Possible immunizations for travelers to developing countries may be divided into three categories: compulsory, commonly recommended and occasionally recommended immunizations. When trying to judge their beneficial effects we may do so from two points of view: by considering risk and benefit or cost and benefit. Calculations can be done by the introduction of simple mathematical formulas. In the case of risk-benefit calculations the risk-benefit ratio (Q) weighs risk of disease against risk of vaccination, which is recommendable if Q > 1.0. The risk-benefit difference considers preventable disease or complications. An immunization is recommendable if D > 0. Similarly, the cost-benefit ratio( Q c ) considers cost-effectiveness and the cost-benefit difference (D c ) presents the amount of money saved. Four examples have been chosen for these calculations: vaccination against cholera, tetanus and poliomyelitis and passive immunization against hepatitis A. In the case of cholera Q c < 1, indicating that this vaccination is not cost effective. However, Q is a bit more than 1 and D above O. Tetanus vaccination of people staying at home or travelling is recommendable and just cost-effective. Costs of OPV are being paid by the Austrian government; Q and D (risk-benefit parameters) are highly positive. Passive immunization against hepatitis A is recommendable and cost-effective for Austrian soldiers on UN mission. For the individual traveler it is cost-effective if the hepatitis risk is > 1:150.
KeywordsHepatitis Europe Transportation Income Tuberculosis
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