Benefits and costs of using an orally absorbed vaccine to control rabies in raccoons

Iyorlumun J. Uhaa From the Viral & Rickettsial Zoonoses Branch (Uhaa), the Division of Viral & Rickettsial Disease, National Center for Infectious Diseases, International Branch (Fishbein), and the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Gl3, Atlanta, GA 30333; the Communicable Diseases Program (Dato); the Veterinary Public Health Unit, Division of Epidemiology and Communicable Diseases (Sorhage), New Jersey Department of Health, Trenton, NJ 08625; the Hunterdon County Department of Health, Administration Building, Flemington, NJ 08822 (Beckley); the Division of Fish, Game, and Wildlife, State of New Jersey Department of Environmental Protection and Energy, Trenton, NJ 08625 (Roscoe); and the Department of Health Management and Policy University of New Hampshire, Durham, NH 03824 (Gorsky).

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Virginia M. Dato From the Viral & Rickettsial Zoonoses Branch (Uhaa), the Division of Viral & Rickettsial Disease, National Center for Infectious Diseases, International Branch (Fishbein), and the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Gl3, Atlanta, GA 30333; the Communicable Diseases Program (Dato); the Veterinary Public Health Unit, Division of Epidemiology and Communicable Diseases (Sorhage), New Jersey Department of Health, Trenton, NJ 08625; the Hunterdon County Department of Health, Administration Building, Flemington, NJ 08822 (Beckley); the Division of Fish, Game, and Wildlife, State of New Jersey Department of Environmental Protection and Energy, Trenton, NJ 08625 (Roscoe); and the Department of Health Management and Policy University of New Hampshire, Durham, NH 03824 (Gorsky).

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Faye E. Sorhage From the Viral & Rickettsial Zoonoses Branch (Uhaa), the Division of Viral & Rickettsial Disease, National Center for Infectious Diseases, International Branch (Fishbein), and the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Gl3, Atlanta, GA 30333; the Communicable Diseases Program (Dato); the Veterinary Public Health Unit, Division of Epidemiology and Communicable Diseases (Sorhage), New Jersey Department of Health, Trenton, NJ 08625; the Hunterdon County Department of Health, Administration Building, Flemington, NJ 08822 (Beckley); the Division of Fish, Game, and Wildlife, State of New Jersey Department of Environmental Protection and Energy, Trenton, NJ 08625 (Roscoe); and the Department of Health Management and Policy University of New Hampshire, Durham, NH 03824 (Gorsky).

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John W. Beckley From the Viral & Rickettsial Zoonoses Branch (Uhaa), the Division of Viral & Rickettsial Disease, National Center for Infectious Diseases, International Branch (Fishbein), and the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Gl3, Atlanta, GA 30333; the Communicable Diseases Program (Dato); the Veterinary Public Health Unit, Division of Epidemiology and Communicable Diseases (Sorhage), New Jersey Department of Health, Trenton, NJ 08625; the Hunterdon County Department of Health, Administration Building, Flemington, NJ 08822 (Beckley); the Division of Fish, Game, and Wildlife, State of New Jersey Department of Environmental Protection and Energy, Trenton, NJ 08625 (Roscoe); and the Department of Health Management and Policy University of New Hampshire, Durham, NH 03824 (Gorsky).

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Douglas E. Roscoe From the Viral & Rickettsial Zoonoses Branch (Uhaa), the Division of Viral & Rickettsial Disease, National Center for Infectious Diseases, International Branch (Fishbein), and the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Gl3, Atlanta, GA 30333; the Communicable Diseases Program (Dato); the Veterinary Public Health Unit, Division of Epidemiology and Communicable Diseases (Sorhage), New Jersey Department of Health, Trenton, NJ 08625; the Hunterdon County Department of Health, Administration Building, Flemington, NJ 08822 (Beckley); the Division of Fish, Game, and Wildlife, State of New Jersey Department of Environmental Protection and Energy, Trenton, NJ 08625 (Roscoe); and the Department of Health Management and Policy University of New Hampshire, Durham, NH 03824 (Gorsky).

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Robin D. Gorsky From the Viral & Rickettsial Zoonoses Branch (Uhaa), the Division of Viral & Rickettsial Disease, National Center for Infectious Diseases, International Branch (Fishbein), and the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Gl3, Atlanta, GA 30333; the Communicable Diseases Program (Dato); the Veterinary Public Health Unit, Division of Epidemiology and Communicable Diseases (Sorhage), New Jersey Department of Health, Trenton, NJ 08625; the Hunterdon County Department of Health, Administration Building, Flemington, NJ 08822 (Beckley); the Division of Fish, Game, and Wildlife, State of New Jersey Department of Environmental Protection and Energy, Trenton, NJ 08625 (Roscoe); and the Department of Health Management and Policy University of New Hampshire, Durham, NH 03824 (Gorsky).

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Daniel B. Fishbein From the Viral & Rickettsial Zoonoses Branch (Uhaa), the Division of Viral & Rickettsial Disease, National Center for Infectious Diseases, International Branch (Fishbein), and the Division of Field Epidemiology, Epidemiology Program Office, Centers for Disease Control, Public Health Service, US Department of Health and Human Services, Gl3, Atlanta, GA 30333; the Communicable Diseases Program (Dato); the Veterinary Public Health Unit, Division of Epidemiology and Communicable Diseases (Sorhage), New Jersey Department of Health, Trenton, NJ 08625; the Hunterdon County Department of Health, Administration Building, Flemington, NJ 08822 (Beckley); the Division of Fish, Game, and Wildlife, State of New Jersey Department of Environmental Protection and Energy, Trenton, NJ 08625 (Roscoe); and the Department of Health Management and Policy University of New Hampshire, Durham, NH 03824 (Gorsky).

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Summary

In November 1989, the epizootic of rabies affecting raccoons in the mid-Atlantic states reached New Jersey. An economic evaluation was conducted in 2 counties first affected by the epizootic to estimate the costs of the epizootic and to assess the costs and benefits of orally administering a newly developed recombinant rabies vaccine to prevent further spread of the disease. Data on expenditures associated with prevention of rabies in human beings and domestic animals and laboratory testing of suspect animals were collected and analyzed for 1988 (before the epizootic) and 1990 (first full year of the epizootic). Benefit-cost ratios were calculated and used to evaluate the economic advisability of the vaccine at various vaccination program alternatives. Two indices of capital investment analysis, payback period and net present value, were used to evaluate the economic benefits of the rabies vaccine. Expenditures were estimated to be $1,952,014 in 1990 (primarily for pet animal vaccinations), compared with $768,488 in 1988. Benefit-cost ratios ranged from 2.21 for the most expensive vaccination program alternative to 6.80 for the least expensive alternative. The payback period varied from 0.69 to 2.11 years, and the net present value ranged from $2,105,453 to $4,877,452. The high costs of this epizootic necessitated the reallocation of scarce public health resources to various rabies prevention activities, particularly the vaccination of dogs. This study also demonstrated the usefulness of benefit-cost analysis in developing public health strategies. Although the mass application of this recombinant vaccine was found to be economically beneficial, other qualitative considerations must be used to supplement these findings.

Summary

In November 1989, the epizootic of rabies affecting raccoons in the mid-Atlantic states reached New Jersey. An economic evaluation was conducted in 2 counties first affected by the epizootic to estimate the costs of the epizootic and to assess the costs and benefits of orally administering a newly developed recombinant rabies vaccine to prevent further spread of the disease. Data on expenditures associated with prevention of rabies in human beings and domestic animals and laboratory testing of suspect animals were collected and analyzed for 1988 (before the epizootic) and 1990 (first full year of the epizootic). Benefit-cost ratios were calculated and used to evaluate the economic advisability of the vaccine at various vaccination program alternatives. Two indices of capital investment analysis, payback period and net present value, were used to evaluate the economic benefits of the rabies vaccine. Expenditures were estimated to be $1,952,014 in 1990 (primarily for pet animal vaccinations), compared with $768,488 in 1988. Benefit-cost ratios ranged from 2.21 for the most expensive vaccination program alternative to 6.80 for the least expensive alternative. The payback period varied from 0.69 to 2.11 years, and the net present value ranged from $2,105,453 to $4,877,452. The high costs of this epizootic necessitated the reallocation of scarce public health resources to various rabies prevention activities, particularly the vaccination of dogs. This study also demonstrated the usefulness of benefit-cost analysis in developing public health strategies. Although the mass application of this recombinant vaccine was found to be economically beneficial, other qualitative considerations must be used to supplement these findings.

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