Document Type

Restricted

Advisor

Monika Lopez-Anuarbe

Publication Date

2015

Abstract

The main goal of this thesis was to evaluate the health and economic effects of the Bacille Calmette–Guérin (BCG) vaccination program for tuberculosis. Two regression models were developed to analyze the impact of mass immunization versus selective administration. From the first, it was determined that BCG protective agency in terms of either efficacy or effectiveness would decline by 0.0591748 (p>0.007) percentage points for every one-unit rise in incidence rate within countries that employ mass immunization. No such trend was found in countries that utilize selective criteria as a means of targeting BCG administration to certain groups. The second regression predicted that the adoption of selective vaccination would induce a decline in prevalence number up to 46.013% (p>0.044) of the initial figure. From this, a statistical model based on the Bayes’ theorem was constructed as a means of computing coverage rate for optimal vaccine protection. BCG demand was determined for countries that qualify for UNICEF support on behalf of the Global Alliance for Vaccines and Immunization (GNI < US$ 1,580), before and after the proposed change in policy. Results were graphed as a function of costs associated with prevalence.

Using India as a test-country case, ideal strategies for vaccine allocation and fund mobilization were derived by applying a game theoretic approach. Results suggested a positive time trend in disease if a selective policy of 0.58 were to be employed. Reduction in the annual economic burden suffered by the Indian population and government were both projected at 46.01%. Given that status of India as an emerging national economy, this reduction in burden will play a crucial role in the process of globalization and the growth of the global economy.

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The views expressed in this paper are solely those of the author.