ARCHIVED - Cost Effectiveness of Universal Hepatitis A Vaccination for Adolescents and Children in Canada

 

Category: Viral Vaccines or Infections

Krahn M, Remis R, Wu J, Hogg R, Sherman M

Objective

To evaluate the costs and cost-effectiveness of universal vaccination against hepatitis A infection in Canada.

Methods

We developed an incidence model, fitted to seroprevalence data, to project future incidence of new hepatitis A infections in different age groups in Canada. A Markov decision analysis model was used to describe the outcomes in vaccinated and non-vaccinated cohorts. Epidemiologic estimates, utility values, and costs were derived from published and unpublished sources.

Results

Universal vaccination of adolescent students under baseline assumptions would cost an incremental amount of about $30,000 per quality adjusted life year gained. For each 100,000 children vaccinated the model suggests 1,400 cases of acute hepatitis A would be prevented over the course of a lifetime of that birth cohort. Approximately 11 deaths would occur in this cohort in the absence of vaccination and four deaths with universal vaccination. The net cost per HAV death averted is approximately $250,000. When indirect costs are included, the net cost per HAV death averted is $150,000.

Conclusion

Universal vaccination against hepatitis A infection is cost effective, although the savings in life years gained is not substantial. Compared to other vaccination programs, universal hepatitis A vaccination is a cost-effective strategy.


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