Immunization to Prevent Insulin-Dependent Diabetes Mellitus?

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Abstract
There is increasing evidence that some cases of insulin-dependent diabetes mellitus are virally induced and vaccination against this disease may become possible. The costs and benefits that would occur if a diabetes vaccine were developed were examined, using a decision tree to model the alternative vaccination policies, including HLA screening. Many cost and likelihood data were found in the literature, and when data on the potential vaccine had to be hypothesized, a sensitivity analysis was used to check estimates. Vaccinating all children at age 3 would be preferable to HLA screening and vaccinating only persons with a genetic predisposition to developing diabetes. A 50% effective vaccine would cut the diabetes incidence rate by 29% and save the USA population $30 million annually in direct costs of diabetes care. If indirect costs are considered these savings could amount to $4.2 billion over 60 yr, discounted to present value at 5%, while preventing over 200,000 cases of insulin-dependent diabetes.