Cost-effectiveness of hepatitis A vaccination for adults in BelgiumCost-effectiveness of hepatitis A vaccination for adults in Belgium
Faculty of Medicine and Health Sciences
Vaccine & Infectious Disease Institute (VAXINFECTIO)
Epidemiology and social medicine (ESOC)
Vaccine / International Society for Vaccines. - Amsterdam
30(2012):42, p. 6070-6080
University of Antwerp
Hepatitis A vaccination targeting adults (or adult risk-groups like e.g. travellers, health care workers, soldiers or teachers) could be considered an alternative to a universal infant or adolescent vaccination program in low endemic countries. We estimated the current disease burden of hepatitis A in Belgium, and evaluated whether adult vaccination is cost-effective. We used a Markov cohort model to simulate the costs and effects of (1) vaccination of adults and (2) serological screening of adults and vaccination of susceptibles and compared these with the current situation. The results indicated that these expanded vaccination strategies are not cost-effective in the epidemiological circumstances of a typical low-endemic western country. In order to gain 1 quality-adjusted life year the health care payer would have to pay 185,000 for vaccination and 223,000 for screening and vaccination of seronegatives. For adult vaccination to be cost-effective, risk-groups would need to be exposed to a force of infection that is 3.54 times higher than currently estimated in the general population; or the total costs of vaccination would have to drop with approximately 75%.