K K Lee1, J Beyer-Blodget. 1. Department of Medicine, Kaiser Permanente Medical Center, 2025 Morse Ave, Sacramento, CA 95825-2115, USA. kenneth.k.lee@ncal.kaiperm.org
Abstract
OBJECTIVES: To measure the seroprevalence of antibodies to hepatitis A virus (anti-HAV) in a health plan population of travelers and to determine whether prevaccination screening for anti-HAV can reduce unnecessary vaccination and thus promote the most effective, economic use of hepatitis A vaccine. DESIGN: Observational, cost-comparison study. SETTING: Central injection clinic of a health maintenance organization medical center. SUBJECTS: Five hundred twenty-seven adults who denied having previous hepatitis A or vaccination. MAIN OUTCOME MEASURES Subgroups with the greatest prevalence of anti-HAV seen between June 1995 and April 1996 for immunizations before traveling to nonindustrialized countries. Relative costs of their screening and immunization. RESULTS: The presence of anti-HAV precluded the need for vaccination in 148 subjects (28.1%). The highest prevalence of anti-HAV (82.7%) was found in subjects born in nonindustrialized countries (62/75), in subjects who had previously traveled to areas of endemic hepatitis A (32.1% [135/420]), and in subjects born before 1945 (29.2% [92/315]). Costs of screening and vaccinating travelers were cheapest if prevaccination antibody sera testing was limited to subjects born in nonindustrialized countries and those born before 1945. CONCLUSIONS: Prevaccination screening of travelers for hepatitis A can be done selectively on the basis of age and country of origin. This strategy could lead to a more economic use of the vaccine and clinic resources.
OBJECTIVES: To measure the seroprevalence of antibodies to hepatitis A virus (anti-HAV) in a health plan population of travelers and to determine whether prevaccination screening for anti-HAV can reduce unnecessary vaccination and thus promote the most effective, economic use of hepatitis A vaccine. DESIGN: Observational, cost-comparison study. SETTING: Central injection clinic of a health maintenance organization medical center. SUBJECTS: Five hundred twenty-seven adults who denied having previous hepatitis A or vaccination. MAIN OUTCOME MEASURES Subgroups with the greatest prevalence of anti-HAV seen between June 1995 and April 1996 for immunizations before traveling to nonindustrialized countries. Relative costs of their screening and immunization. RESULTS: The presence of anti-HAV precluded the need for vaccination in 148 subjects (28.1%). The highest prevalence of anti-HAV (82.7%) was found in subjects born in nonindustrialized countries (62/75), in subjects who had previously traveled to areas of endemic hepatitis A (32.1% [135/420]), and in subjects born before 1945 (29.2% [92/315]). Costs of screening and vaccinating travelers were cheapest if prevaccination antibody sera testing was limited to subjects born in nonindustrialized countries and those born before 1945. CONCLUSIONS: Prevaccination screening of travelers for hepatitis A can be done selectively on the basis of age and country of origin. This strategy could lead to a more economic use of the vaccine and clinic resources.
Authors: J J Berge; D P Drennan; R J Jacobs; A Jakins; A S Meyerhoff; W Stubblefield; M Weinberg Journal: Hepatology Date: 2000-02 Impact factor: 17.425
Authors: P Gardner; T Eickhoff; G A Poland; P Gross; M Griffin; F M LaForce; W Schaffner; R Strikas Journal: Ann Intern Med Date: 1996-01-01 Impact factor: 25.391
Authors: R Tapia-Conyer; J I Santos; A M Cavalcanti; E Urdaneta; L Rivera; A Manterola; M Potin; R Ruttiman; J Tanaka Kido Journal: Am J Trop Med Hyg Date: 1999-11 Impact factor: 2.345