss, orchitis and oophoritis [ 5 ]. This mumps epidemic is causing significant burdens not only for patients but also for their families because most of mumps patients are children, and their parents need to take care of them.…”

“…This mumps epidemic is causing significant burdens not only for patients but also for their families because most of mumps patients are children, and their parents need to take care of them. It leads to billions of medical and social costs each year in addition to loss of healthy lives [ 5 ].…”

“…One of the major concerns for vaccination programmes is cost-effectiveness. Though few studies using the dynamic transmission model have been implemented, the mumps vaccine has been shown in previous studies in Japan to be highly cost-effective by using static models and the Markov model [ 5 , 6 ].…”

Questionnaire survey on mumps vaccination for parents in Nara prefecture, Japan

“…The lack of financial support from the government makes the coverage rate very low (30–40%) . The suboptimal coverage has led to an epidemic in Japan . This situation is severely criticized by highly vaccinated countries, but the situation has not changed greatly .…”

“…[2][3][4] The suboptimal coverage has led to an epidemic in Japan. 5,6 This situation is severely criticized by highly vaccinated countries, but the situation has not changed greatly. 7 From a social and a payer's perspective, a two-dose routine vaccine program would be highly cost-effective in Japan.…”