OBJECTIVES: Measles-mumps-rubella (MMR) vaccination is recommended at 15 months-of-age and 4 years-of-age in Denmark. The objective was to determine the overall net costs impact of MMR childhood vaccination schedules when considering alternative timing of MMR vaccinations and averted hospitalizations for any infectious disease.

METHODS: A decision tree model was developed to estimate the benefits and costs associated with alternative MMR vaccination programs in birth cohorts of children. Estimates of register-based rates of hospitalizations for any infectious disease, average costs per hospitalization for any infectious disease and vaccination coverage rates were used to populate the model. Annual Danish birth cohorts from 2008 to 2010 (n=181,264 children) were followed from 15- months-of-age to 48 months-of age.

RESULTS: The average costs for any infectious disease hospitalization (adjusted for age) were 36% lower when MMR was the most recent vaccine administered compared to when MMR was not the most recent vaccine administered. The odds of having a higher than mean value hospitalization cost was 2.45 times higher (Odds ratio=2.45, 95% CI=2.43 – 2.47, p=0.00) for children who had not received MMR as the most recent vaccine as opposed to children who had received MMR as the most recent vaccine. Alternative MMR schedules resulted in negative net costs in the base case when the MMR vaccination coverage rates from the actual MMR schedule were utilized, with incremental discounted savings of € 685 401 in Schedule B: MMR at 13 and 4 years-of-age, € 1.5 million in Schedule C: MMR at 6 and 15 months-of-age, € 2.0 million in Schedule D: MMR at 6 and 13 months-of-age.

CONCLUSIONS: When comparing alternative childhood MMR vaccination schedules in Denmark programs with lower MMR vaccination age may result in negative net costs compared to the present schedules when including changes in the incidence of any infectious disease hospitalizations and varying coverage rates.