LAUSR

We read the publication on “Cost‐effectiveness of varicella vaccination program in Iran” with a great interest.[1] Esmaeeli et al. concluded that “Varicella vaccination is not cost‐effective in Iran in one‐dose and two‐dose scenario under the assumptions of this study.[1]” We would like to share ideas on this report. In our country in tropical Indochina, there was a recent similar introduction of varicella vaccination. Despite a high prevalence of varicella, the vaccination is also proved not cost effective in our setting and it is presented limited recommended for only medical personnel group.[2] The high cost of the vaccine is the big obstacle for mass immunization. At present, the cost for vaccination in Thailand is about 60 USD, which is more than 6 times of daily minimum wage in the country (9.6 USD). How to decrease the cost of the vaccine to support the possibility for generalization of varicella vaccine seems to be the common consideration in several countries. To increase the cost effectiveness, reduction of the cost of vaccination is necessary. There are many possible ways to reduce the cost of vaccination. First, the local governmental public health unit might deal directly with the pharmaceutical company about purchasing of a big lot of vaccines and bargaining to get the lower cost of vaccine will be possible.[3] Second, there should also be the plan to reduce the unnecessary cost of vaccination. For example, good appointment of the patients for getting vaccination at the same time might help reduce the operational cost.