Cost-effectiveness of childhood hepatitis A vaccination in Argentina: a second dose is warranted.

Objectives: To investigate the cost-effectiveness of childhood vaccination against hepatitis A in the five geographic regions of Argentina, and to determine whether adding a second dose to the current one-dose schedule would provide health gains justifying its added cost.

Methods: A Markov model was used to consider four immunization options for the 2005 birth cohort: (1) no vaccination; (2) vaccination at 12 months of age, (3) vaccinations at 12 and 72 months of age; or (4) vaccinations at 12 and 18 months of age. Hepatitis A costs and consequences were predicted over 50 years.

Hepatitis B risks and immunization coverage among American travelers.

Background: Hepatitis B is endemic in much of Asia, Africa, and parts of South America, regions that are increasingly popular destinations for American travelers. The frequency of hepatitis B risks during travel has been examined for Europeans but not Americans. Further, limited data are available to describe the domestic hepatitis B risk factors of American travelers, the proportion vaccinated, and whether immunization activities target travelers at highest risk.

Hepatitis A immunization strategies: universal versus targeted approaches.

The alternative to nationwide childhood hepatitis A vaccination is to continue targeting high-risk adults. To consider how many of today's children will become vaccination candidates, the proportion of adults reporting a lifetime history of hepatitis A risk factors was examined. One thousand thirty-four US adults responded to a confidential postal survey, 49% of whom had met current Advisory Committee on Immunization Practices (ACIP) criteria for immunization and 72% had met an expanded set of criteria.

Immunization needs of chronic liver disease patients seen in primary care versus specialist settings.

Chronic liver disease patients may benefit from certain vaccines, but their immunization coverage levels have not been widely studied. We examined the serologic and vaccination status of 693 chronic liver disease patients from 37 primary care and specialist centers. Patients in primary care had more often received influenza (47 versus 32%; P < .

Cost-effectiveness of universal childhood hepatitis A vaccination in Chile.

Hepatitis A is an important public health problem in Chile. Childhood vaccination has reduced hepatitis A rates in several countries, prompting this evaluation of its cost-effectiveness in Chile. Using a Markov model, we project mass vaccination would reduce hepatitis A cases among birth cohort members and their personal contacts >80%.

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

Objective: 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.

Participants: A cohort of 100,000 hypothetical healthcare and public safety workers from 11 western states with hepatitis A rates twice the national average.

Design: A Markov model of hepatitis A was developed using estimates from U.

Effect of middle school entry requirements on hepatitis B vaccination coverage.

We examined hepatitis B immunization coverage in states with and without middle school entry vaccination requirements. Hepatitis B vaccination was initiated and completed more frequently in states with middle school mandates, although near-universal coverage was not obtained. Nonetheless, establishment of mandates in states without them could significantly reduce hepatitis B transmission.

Cost effectiveness of hepatitis A/B versus hepatitis B vaccination for US prison inmates.

Hepatitis B immunization is provided in many US prison systems. We examined the cost effectiveness of substituting bivalent hepatitis A/B vaccine in this setting, considering regional variation in hepatitis A risks and the potential for disease transmission by former prisoners. Where hepatitis A rates are >200, 100-200, and <100% the national average, declines in hepatitis A treatment costs would offset 137, 88, and 40% of the bivalent vaccine's added cost.

Cost-effectiveness of hepatitis A/B vaccine versus hepatitis B vaccine in public sexually transmitted disease clinics.

Background: Many patients seen at U.S. sexually transmitted disease (STD) clinics are offered hepatitis B vaccination.

An economic assessment of pre-vaccination screening for hepatitis A and B.

Objective: The availability of a single vaccine active against hepatitis A and B may facilitate prevention of both infections, but complicates the question of whether to conduct pre-vaccination screening. The authors examined the cost-effectiveness of pre-vaccination screening for several populations: first-year college students, military recruits, travelers to hepatitis A-endemic areas, patients at sexually transmitted disease clinics, and prison inmates.

Methods: Three prevention protocols were examined: (1) screen and defer vaccination until serology results are known; (2) screen and begin vaccination immediately to avoid a missed vaccination opportunity; and (3) vaccinate without screening.

Regional variation in the cost effectiveness of childhood hepatitis A immunization.

Background: Routine childhood hepatitis A immunization is recommended in regions with incidence rates twice the national average, but it may be cost-effective in a wider geographic area.

Objective: To evaluate the costs and benefits of potential hepatitis A immunization of healthy US children in regions with varying hepatitis A incidences.

Methods: We considered vaccination of the 2000 US birth cohort in states defined by historic hepatitis A incidence rates.

The cost effectiveness of hepatitis immunization for US college students.

Hepatitis B immunization is recommended for all American children, and hepatitis A immunization is recommended for children who live in areas with elevated disease rates. Because hepatitis A and B occur most commonly in young adults, the authors examined the cost effectiveness of college-based vaccination. They developed epidemiologic models to consider infection risks and disease progression and then compared the cost of vaccination with economic, longevity, and quality of life benefits.

Valuation of symptomatic hepatitis a in adults: estimates based on time trade-off and willingness-to-pay measurement.

Background: The cost effectiveness of hepatitis A prevention is typically assessed by comparing vaccination costs with the number of life-years saved. This endpoint does not consider the benefits of preventing nonfatal yet symptomatic infections. Nearly as many days of healthy life are lost to hepatitis A morbidity as mortality.

The cost-effectiveness of vaccinating chronic hepatitis C patients against hepatitis A.

Objectives: Although hepatitis A vaccination is recommended for persons with chronic liver disease, the cost-effectiveness of vaccinating patients with chronic hepatitis C virus has not been extensively studied. We evaluated its costs and benefits.

Methods: A Markov model was used to assess cost-effectiveness from the health system and societal perspectives.