BACKGROUND: Socioeconomic improvements can reduce levels of endemic hepatitis A, but conversely increase the burden of disease. Routine childhood vaccination can rapidly control hepatitis A infection rates through the induction of herd immunity, although such programs can be costly. METHODS: We evaluated the healthcare benefits and cost-effectiveness of a routine childhood vaccination program against hepatitis A in Argentina, using a dynamic model that incorporated the changing epidemiology of infection and the impact of vaccine-induced herd immunity. Demographic, disease, and economic data from Argentina were used where available. RESULTS: At 95% coverage, the program would reduce the number of hepatitis A infections by 352,405 annually, avoiding 121,587 symptomatic cases and 428 deaths. Substantial healthcare benefits were also observed with vaccination coverage as low as 70%, which would prevent 295,826 infections. Economically, the program would save 23,989,963 US$ annually at 95% coverage, equivalent to 3,429 US$ per life-year gained. The program remained cost-saving in response to variation in factors, including disease-related costs, discount rate, herd immunity level, and rate of decrease of force of infection. The break-even cost per vaccine dose for the society was 25 US$ in the base-case, more than three times the current public cost of 7 US$ per dose. CONCLUSIONS: Routine childhood vaccination against hepatitis A showed both health benefits and robust economic benefits in this analysis, supporting the recent decision of the Argentine government to implement such a program.
BACKGROUND: Socioeconomic improvements can reduce levels of endemic hepatitis A, but conversely increase the burden of disease. Routine childhood vaccination can rapidly control hepatitis A infection rates through the induction of herd immunity, although such programs can be costly. METHODS: We evaluated the healthcare benefits and cost-effectiveness of a routine childhood vaccination program against hepatitis A in Argentina, using a dynamic model that incorporated the changing epidemiology of infection and the impact of vaccine-induced herd immunity. Demographic, disease, and economic data from Argentina were used where available. RESULTS: At 95% coverage, the program would reduce the number of hepatitis A infections by 352,405 annually, avoiding 121,587 symptomatic cases and 428 deaths. Substantial healthcare benefits were also observed with vaccination coverage as low as 70%, which would prevent 295,826 infections. Economically, the program would save 23,989,963 US$ annually at 95% coverage, equivalent to 3,429 US$ per life-year gained. The program remained cost-saving in response to variation in factors, including disease-related costs, discount rate, herd immunity level, and rate of decrease of force of infection. The break-even cost per vaccine dose for the society was 25 US$ in the base-case, more than three times the current public cost of 7 US$ per dose. CONCLUSIONS: Routine childhood vaccination against hepatitis A showed both health benefits and robust economic benefits in this analysis, supporting the recent decision of the Argentine government to implement such a program.
Authors: F Averhoff; C N Shapiro; B P Bell; I Hyams; L Burd; A Deladisma; E P Simard; D Nalin; B Kuter; C Ward; M Lundberg; N Smith; H S Margolis Journal: JAMA Date: 2001-12-19 Impact factor: 56.272
Authors: Ricardo Arraes de Alencar Ximenes; Celina Maria Turchi Martelli; Marcos Amaku; Ana Marli C Sartori; Patricia Coelho de Soárez; Hillegonda Maria Dutilh Novaes; Leila Maria Moreira Beltrão Pereira; Regina Célia Moreira; Gerusa Maria Figueiredo; Raymundo Soares de Azevedo Journal: PLoS One Date: 2014-05-20 Impact factor: 3.240
Authors: Carlos Espul; Laura Benedetti; Mariela Linares; Hector Cuello; Ivana Lo Castro; Yaël Thollot; Anvar Rasuli Journal: Hum Vaccin Immunother Date: 2017-09-21 Impact factor: 3.452
Authors: Wail A Hayajneh; Vincent J Daniels; Cerise K James; Muhammet Nabi Kanıbir; Matthew Pilsbury; Morgan Marks; Michelle G Goveia; Elamin H Elbasha; Erik Dasbach; Camilo J Acosta Journal: BMC Infect Dis Date: 2018-03-07 Impact factor: 3.090
Authors: Rohan Deogaonkar; Raymond Hutubessy; Inge van der Putten; Silvia Evers; Mark Jit Journal: BMC Public Health Date: 2012-10-16 Impact factor: 3.295
Authors: Orlando Mayorga Perez; Martin W G Brinkhof; Matthias Egger; Gert Frösner; Christian Herzog; Marcel Zwahlen Journal: PLoS One Date: 2014-02-11 Impact factor: 3.240