Targeted hepatitis E vaccination for women of childbearing age is cost-effective in China

Xia, Ruyi; Sun, Shuliu; Shen, Mingwang; Zhang, Lei; Zhuang, Guihua

doi:10.1016/j.vaccine.2019.08.003

Cited by 10 publications

(5 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results of cost‐effectiveness analyses revealed that additional costs per QALY gained in the vaccination strategies were higher than those of no vaccination strategy, but their ICERs were below the WTP threshold, indicating that they were cost‐effective. Our results also showed that the screening‐based vaccination strategy was more cost‐effective than vaccination without screening strategy, which was in accordance with conclusions from the evaluation of hepatitis E vaccination strategies among women of childbearing age, 29 the elderly population, 24 and pregnant women 25 . One‐way sensitivity analysis suggested that the vaccine price, vaccine protection rate, and decay rate of vaccine protection had the greatest impact on the cost‐effectiveness analysis; in particular, the decay rate of vaccine protection influenced the robustness of some results.…”

Section: Discussionsupporting

confidence: 91%

Cost‐effectiveness analysis of hepatitis E vaccination strategies among patients with chronic hepatitis B in China

Cui,

Zhang,

Wang

et al. 2023

Hepatology Research

View full text Add to dashboard Cite

AimThis study aimed to evaluate the cost‐effectiveness of hepatitis E vaccination strategies in the chronic hepatitis B (CHB) patients.MethodsBased on the societal perspective, cost‐effectiveness of three hepatitis E vaccination strategies: vaccination without screening, screening‐based vaccination, and no vaccination among CHB patients was evaluated using a decision tree‐Markov model, and incremental cost‐effectiveness ratios (ICERs) were calculated. Values for treatment costs and health utilities were estimated from a prior investigation on disease burden, and values for transition probabilities and vaccination‐related costs were obtained from previous studies and government agencies. Sensitivity analyses were performed for assessing model uncertainties.ResultsIt was estimated that CHB patients superinfected with HEV incurred significantly longer disease course, higher economic burden, and more health loss compared to those with HEV infection alone (all P < 0.05). The ICERs of vaccination without screening and screening‐based vaccination compared to no vaccination were 41,843.01 yuan/QALY and 29,147.32 yuan/QALY, respectively, both lower than China’s per‐capita GDP in 2018. The screening‐based vaccination reduced the cost and gained more QALYs than vaccination without screening. One‐way sensitivity analyses revealed that vaccine price, vaccine protection rate, and decay rate of vaccine protection had the greatest impact on the cost‐effectiveness analysis. Probabilistic sensitivity analyses confirmed the base‐case results, and if the willingness‐to‐pay value reached per‐capita GDP, the probability that screening‐based vaccination would be cost‐effective was approaching 100%.ConclusionsThe disease burden in CHB patients superinfected with HEV is relatively heavy in China, and the screening‐based hepatitis E vaccination strategy for CHB patients is the most cost‐effective option.This article is protected by copyright. All rights reserved.

show abstract

Section: Discussionsupporting

confidence: 91%

Cost‐effectiveness analysis of hepatitis E vaccination strategies among patients with chronic hepatitis B in China

Cui,

Zhang,

Wang

et al. 2023

Hepatology Research

View full text Add to dashboard Cite

show abstract

“…As the only one commercialized HE vaccine around the world, Hecolin is of high priority for susceptible populations, including women of child-bearing age, and vaccinating women of child-bearing age has been indicated to be cost-effective from the societal perspective especially in epidemic regions [ 37 , 38 ]. In 2022, Médecins Sans Frontières (MSF) and South Sudan’s Ministry of Health jointly carried out two rounds of the hepatitis E vaccination campaign in Bentiu internally displaced persons camp in South Sudan’s Unity state.…”

Section: Discussionmentioning

confidence: 99%

Safety of hepatitis E vaccination for pregnancy: a post-hoc analysis of a randomized, double-blind, controlled phase 3 clinical trial

Zhong

Zhuang

et al. 2023

Emerging Microbes & Infections

View full text Add to dashboard Cite

Special attention has been paid to Hepatitis E (HE) prophylaxis for pregnant women due to poor prognosis of HE in this population. We conducted a post-hoc analysis based on the randomized, double-blind, HE vaccine (Hecolin)-controlled phase 3 clinical trial of human papillomavirus (HPV) vaccine (Cecolin) conducted in China. Eligible healthy women aged 18–45 years were randomly assigned to receive three doses of Cecolin or Hecolin and were followed up for 66 months. All the pregnancy-related events throughout the study period were closely followed up. The incidences of adverse events, pregnancy complications, and adverse pregnancy outcomes were analysed based on the vaccine group, maternal age, and interval between vaccination and pregnancy onset. During the study period, 1263 Hecolin receivers and 1260 Cecolin receivers reported 1684 and 1660 pregnancies, respectively. The participants in the two vaccine groups showed similar maternal and neonatal safety profiles, regardless of maternal age. Among the 140 women who were inadvertently vaccinated during pregnancy, the incidences of adverse reactions had no statistical difference between the two groups (31.8% vs 35.1%, p = 0.6782). The proximal exposure to HE vaccination was not associated with a significantly higher risk of abnormal foetal loss (OR 0.80, 95% CI 0.38–1.70) or neonatal abnormality (OR 2.46, 95% CI 0.74–8.18) than that to HPV vaccination, as did distal exposure. Significant difference was not noted between pregnancies with proximal and distal exposure to HE vaccination. Conclusively, HE vaccination during or shortly before pregnancy is not associated with increased risks for both the pregnant women and pregnancy outcomes.

show abstract

“…Third, the main strategies to deal with HEV in China at this stage are the development of HEV vaccines and the improvement of laboratory diagnosis rates. One study considered the strategy of HEV vaccination in women of childbearing age ( 34 ), and public health professionals recommended promoting HEV vaccine in Shanghai ( 35 ). We believe there is a need to consider the strategy of HEV vaccination in high-risk occupational groups, such as farmers, to effectively reduce the disease burden.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis E in 24 Chinese Cities, 2008–2018: A New Analysis Method for the Disease's Occupational Characteristics

Rui

Cheng

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

Background: The disease burden of hepatitis E remains high. We used a new method (richness, diversity, evenness, and similarity analyses) to classify cities according to the occupational classification of hepatitis E patients across regions in China and compared the results of cluster analysis.Methods: Data on reported hepatitis E cases from 2008 to 2018 were collected from 24 cities (9 in Jilin Province, 13 in Jiangsu Province, Xiamen City, and Chuxiong Yi Autonomous Prefecture). Traditional statistical methods were used to describe the epidemiological characteristics of hepatitis E patients, while the new method and cluster analysis were used to classify the cities by analyzing the occupational composition across regions.Results: The prevalence of hepatitis E in eastern China (Jiangsu Province) was similar to that in the south (Xiamen City) and southwest of China (Chuxiong Yi Autonomous Prefecture), but higher than that in the north (Jilin Province). The age of hepatitis E patients was concentrated between 41 and 60 years, and the sex ratio ranged from 1:1.6 to 1:3.4. Farming was the most highly prevalent occupation; other sub-prevalent occupations included retirement, housework and unemployment. The incidence of occupations among migrant workers, medical staff, teachers, and students was moderate. There were several occupational types with few or no records, such as catering industry, caregivers and babysitters, diaspora children, childcare, herders, and fishing (boat) people. The occupational similarity of hepatitis E was high among economically developed cities, such as Nanjing, Wuxi, Baicheng, and Xiamen, while the similarity was small among cities with large economic disparities, such as Nanjing and Chuxiong Yi Autonomous Prefecture. A comparison of the classification results revealed more similarities and some differences when using these two methods.Conclusion: In China, the factors with the greatest influence on the prevalence of hepatitis E are living in the south, farming as an occupation, being middle-aged or elderly, and being male. The 24 cities we studied were highly diverse and moderately similar in terms of the occupational distribution of patients with hepatitis E. We confirmed the validity of the new method on in classifying cities according to their occupational composition by comparing it with the clustering method.

show abstract

Targeted hepatitis E vaccination for women of childbearing age is cost-effective in China

Cited by 10 publications

References 42 publications

Cost‐effectiveness analysis of hepatitis E vaccination strategies among patients with chronic hepatitis B in China

Cost‐effectiveness analysis of hepatitis E vaccination strategies among patients with chronic hepatitis B in China

Safety of hepatitis E vaccination for pregnancy: a post-hoc analysis of a randomized, double-blind, controlled phase 3 clinical trial

Hepatitis E in 24 Chinese Cities, 2008–2018: A New Analysis Method for the Disease's Occupational Characteristics

Contact Info

Product

Resources

About