Cost Analysis of Single-Dose Hepatitis B Revaccination Among Infants Born to Hepatitis B Surface Antigen-Positive Mothers and Not Responding to the Initial Vaccine Series
| Autor: | Monica Trigg, Noele P. Nelson, Eric W. Hall, Eli S. Rosenberg, Sarah Schillie |
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| Rok vydání: | 2018 |
| Předmět: |
HBsAg
Immunization Secondary Hepatitis b surface antigen 03 medical and health sciences 0302 clinical medicine Pregnancy 030225 pediatrics medicine Humans Hepatitis B Vaccines 030212 general & internal medicine Hepatitis B Antibodies Pregnancy Complications Infectious Hepatitis B Surface Antigens business.industry Research Vaccination Infant Newborn Public Health Environmental and Occupational Health Hepatitis B surface antigen positive Hepatitis B medicine.disease Perinatal hepatitis Antibody Formation Immunology Costs and Cost Analysis Cost analysis Female business |
| Zdroj: | Public Health Reports. 133:338-346 |
| ISSN: | 1468-2877 0033-3549 |
| Popis: | Objectives: Infants born to mothers who are hepatitis B surface antigen (HBsAg) positive are at risk for perinatal hepatitis B infection. As prevention, these infants receive a series of 3 or 4 doses of hepatitis B vaccine starting at birth and postvaccination serologic testing. Infants with antibody levels Methods: We used a decision analytic tree to compare the costs of a single-dose revaccination strategy with the costs of a 3-dose revaccination strategy. The analysis consisted of 3 epidemiologic scenarios that varied levels of previous protection among infants indicated for revaccination. We assumed health outcomes in each strategy were the same, and we evaluated costs from the societal perspective using 2016 US dollars. We conducted sensitivity analyses on key variables, including the minimum required efficacy of a single revaccination dose. Results: In all analyses, the single-dose revaccination strategy was a lower-cost option than the 3-dose revaccination strategy. Under the assumption that all revaccination visits were previously unscheduled, single-dose revaccination reduced the cost per infant by $119.81 to $155.72 (depending on the scenario). Across all scenarios, the most conservative estimate for the threshold efficacy (the minimum efficacy required to result in a lower-cost option) value of single-dose revaccination was 67%. Conclusions: For infants who were born to HBsAg-positive mothers and who were not responding to the initial vaccine series, a single-dose revaccination strategy, compared with a 3-dose revaccination strategy, reduced costs across several scenarios. These results helped inform the Advisory Committee on Immunization Practices’ vote in February 2017 to recommend single-dose revaccination. |
| Databáze: | OpenAIRE |
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