title: [The optimization of the use of economic resources for vaccination against hepatitis B in professionals in the health area].
abstract: In order to optimize the employment of financial resources to be allocated for hepatitis B vaccination programs involving health care workers, two different aspects were studied: the need of a pre-vaccination screening and the efficacy of low-doses schedules of HBV vaccine by the intradermal (ID) route. The economical analysis (a cost-minimization study) showed that when the prevalence of immune individuals is higher than 11% it is more cost-effective to perform pre-vaccination screening. This situation was observed in the employees group. For students and doctors vaccination without screening was the best approach. Regarding the schedules, 3 doses of HBV vaccine by the intramuscular (IM) route (group A) were compared to first dose by the ID route and second and third doses by the IM route (group B) and to first and second doses by the ID route and the last dose by the IM route (group C). After the third dose, soroconversion rates in groups A and B (92% and 93%, respectively) and geometric mean titers of antiHBs (1278 UI/L and 789.6 UI/L) were similar, and both were different from group A (p < 0.05), showing that alternative vaccination schedules may be cost-effective.
authors.affiliation: Disciplina de Gastroenterologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP).
authors.forename: M L
authors.initials: ML
authors.lastname: Ferraz
authors.forename: P M
authors.initials: PM
authors.lastname: de Oliveira
authors.forename: V M
authors.initials: VM
authors.lastname: Figueiredo
authors.forename: V L
authors.initials: VL
authors.lastname: Kemp
authors.forename: A
authors.initials: A
authors.lastname: Castelo Filho
authors.forename: A E
authors.initials: AE
authors.lastname: Silva
mesh_terms: D001938:Brazil; D003362:Cost-Benefit Analysis; D004306:Dose-Response Relationship, Immunologic; D006282:Health Personnel / Q000191:economics; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006509:Hepatitis B / Q000191:economics / Q000276:immunology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000191:economics / Q000276:immunology*; D006801:Humans
chemical_list: D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines
vernacular_title: Otimização do emprego de recursos econômicos para vacinação contra hepatite B em profissionais da área de saúde.