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Reuters Health Information (2007-01-31): Routine childhood vaccination for hepatitis A deemed cost-effective

Economic

Routine childhood vaccination for hepatitis A deemed cost-effective

Last Updated: 2007-01-31 13:34:07 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Routine childhood vaccination for hepatitis A in the United States is similar to other accepted public health interventions in terms of cost-effectiveness, according to a report in the January issue of Pediatrics.

"The hepatitis A vaccine is probably one of the safest and most effective vaccines available," Dr. David B. Rein from RTI International, Atlanta, Georgia told Reuters Health. "It provides an easy opportunity for pediatricians to offer additional health benefits to their patients."

Dr. Rein and colleagues evaluated the cost-effectiveness of routine hepatitis A vaccination for all children aged 12 to 23 months compared to current vaccination rates and to no vaccination.

Based on the 2005 birth cohort, vaccination at age 1 year would result in 172,334 fewer hepatitis A infections and 32 fewer deaths nationwide than no childhood vaccination, the researchers report. Vaccination at age 1 year would cost $49.3 million more than no vaccination.

Based on these figures, vaccination at age 1 year would cost $284 per infection averted, $199,000 per life year gained, and $28,000 per quality-adjusted life-year (QALY) saved, the results indicate.

Compared with coverage levels in 2003, universal vaccination of 1-year-olds would carry an incremental cost of $496 per infection averted, $338,000 per life year gained, and $45,000 per QALY saved.

"Compared with no vaccination, the cost-effectiveness of nationwide routine hepatitis A vaccination at age 1 year is similar to that of other recently recommended vaccine policies," the investigators say.

Even assuming the vaccine were half as effective as what has been observed in clinical trials, the cost-effectiveness ratio of universal childhood vaccination would be $62,000 per QALY saved.

"One very clear implication of the paper is that the cost-effectiveness of full vaccination coverage in the States covered under the 1999 ACIP recommendations (that is, those with high prevalence rates of hepatitis A) is cost-saving, and thus highly favorable," Dr. Rein said. "Given that, the fact that the hepatitis A vaccination rates in those states lag so far behind other vaccines is a bit alarming."

"The vaccine has been indicated for use starting at age 1, and it can be administered at the same time as other vaccines," Dr. Rein pointed out. "Because the hepatitis A vaccine has been recommended by the ACIP, its coverage should be standard from most health insurers. The Vaccines for Children program provides reimbursement for patients who lack health insurance, or whose insurance does not cover the hepatitis A vaccine."

Pediatrics 2007;119:e12-e21.

 
 
 
 
                 
 
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