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Pertussis vaccination policy in the Friuli-Venezia Giulia region: a cost-benefit analysisTo estimate the most favourable cost-benefit ratio in vaccination campaigns using different pertussis vaccines. Design: The study was conducted according to the cost-benefit analysis methodology. Data were obtained from the Regional Health Information System and, when missing, from literature. Four alternative pertussis vaccination scenarios were defined to compare costs and benefits, assuming as reference an hypothetical cohort of 10,000 children, followed from birth until 6 years of age:a: whole-cell vaccination, 83.9% coverage rate (CR) and 36.1% vaccine efficacy (VE);b: whole-cell vaccination, 83.9% CR and 83.0% VE;c: whole-cell vaccination 83.9% CR and 97.6% VE;d: acellular vaccination 95.7% CR and 84.0% VE.The study was conducted in the Friuli-Venezia Giulia region, where coverage rates for compulsory and recommended vaccinations are traditionally high.Total costs of the vaccination campaign were € 506,567.62 using whole cell vaccines and € 256,012.44 using acellular vaccines. Total benefits in the four scenarios were € 892,895.31 (A), € 2,053,145.07 (B), € 2,414,330.65 (C) and € 2,370,200.02 (D). The benefit-cost ratio was 1.76, 4.05, 4.77 and 9.26, respectively.A pertussis vaccination schedule based on acellular vaccine shows the best benefit-cost ratio also in areas with high compliance to recommended vaccinations.