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Cost-Effectiveness of Hepatitis A Vaccination in Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Shanon Smith ,
Stefan Weber ,
Todd Wiblin  and
Mary Nettleman
Shanon Smith
Affiliation:
University of Iowa College of Medicine, Iowa City, Iowa
Stefan Weber
Affiliation:
Virginia Commonwealth University, and the Deutscher Akademischer Austauschdienst, Germany
Todd Wiblin
Affiliation:
University of Iowa College of Medicine, Iowa City, Iowa
Mary Nettleman*
Affiliation:
Virginia Commonwealth University, Richmond, Virginia
*
Division of General Medicine, Department of Internal Medicine, VCU/Medical College of Virginia, PO Box 980102, Richmond, VA 23298-0102
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Abstract

Objective:

To study the cost-effectiveness of vaccination for hepatitis A.

Setting:

Hypothetical analysis of students currently enrolled in medical school in the United States.

Method:

A Markov-based model was developed using data from the literature, actual hospital costs, and an annual discount rate of 5%. The incidence rate was based on the lowest annual rate for the US population during the past decade.

Results:

Over the lifetimes of students currently in medical school, the model estimated that there would be 286 hepatitis A cases with four deaths and 107 lost years of life. With routine vaccination, these numbers would decrease to 17, 0.3, and 6, respectively. The costs per life-year saved and quality adjusted life-year saved were $58,000 and $47,000, respectively. Serologic screening prior to vaccination was less cost-effective than universal vaccination. If the incidence of hepatitis A was underestimated by a factor of 5, the cost per life-year saved would decrease to $5,500. If the incidence of hepatitis was underestimated by a factor of 10, vaccination would result in a net cost savings.

Conclusion:

We conclude that the cost per life-year saved by routine hepatitis A vaccination was similar to many other standard medical modalities. For routine vaccination of medical students to be cost-saving, the incidence rate for hepatitis A must be at least 10 times higher than the rate presently reported for the general population. Serological screening prior to vaccination was not cost-effective.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 10 , October 1997 , pp. 688 - 691
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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