The Cost-effectiveness of Adolescent Hepatitis A Vaccination in States With the Highest Disease Rates

Abstract

Hepatitis A vaccination of adolescents in states with high disease rates would reduce costs to society. Although health system costs would increase, cost-effectiveness is comparable to other recommended vaccines and superior to many commonly used medical interventions. Arch Pediatr Adolesc Med. 2000;154:763-770

Cost-Effectiveness of Hepatitis A–B Vaccine Versus Hepatitis B Vaccine for Healthcare and Public Safety Workers in the Western United States

“…Hepatitis A vaccination of children and adolescents meets conventional standards of cost-effectiveness, 510 ' 11 particularly in areas with elevated disease rates. 5,11 Vaccination at the age of 50 years, however, does not meet these standards, 12 consistent with surveillance data indicating that only 9% of reported hepatitis A cases occur in individuals 50 years and older. 4 Hepatitis A vaccination of medical school students has been shown to be moderately cost-effective.…”

Cost-effectiveness of hepatitis A vaccination in children, adolescents, and adults

“…The ACIP recommends universal vaccination of children who live in areas where the average annual hepatitis rate between 1987 and 1997 was 20 or more cases per 100,000 population (i.e., approximately twice the national average) 7 and certain high-risk groups (travelers to moderately or highly endemic countries, men who have sex with men, users of injectable and noninjectable drugs, those who have clotting-factor disorders, persons working with nonhuman primates, and individuals with chronic liver disease). 19 Economic analyses generally support these recommendations (Table 6), showing a degree of cost-effectiveness comparable with that of other vaccines in children living both in highly endemic areas of the United States and in the nation as a whole, 1,32,42 as well as cost-effectiveness well within accepted boundaries 28 for adolescents 31 and adults in several high-risk categories. 20,36,[38][39][40][46][47][48][49][50] Moreover, the combination vaccine for hepatitis A and hepatitis B may further improve the cost-effectiveness of vaccination programs.…”

Economic evaluation of hepatitis A vaccines by income level of the country: A systematic review

“…The seroprevalence varied from 0.1-4 per cent 44 to 91-94 per cent 24 . Only 10 studies considered herd immunity in the analysis 20 , 27 , 28 , 36 , 39 , 40 , 49 , 50 , 54 , 61 .…”

“…It should be noted that cost-effectiveness studies need to be conducted using locally available epidemiological data as such data from other settings have low transferability 13 . Although the age-specific incidence of hepatitis A infection had a significant impact on cost-effectiveness finding 12 , we found that many included studies 20 , 21 , 27 , 28 , 31 adopted such data from the US study 54 , 55 , 71 . However, it was suggested that if the hepatitis A incidence data were not available, seroprevalence data of the country could be used to estimate the incidence 71 , 72 .…”