Exploratory Research On Engineering The Service Sector: Collaborative Research: Research on Designing Vaccine Formularies for Childhood Immunization

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Childhood vaccination has become the single greatest defense against infectious diseases among children in the United States. Moreover, biotechnology breakthroughs are making it possible for vaccine manufacturers to develop vaccine antigens for numerous diseases. One unplanned consequence of such innovations is that the Recommended Childhood Immunization Schedule (as set forth by the Advisory Committee on Immunization Practices) has become sufficiently crowded that the prospect of adding additional vaccines (hence additional injections) to this schedule may not be well received by either health-care providers or parents/guardians. This has prompted vaccine manufacturers to develop vaccines products that combine several antigens into a single injection. Such vaccines, termed combination vaccines, permit new vaccines to be added to the schedule without placing additional burdens on parents/guardians, nor requiring children to endure an unacceptable number of injections during single clinic visits. Such innovations have also created a combinatorial explosion of choices for health-care providers that will continue to escalate and expand as additional vaccines are added to the immunization schedule and as new combination vaccines gain approved for distribution. The goals of this project are to design operations research models that capture all the vaccines that are presently in the recommended childhood immunization schedule, as well as vaccines that may enter the schedule over the next decade, to formulate and analyze optimization models that can be used to determine the maximal price at which new combination vaccine products provide good value to the health-care consumer, and to perform sensitivity analysis to determine the impact of new vaccines on the optimal vaccine formularies and vaccine prices.The results of this research provide a systematic approach to compare and evaluate existing and new pediatric vaccines within the recommended childhood immunization schedule. This, in turn, will provide a vehicle upon which opportunities for new vaccines and vaccine combinations can be evaluated using operations research models, hence has the potential to enhance immunization rates given the set of vaccine choices available. Moreover, the tools developed will provide a mechanism by which health-care providers and consumers can assess the economic value of such vaccines, hence facilitating the application of market principles within the pediatric vaccine industry. This in turn may also serve to put downward pressure on the prices of such vaccines, an issue of significant national concern. This research will be conducted in collaboration with personnel within the National Immunization Program at the Center for Disease Control and Prevention (CDC).