+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Cost-effectiveness of hepatitis A-B vaccine versus hepatitis B vaccine for healthcare and public safety workers in the western United States



Cost-effectiveness of hepatitis A-B vaccine versus hepatitis B vaccine for healthcare and public safety workers in the western United States



Infection Control and Hospital Epidemiology 25(7): 563-569



To determine the cost-effectiveness of substituting hepatitis A-B vaccine for hepatitis B vaccine when healthcare and public safety workers in the western United States are immunized to protect against occupational exposures to hepatitis B. A cohort of 100,000 hypothetical healthcare and public safety workers from 11 western states with hepatitis A rates twice the national average. A Markov model of hepatitis A was developed using estimates from U.S. government databases, published literature, and an expert panel. Added costs of hepatitis A-B vaccine were compared with savings from reduced hepatitis A treatment and work loss. Cost-effectiveness was expressed as the ratio of net costs to quality-adjusted life-years (QALYs) gained. Substituting hepatitis A-B vaccine would prevent 29,796 work-loss-days, 222 hospitalizations, 6 premature deaths, and the loss of 214 QALYs. Added vaccination costs of $5.4 million would be more than offset by $1.9 million and $6.1 million reductions in hepatitis A treatment and work loss costs, respectively. Cost-effectiveness improves as the time horizon is extended, from $232,600 per QALY after 1 year to less than $0 per QALY within 11 years. Estimates are most sensitive to community-wide hepatitis A rates and the degree to which childhood vaccination may reduce future rates. For healthcare and public safety workers in western states, substituting hepatitis A-B vaccine for hepatitis B vaccine would reduce morbidity, mortality, and costs.

(PDF emailed within 0-6 h: $19.90)

Accession: 011907302

Download citation: RISBibTeXText

PMID: 15301028

DOI: 10.1086/502440


Related references

Cost-effectiveness of hepatitis A/B vaccine versus hepatitis B vaccine in public sexually transmitted disease clinics. Sexually Transmitted Diseases 30(11): 859-865, 2003

The cost-effectiveness of using hepatitis A/B combined vaccine versus hepatitis B vaccine alone for high-risk heterosexuals. Vaccine 26(42): 5331-5333, 2008

Supplement 1. An Overview of the Clinical Development of Hepatitis A Vaccine || Discussion: Who Should Receive Hepatitis A Vaccine? A Strategy for Controlling Hepatitis A in the United States. Journal of Infectious Diseases 171: S73-S77, 1995

Prediction of response to hepatitis B vaccine in health care workers: whose titers of antibody to hepatitis B surface antigen should be determined after a three-dose series, and what are the implications in terms of cost-effectiveness?. Clinical Infectious Diseases 26(3): 566-571, 1998

Cost-effectiveness of live attenuated influenza vaccine versus inactivated influenza vaccine among children aged 24-59 months in the United States. Vaccine 26(23): 2841-2848, 2008

Intradermal recombinant hepatitis B vaccine for healthcare workers who fail to respond to intramuscular vaccine. Infection Control and Hospital Epidemiology 23(2): 87-90, 2002

Cost-Effectiveness of Quadrivalent versus Trivalent Influenza Vaccine in the United States. Value in Health 19(8): 964-975, 2017

Cost-Effectiveness of Quadrivalent Versus Trivalent Influenza Vaccine in the United States. Value in Health 17(7): A679, 2014

Prevalence of hepatitis B virus infection and uptake of hepatitis B vaccine among healthcare workers, Makueni County, Kenya 2017. Journal of Public Health 2018, 2018

Supplement 1. An Overview of the Clinical Development of Hepatitis A Vaccine || Administration of Hepatitis A Vaccine to a Military Population by Needle and Jet Injector and with Hepatitis B Vaccine. Journal of Infectious Diseases 171: S53-S60, 1995

Cost-effectiveness analysis of the universal use of hepatitis A vaccine in patients with chronic hepatitis C. Gastroenterology 118(4 Suppl 2 Part 1): AGA A679, 2000

Hepatitis B vaccine and hepatitis B markers: cost effectiveness of screening prehospital personnel. American Journal of Emergency Medicine 5(3): 205-206, 1987

Cost-effectiveness of hepatitis A vaccine in prevention of secondary hepatitis A infection. Vaccine 21(25-26): 3556-3564, 8 September, 2003

Discussion: who should receive hepatitis A vaccine? A strategy for controlling hepatitis A in the United States. Journal of Infectious Diseases 171 Suppl 1: S73-S77, 1995

Hepatitis B and hepatitis B vaccine requirements in schools of nursing in the United States: a national survey. American Journal of Infection Control 18(4): 240-249, 1990