Cost-effectiveness of universal childhood hepatitis A vaccination in Chile

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

“…A Markov model, previously described (11,17), was used to predict hepatitis A outcomes with and without vaccination. Markov models can be powerful tools for economic evaluation, since they allow both costs and outcomes to be predicted over extended time periods (23).…”

“…Because Argentinaspecific data were unavailable, the hospitalization rate for older cases was assumed to be 38% greater, as seen in Chile (11). Between 2000 and 2004, 1 030 liver transplants were performed in Argentina, of which 22% were received by persons < 15 years of age (35).…”

“…Vaccine administration was estimated to cost US$ 0.40 per dose (11). Medical costs of hepatitis A patients were determined through review of Hospital Posadas (Buenos Aires) records and national cost data (37) as follows: outpatients, US$ 44; hospitalized patients without acute liver failure, US$ 160; hospitalized patients with acute liver failure but no transplant, US$ 2 400; hospitalized patients with acute liver failure receiving a liver transplant, US$ 54 650.…”

“…Hepatitis A endemicity is declining in Argentina, as in much of Latin America (9,10). Seroprevalence among children 11 to 15 years old is 54% (9), so by adolescence, nearly half the population lacks immunity from a common disease that causes substantial medical and work loss costs (5,11). Yet outbreaks among children still cause horrific results.…”

“…Kinetic models of antibody decline suggest vaccine-induced immunity will persist for decades after a two-dose series (14,15). Childhood vaccination is costeffective in many (11,(16)(17)(18)(19)(20) but not all countries (8,21). Cost-effectiveness is largely determined by the proportion of children with natural immunity and the ratio of vaccination-to-illness costs.…”