An economic evaluation of hepatitis A vaccination in Dutch military personnel.
We analyzed the cost-effectiveness of hepatitis A vaccination regimens using a mathematical simulation model. Passive immunization and two active vaccination strategies (with and without prior screening) were compared with "doing nothing." Hepatitis A antibodies were determined in 2,325 Dutch marines; other input data were retrieved from published and unpublished sources. The prevalence of hepatitis A antibody was 14%. Screening before vaccination was identified as appropriate at a prevalence > 20%. Passive immunization was the cheapest prevention for a single 6-month deployment per 10 years. The inactivated vaccine containing 1,440 enzyme-linked immunosorbent assay units without prior screening was identified as the best option for more frequent deployments. It was cost-saving with two or more missions per 10 years. A 5.3% hepatitis A attack rate validated the investment for this policy. Overall, immunization with inactivated hepatitis A vaccine without prior screening proved to be the optimum strategy for troops at regular risk.
Medical Service, Royal Netherlands Navy, NATO Headquarters Eastern Atlantic Area, Middlesex, United Kingdom.
A H
AH
Buma
P
P
Beutels
P
P
van Damme
G
G
Tormans
E
E
van Doorslaer
A
A
Leentvaar-Kuijpers
D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D006506:Hepatitis A / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D022362:Hepatitis A Vaccines; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel; D009426:Netherlands; D015995:Prevalence; D014611:Vaccination / Q000191:economics*; D015164:Vaccines, Inactivated / Q000191:economics*; D014761:Viral Hepatitis Vaccines / Q000191:economics*
D022362:Hepatitis A Vaccines; D015164:Vaccines, Inactivated; D014761:Viral Hepatitis Vaccines