The economics of vaccinating restaurant workers against hepatitis A.

The economics of vaccinating restaurant workers against hepatitis A were studied using Monte Carlo simulation models, one with a restaurant-owner perspective, and one with a societal perspective. The restaurant model allowed for a different size, number of employees and employee turnover rate. Benefits were the avoidance of loss of business (including the possibility of bankruptcy) after publicity linking the restaurant to an outbreak associated with a case of hepatitis A in a food handler. Additional benefits in the societal model included reductions in costs of food handler-associated cases of hepatitis A. The outcome used was Net Present Value (NPV), allowing comparison between models. Regardless of the cost of vaccination ($50-140/employee), for a restauranteur to ensure that all employees were vaccinated at all times substantial costs were involved (i.e. negative NPV). Even a 75% probability of bankruptcy still resulted in negative NPVs at the 95th percentiles. For society, vaccination was only cost-saving (i.e. positive NPV) if done only during epidemics and if it cost < $20/employee. Vaccinating restaurant employees is unlikely to be economical from either the restaurant owner or the societal perspective, even during hepatitis A epidemics.