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JAMA. 1995 Oct 18;274(15):1201-8.

Prevention of hepatitis B virus transmission by immunization. An economic analysis of current recommendations.

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  • 1Hepatitis Branch (A-33), Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

Abstract

OBJECTIVE:

To evaluate the outcome of immunization strategies to prevent hepatitis B virus (HBV) transmission.

DESIGN AND SETTING:

A decision model was used to determine the incremental effects of the following hepatitis B immunization strategies in a birth cohort receiving immunization services in the public sector: (1) prevention of perinatal HBV infection, (2) routine infant vaccination, or (3) routine adolescent vaccination.

MAIN OUTCOME MEASURES:

Over the lifetime of the cohort, the reduction in infections and medical and work-loss costs of HBV-related liver disease were determined for each strategy and compared with the outcome without immunization.

RESULTS:

Prevention of perinatal infection and routine infant vaccination would lower the 4.8% lifetime risk of HBV infection by at least 68%, compared with a 45% reduction for adolescent vaccination. From a societal perspective, each strategy was found to be cost saving, but was not cost saving with respect to direct medical costs. The estimated cost per year of life saved was $164 to prevent perinatal HBV infection, $1522 for infant vaccination, and $3730 for adolescent vaccination.

CONCLUSIONS:

Routine vaccination of infants in successive birth cohorts to prevent HBV transmission is cost-effective over a wide range of assumptions. While economically less attractive than infant vaccination, adolescent vaccination could serve to protect those children who were not vaccinated as infants.

Comment in

PMID:
7563509
[PubMed - indexed for MEDLINE]
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