Socioeconomic improvements can reduce levels of endemic hepatitis A, but conversely increase the burden of disease. Routine childhood vaccination can rapidly control hepatitis A infection rates through the induction of herd immunity, although such programs can be costly.
We evaluated the healthcare benefits and cost-effectiveness of a routine childhood vaccination program against hepatitis A in Argentina, using a dynamic model that incorporated the changing epidemiology of infection and the impact of vaccine-induced herd immunity. Demographic, disease, and economic data from Argentina were used where available.
At 95% coverage, the program would reduce the number of hepatitis A infections by 352 405 annually, avoiding 121 587 symptomatic cases and 428 deaths. Substantial healthcare benefits were also observed with vaccination coverage as low as 70%, which would prevent 295 826 infections. Economically, the program would save US$23 989 963 annually at 95% coverage, equivalent to US$3 429 per life-year gained. The program remained cost-saving in response to variation in factors, including disease-related costs, discount rate, herd immunity level, and rate of decrease of force of infection. The break-even cost per vaccine dose for the society was US$25 in the base-case, more than three times the current public cost of US$7 per dose.
Routine childhood vaccination against hepatitis A showed both health benefits and robust economic benefits in this analysis, supporting the recent decision of the Argentine government to implement such a program.
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Lopez, E., Debbag, R., Coudeville, L. et al. The cost-effectiveness of universal vaccination of children against hepatitis A in Argentina: results of a dynamic health–economic analysis. J Gastroenterol 42, 152–160 (2007). https://doi.org/10.1007/s00535-006-1984-x
- hepatitis A
- health economics