Cost-effectiveness of routine catch-up hepatitis a vaccination in the United States: Dynamic transmission modeling study
| Autor: | Elamin H. Elbasha, Michelle G. Goveia, Yoonyoung Choi, Vincent J. Daniels |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Adolescent Cost effectiveness Cost-Benefit Analysis Hepatitis A vaccine Population HEPA medicine Humans Child education Aged 80 and over Hepatitis A Vaccines education.field_of_study General Veterinary General Immunology and Microbiology business.industry Public health Vaccination Public Health Environmental and Occupational Health Hepatitis A Cost-effectiveness analysis medicine.disease United States Infectious Diseases Child Preschool Molecular Medicine Quality-Adjusted Life Years business |
| Zdroj: | Vaccine. 39:6315-6321 |
| ISSN: | 0264-410X |
| DOI: | 10.1016/j.vaccine.2021.08.087 |
| Popis: | Background Despite routine vaccination of children against hepatitis A (HepA), a large segment of the United States population remains unvaccinated, imposing a risk of hepatitis A virus (HAV) to adolescents and adults. In July of 2020, the Advisory Committee on Immunization Practices recommended that all children and adolescents aged 2–18 years who have not previously received a HepA vaccine be vaccinated. We evaluated the public health impact and cost-effectiveness of this HepA catch-up vaccination strategy. Methods We used a dynamic transmission model to compare adding a HepA catch-up vaccination of persons age 2–18 years to a routine vaccination of children 12–23 months of age with routine vaccination only in the United States. The model included various health compartments: maternal antibodies, susceptible, exposed, asymptomatic infectious, symptomatic infectious (outpatient, hospitalized, liver transplant, post- liver transplant, death), recovered, and vaccinated with and without immunity. Using a 3% annual discount rate, we estimated the incremental cost per quality-adjusted life year (QALY) gained from a societal perspective over a 100-year time horizon. All costs were converted into 2020 US dollars. Findings Compared with the routine vaccination policy at 12–23 months of age over 100 years, the catch-up program for unvaccinated children and adolescents aged 2–18 years, prevented 70,072 additional symptomatic infections, 51,391 outpatient visits, 16,575 hospitalizations, and 413 deaths. The catch-up vaccination strategy was cost-saving when compared with the routine vaccination strategy. In scenario analysis allowing administering a second dose to partially vaccinated children, the cost-effectiveness of was not favorable at a higher vaccination coverage ($196,701/QALY at 5% and $476,241/QALY at 50%). Interpretation HepA catch-up vaccination in the United States is expected to reduce HepA morbidity and mortality and save cost. The catch-up program would be optimized when focusing on unvaccinated children and adolescents and maximizing their first dose coverage. |
| Databáze: | OpenAIRE |
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