title: A cost-effectiveness model for analyzing two varicella vaccination strategies.
abstract: A model for estimating the cost-effectiveness of a program for vaccinating employees at a health care institution against varicella zoster virus (VZV) was studied. Three outcomes of varicella vaccination--cost-effectiveness, reduction in employee infections, and reduction in patient exposures--were stratified to estimate the incremental costs of vaccinating three employee groups. The groups consisted of all employees (vaccinate-all group), employees providing direct patient care (direct care group), and employees working in high-risk patient care areas (high-risk group). Two strategies for employee vaccination were used: screen (by antibody titer testing) and then vaccinate, and vaccination alone. A model was used to estimate the various outcomes of the vaccination program. The model supported the screen, then vaccinate strategy of vaccinating employees, at a cost savings of about $50 per employee. Vaccination of all employees prevented 35 employee infections and 674 patient exposures for every 10,000 potentially susceptible employees. The cost of preventing one employee infection was about $15,000, and the cost of preventing one patient exposure was about $775. An employee vaccination program is a good investment in preventing patient exposures to VZV and may be cost-effective compared with only screening employees.
authors.affiliation: Department of Pharmaceutical Services, Palmetto Richland Memorial Hospital, Columbia, SC 29203, USA. jayne.gayman@rmh.edu
authors.forename: J
authors.initials: J
authors.lastname: Gayman
mesh_terms: D019433:Chickenpox Vaccine / Q000191:economics*; D003362:Cost-Benefit Analysis; D006562:Herpes Zoster / Q000517:prevention & control*; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006779:Hospitals, Public; D006801:Humans; D008403:Mass Screening; D018803:Models, Economic; D009657:North Carolina; D016272:Occupational Health; D010564:Personnel, Hospital / Q000191:economics*; D014611:Vaccination / Q000191:economics* / Q000379:methods
chemical_list: D019433:Chickenpox Vaccine