BACKGROUND: US college students are at increased risk for serogroup B meningococcal disease (MenB). MenB caused ~57% of meningococcal disease cases among 16- to 23-year-olds in 2016, and was responsible for 10 US college outbreaks from 2011−17 involving 41 cases and an at-risk population of ~182,000 enrolled undergraduates. Outbreaks cause disruptive anxiety among university communities and implementing a mass vaccination response imposes an often unforeseen financial burden. This study aimed to enumerate costs incurred during a points-of-dispensing, mass vaccination response to a US campus MenB outbreak.
METHODS: The 2015 MenB outbreak at Providence College was used as a case study to develop an Excel-based (Microsoft, Redmond, WA) cost calculator to capture costs and resources associated with a MenB outbreak response. The calculator has user-modifiable inputs related to the vaccine-eligible population, accounts for each vaccination event and vaccine dose (Fig. 1), and estimates direct costs (2016 USD) during 18 months post-outbreak. Potential/expected costs computed (assuming 100% vaccine coverage) were compared with estimated actual costs incurred during the outbreak, using a micro-costing approach.
RESULTS: The estimated total cost for full vaccination of 4,795 eligible individuals was $1,798,399 ($375.06/person); based on actual vaccinations received, the cost calculator computed $1,350,963 in aggregate direct costs ($636.05/person fully vaccinated) (Table 1). In both analyses, medical supplies were the majority of costs (88%–89%), followed by labor resources (7%–9%).
CONCLUSION: This cost calculator quantifies the direct cost of a mass vaccination response to one campus MenB outbreak. Although the cost estimates herein are higher than previously reported, the calculator does not account for follow-up costs or productivity losses and therefore underestimates the true economic burden of a campus MenB outbreak. This outbreak response cost calculator can be used to aid in response planning and highlights the need to shift the public health response from outbreak control to prevention by proactive, pre-emptive vaccination using available licensed meningococcal vaccines.
