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The annualized present value of vaccine costs incorporates the annual number of potential new vaccines; the cost per dose; and the number of doses required, adjusted for the probability of successful vaccine development and the time at which steady-state vaccine use would be achieved. The annualized present value of vaccine expenditures incorporates the vaccine cost for the immunization program and the annualized vaccine development cost (i.e., the discount rate multiplied by the cost of development).

These cost calculations can be used to compare vaccine candidates from various viewpoints, as discussed in Chapter 9. Sensitivity analyses described in that chapter also show the effects on the priority rankings of assumptions other than those in the central analysis.

The health benefit values and the vaccine expenditures necessary to achieve these benefits do not incorporate adjustments for utilization, which was judged to be uniform in this analysis. Thus, values represent potential benefits and expenditures.


Institute of Medicine. 1985. New Vaccine Development: Establishing Priorities, Volume I. Diseases of Importance in the United States. Washington, D.C.: National Academy Press.

Weinstein, M.C., and W.B. Stason. 1977. Foundations of cost-effectiveness analysis for health and medical practices. N. Engl. J. Med. 296(13):716–721.

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