Effectiveness and cost comparison of two strategies for hepatitis B vaccination of schoolchildren.
BACKGROUND
In 1994, immunization against hepatitis B was implemented in schools in Quebec, targeting grade 4 students. In 1996-1997 and 1997-1998, one Local Community Service Centre (CLSC) replaced the school-based program in its district with vaccination offered in community clinics after school hours. The aim of the current study was to compare the effectiveness and costs of school-based and clinic-based programs.


METHODS
Vaccination coverage data were collected in the CLSC with the clinic-based program (CBP), and in three matched CLSCs with a school-based program (SBP), from 1994 to 2000. Surveys were conducted to estimate costs to parents, to schools and to CLSCs in 1997-1998.


RESULTS
With the implementation of the CBP, the vaccination coverage fell to 73%, compared with over 90% in the SBPs. Coverage increased to 90% when the CBP was abandoned. Costs to the CLSC were not much lower in the CBP. Societal costs were $63 per student vaccinated in the CBP, and < or = $40 in the SBPs.


CONCLUSIONS
Results demonstrate the advantage of a SBP over a CBP for the immunization of schoolchildren.
Guay
Maryse
M
Direction de la santé publique, de la planification et de l'évaluation, Régie régionale de la santé et des services sociaux de la Montérégie, Longueuil, QC. m.guay@rrss16@gouv.qc.ca
Clouâtre
Anne-Marie
AM
Blackburn
Manon
M
Baron
Geneviève
G
De Wals
Philippe
P
Roy
Chantale
C
Desrochers
Jean
J
Milord
François
F
D002648:Child; D003151:Community Health Centers / Q000191:economics* / Q000592:standards; D003362:Cost-Benefit Analysis; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000191:economics; D006801:Humans; D017589:Immunization Programs / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D008297:Male; D015397:Program Evaluation; D011792:Quebec; D012572:School Health Services / Q000191:economics* / Q000592:standards
D017325:Hepatitis B Vaccines