[Modern trends in vaccination policy: evaluation of benefits, risks and cost (author's transl)]

Abstract

A number of newly-developed vaccines are available nowadays, whilst others, which are well-established, have been improved. The collection of epidemiological data, however, is equally important in assessing and providing insight into prophylactic measures. The beneficial effects and risks of vaccination may be calculated by special formulae. Changes in the effect of vaccines can be detected by constant reevaluation of the epidemiological situation by means of these formulae. Another possibility lies in the calculation of the borderline number of complications of a certain disease when the risks of the sequelae of the disease or of the vaccination are about equal. Examples of valuable and recommendable vaccinations are vaccination against measles, poliomyelitis, tetanus and tick-borne encephalitis. A follow-up of the case mortality of whooping-cough in Austria over the past 15 years and a consideration of the fatal complications of vacinnation, as quoted by Ehrengut, reveals that the risks of the disease balanced the risks of vaccination with usual vaccines, already in 1971 (1976 with WHO data). A beneficial effect of BCG vaccination is still present, but the influence on mortality figures is very slight only. However, the benefit of BCG may lie in the prevention of deaths from leukaemia observed by some authors. Paraspecific effects of some vaccinations are mentioned. Finally, cost-benefit calculations for Austria are presented in the case of vaccination against measles and mumps, which appear to be highly recommendable, not only from the medical, but also the economic point of view.