Controlling varicella in the healthcare setting: the cost effectiveness of using varicella vaccine in healthcare workers.
OBJECTIVE
To determine if varicella vaccination of healthcare workers would result in a net cost savings.


METHODS
A Markov-based decision analysis.


METHODS
The analysis was based on a hypothetical population of healthcare workers. Data were obtained from exposure records of a tertiary-care hospital and from the literature. Workers were considered potentially susceptible if they had no past history of varicella.


RESULTS
Vaccination of potentially susceptible workers would result in a net cost savings of $59 per person. Serological testing prior to vaccination resulted in smaller net savings. The results were robust across a wide range of assumptions. Importantly, however, the result was very dependent on infection control policy regarding work restrictions for vaccine recipients. If more than 3% of vaccinees were removed from work due to vaccine-associated rash, vaccination no longer would result in a net cost savings.


CONCLUSIONS
Varicella vaccination of potentially susceptible healthcare workers can reduce costs and decrease morbidity. Infection control policy regarding work restrictions for vaccine recipients will play a key role in the feasibility of vaccination.
Nettleman
M D
MD
Department of Internal Medicine, Medical College of Virginia, 207 West Hospital, Richmond, USA.
Schmid
M
M
D002644:Chickenpox / Q000191:economics / Q000517:prevention & control*; D019433:Chickenpox Vaccine / Q000191:economics*; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000191:economics / Q000517:prevention & control*; D003661:Decision Support Techniques; D006801:Humans; D017053:Infection Control / Q000191:economics*; D007484:Iowa; D008390:Markov Chains; D010564:Personnel, Hospital; D014611:Vaccination / Q000191:economics*
D019433:Chickenpox Vaccine