Details:

Alternative Title:
Vaccine
Personal Author:
Hankin-Wei, Abigail ; Rein, David B. ; Hernandez-Romieu, Alfonso ; Kennedy, Mallory J. ; Bulkow, Lisa ; ... More +
Hankin-Wei, Abigail ; Rein, David B. ; Hernandez-Romieu, Alfonso ; Kennedy, Mallory J. ; Bulkow, Lisa ; Rosenberg, Eli ; Trigg, Monica ; Nelson, Noele P. Less -
Description:
Background

Since 2006, the US Centers for Disease Control and Prevention has recommended hepatitis A (HepA) vaccination routinely for children aged 12–23 months to prevent hepatitis A virus (HAV) infection. However, a substantial proportion of US children are unvaccinated and susceptible to infection. We present results of economic modeling to assess whether a one-time catch-up HepA vaccination recommendation would be cost-effective.

Methods

We developed a Markov model of HAV infection that followed a single cohort from birth through death (birth to age 95 years). The model compared the health and economic outcomes from catch-up vaccination interventions for children at target ages from two through 17 years vs. outcomes resulting from maintaining the current recommendation of routine vaccination at age one year with no catch-up intervention.

Results

Over the lifetime of the cohort, catch-up vaccination would reduce the total number of infections relative to the baseline by 741 while increasing doses of vaccine by 556,989. Catch-up vaccination would increase net costs by $10.2 million, or $2.38 per person. The incremental cost of HepA vaccine catch-up intervention at age 10 years, the midpoint of the ages modeled, was $452,239 per QALY gained. Across age-cohorts, the cost-effectiveness of catch-up vaccination is most favorable at age 12 years, resulting in an Incremental Cost-Effectiveness Ratio of $189,000 per QALY gained.

Conclusions

Given the low baseline of HAV disease incidence achieved by current vaccination recommendations, our economic model suggests that a catch-up vaccination recommendation would be less cost-effective than many other vaccine interventions, and that HepA catch-up vaccination would become cost effective at a threshold of $50,000 per QALY only when incidence of HAV rises about 5.0 cases per 100,000 population.


Subjects:
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Article Economic Modeling Hepatitis A Vaccine Recommendation
Source:
Vaccine. 34(35):4243-4249.
Pubmed ID:
27317459
Pubmed Central ID:
PMC5582969
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States ; U38 PS004646/PS/NCHHSTP CDC HHS/United States
CC999999/Intramural CDC HHS/United States ; U38 PS004646/PS/NCHHSTP CDC HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:87230ecf2a7124af8341f9ae14d76c31a95592fa903efd455c25cfd0ce97bd67
Download URL:
https://stacks.cdc.gov/view/cdc/47999/cdc_47999_DS1.pdf
File Type:

Supporting Files

• 	NIHMS899946-supplement-supplemental_1.pdf	pdf
  	nihms899946.nxml	bin
  	nihms899946f1.gif	gif
  	nihms899946f1.jpg	jpeg

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