Universal vaccination against Neisseria meningitidis serogroup B (MenB) at college entry does not appear to be cost-effective, according to a study published online Dec. 17 in the American Journal of Preventive Medicine.

Ira L. Leeds, M.D., from Johns Hopkins University in Baltimore, and colleagues estimated the costs and benefits of universal vaccination at college entry versus no universal vaccination with an outbreak response in 2018 in the context of a midsized four-year college from a health sector and societal perspective.

The researchers found that with universal vaccination, the incremental cost per quality-adjusted life-year gained was $13.9 million and $13.8 million under the health sector perspective and societal perspective, respectively; each perspective was compared with a willingness-to-pay threshold of $150,000 per quality-adjusted life-year. Universal vaccination was not the preferred strategy for <$15 million per quality-adjusted life-year in a multivariable probabilistic sensitivity analysis. A universal vaccination strategy became cost-effective for vaccine series costing <$65 under an extremely favorable model.

"Despite the safety and short-term efficacy of MenB vaccination, the extreme low incidence of MenB and high cost of vaccination prevent universal vaccination of college-aged individuals from being a cost-effective strategy," the authors write.

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