Minority Health Archive

An Economic Assessment of Pre-Vaccination Screening for Hepatitis A and B

Jacobs, R. Jake and Saab, Sammy and Meyerhoff, Allen and Koff, Raymond (2003) An Economic Assessment of Pre-Vaccination Screening for Hepatitis A and B. Public Health Reports, 118 (6). pp. 550-558.

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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 costeffectiveness 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. Data describing pre-vaccination immunity, vaccine effectiveness, and prevention costs borne by the health system (i.e., serology, vaccine acquisition, and administration) were derived from published literature and U.S. government websites. Using spreadsheet models, the authors calculated the ratio of prevention costs to the number of vaccine protections conferred. Results. The vaccinate without screening protocol was most cost-effective in nine of 10 analyses conducted under baseline assumptions, and in 69 of 80 sensitivity analyses. In each population considered, vaccinate without screening was less costly than and at least equally as effective as screen and begin vaccination. The screen and defer vaccination protocol would reduce costs in seven populations, but effectiveness would also be lower. Conclusions. Unless directed at vaccination candidates with the highest probability of immunity, pre-vaccination screening for hepatitis A and B immunity is not cost-effective. Balancing cost reduction with reduced effectiveness, screen and defer may be preferred for older travelers and prison inmates.

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Item Type: Article
Additional Information: After clicking the link, scroll down the page to find the article. This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: Hepatitis A, Hepatitis B, Economic Assessment, Pre-Vaccination
Subjects: Health > Public Health
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Depositing User: Maya Gist
Date Deposited: 23 Dec 2003
Last Modified: 26 Jun 2011 16:26
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/17

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