Economic analysis of a child vaccination project among Asian Americans in Philadelphia, Pa.
OBJECTIVE
To ascertain the cost-effectiveness and the benefit-cost ratios of a community-based hepatitis B vaccination catch-up project for Asian American children conducted in Philadelphia, Pa, from October 1, 1994, to February 11, 1996.


METHODS
Program evaluation.


METHODS
South and southwest districts of Philadelphia.


METHODS
A total of 4384 Asian American children.


METHODS
Staff in the community-based organizations (1) educated parents about the hepatitis B vaccination, (2) enrolled physicians in the Vaccines for Children program, and (3) visited homes of children due for a vaccine dose. Staff in the Philadelphia Department of Public Health developed a computerized database; sent reminder letters for children due for a vaccine dose; and offered vaccinations in public clinics, health fairs, and homes.


METHODS
The numbers of children having received 1, 2, or 3 doses of vaccine before and after the interventions; costs incurred by the Philadelphia Department of Public Health and the community-based organizations for design, education, and outreach activities; the cost of the vaccination; cost-effectiveness ratios for intermediate outcomes (ie, per child, per dose, per immunoequivalent patient, and per completed series); discounted cost per discounted year of life saved; and the benefit-cost ratio of the project.


RESULTS
For the completed series of 3 doses, coverage increased by 12 percentage points at a total cost of $268 660 for design, education, outreach, and vaccination. Costs per child, per dose, and per completed series were $64, $119, and $537, respectively. The discounted cost per discounted year of life saved was $11 525, and 106 years of life were saved through this intervention. The benefit-cost ratio was 4.44:1.


CONCLUSIONS
Although the increase in coverage was modest, the intervention proved cost-effective and cost-beneficial.
Deuson
R R
RR
National Immunization Program, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, GA, USA. robert_deuson@merck.com
Brodovicz
K G
KG
Barker
L
L
Zhou
F
F
Euler
G L
GL
D000293:Adolescent; D001213:Asian / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006509:Hepatitis B / Q000208:ethnology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000191:economics*; D006801:Humans; D017589:Immunization Programs / Q000191:economics* / Q000458:organization & administration; D008297:Male; D015143:Philadelphia; D016730:Program Development; D015397:Program Evaluation; D012042:Registries; D014505:Urban Population; D014611:Vaccination / Q000592:standards / Q000639:trends
D017325:Hepatitis B Vaccines