Financial Evaluation of Different Vaccination Strategies for Controlling the Bluetongue Virus Serotype 8 Epidemic in the Netherlands in 2008

Background: Bluetongue (BT) is a vector-borne disease of ruminants caused by bluetongue virus that is transmitted by biting midges (Culicoides spp.). In 2006, the introduction of BTV serotype 8 (BTV-8) caused a severe epidemic in Western and Central Europe. The principal effective veterinary measure in response to BT was believed to be vaccination accompanied by other measures such as movement restrictions and surveillance. As the number of vaccine doses available at the start of the vaccination campaign was rather uncertain, the Dutch Ministry of Agriculture, Nature and Food Quality and the Dutch agricultural industry wanted to evaluate several different vaccination strategies. This study aimed to rank eight vaccination strategies based on their efficiency (i.e. net costs in relation to prevented losses or benefits) for controlling the bluetongue virus serotype 8 epidemic in 2008 Methodology/Principal Findings: An economic model was developed that included the Dutch professional cattle, sheep and goat sectors together with the hobby farms. Strategies were evaluated based on the least cost - highest benefit frontier, the benefit-cost ratio and the total net returns. Strategy F, where all adult sheep at professional farms in the Netherlands would be vaccinated was very efficient at lowest costs, whereas strategy D, where additional to all adult sheep at professional farms also all adult cattle in the four Northern provinces would be vaccinated, was also very efficient but at a little higher costs. Strategy C, where all adult sheep and cattle at professional farms in the whole of the Netherlands would be vaccinated was also efficient but again at higher costs. Conclusions/Significance: This study demonstrates that a financial analysis differentiates between vaccination strategies and indicates important decision rules based on efficienc

Reasons for joining the vaccination campaign of 2012.

<p>*Dog owners were allowed to provide more than one response; therefore, percentages of reasons do not sum to 100%; **To support the government’s campaign or in response to the fact that vaccinators were visiting at home; ***Neighbor, relative, family, and village leaders.</p

Statistical heterogeneity tests comparing vaccination coverage rates resulting from charged versus free-of-charge vaccination schemes.

<p>Statistical heterogeneity tests comparing vaccination coverage rates resulting from charged versus free-of-charge vaccination schemes.</p

Systematic literature review framework (n = number of peer reviewed articles recovered/selected).

<p>Systematic literature review framework (n = number of peer reviewed articles recovered/selected).</p

Determinants of the level of knowledge of rabies control measures (<i>high > = 3 measures /low < 3 measures</i>) in the logistic multivariable regression model (n = 399).

<p>OR = Odds ratio; CI = Confidence interval.</p><p>*4 missing values.</p><p>¹The currency rate when the study was conducted, 1 February 2013: 1US$ = Rp 9,651.</p><p>The Hosmer-Lemeshow goodness-of-fit test p-value for this model was 0.80.</p><p>Determinants of the level of knowledge of rabies control measures (<i>high > = 3 measures /low < 3 measures</i>) in the logistic multivariable regression model (n = 399).</p

Forest plot comparing dog rabies vaccination coverage by financial arrangement.

<p>Forest plot comparing dog rabies vaccination coverage by financial arrangement.</p

Demography and ownership status of African dogs by the 16 selected peer reviewed papers.

<p>mo = month, yr = year, N/A = not available</p><p>Demography and ownership status of African dogs by the 16 selected peer reviewed papers.</p

Distribution of socio-demographic characteristics of the surveyed dog owners in Flores Island in relation to their knowledge of rabies and its control and their uptake of the 2012 vaccination campaign.

<p>*The question was only posed to dog owners who knew that “rabies in humans could be prevented” (n = 403).</p><p>**Fisher x² square test.</p><p>***4 missing values.</p><p>****The economic value of dogs was based on the owners’ estimation.</p><p>¹The currency rate when the study was conducted, 1 February 2013: 1US$ = Rp 9.651.</p><p>²The actual influence of the religion variable could not be quantified due to the small sample size in some categories.</p><p>³Female dogs that had been giving birth during their life.</p><p>p-value shown in bold represents p<0.25.</p><p>Differences were tested with a Chi square test.</p><p>Distribution of socio-demographic characteristics of the surveyed dog owners in Flores Island in relation to their knowledge of rabies and its control and their uptake of the 2012 vaccination campaign.</p