title: Critical prevalence of antibodies minimizing vaccination costs for hepatitis A, hepatitis B, varicella, measles and tetanus in adults and adolescents in Catalonia, Spain.
abstract: The prevalence of seropositive individuals that makes costs of vaccinating all individuals equal to that for screening and vaccination of susceptible individuals is defined as the critical prevalence of antibodies (p*). Screening and vaccination is more efficient when the prevalence of seropositive individuals (p) in the population is higher than p*. In this study, the formula to obtain p* was derived from the cost-effectiveness equations, showing that it depends on screening and vaccination costs, programme compliance, screening test performance, vaccine efficacy and disease costs. The formula was used to determine the least costly vaccination strategy for hepatitis A and B, varicella, measles and tetanus in adults and adolescents in Catalonia. The least costly vaccination strategy was vaccination without screening (since p was lower than p*) for hepatitis B, measles and tetanus in adults and adolescents (5-14 years) and for hepatitis A in individuals aged 5-24 years, and screening and vaccination (since p was higher than p*) for varicella in adults and adolescents and for hepatitis A in adults aged >24 years. Vaccination strategies based on the critical prevalence of antibodies could maximize the immunity level in the community from available resources.
authors.affiliation: Department of Health, General Direction of Public Health, Travessera de les Corts 131-159, 08028 Barcelona, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Plans-Rubió
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D002644:Chickenpox / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003017:Clostridium tetani / Q000276:immunology; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D006506:Hepatitis A / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000097:blood; D006509:Hepatitis B / Q000276:immunology*; D014645:Herpesvirus 3, Human / Q000276:immunology; D006801:Humans; D017589:Immunization Programs / Q000191:economics; D008297:Male; D008403:Mass Screening / Q000191:economics; D008457:Measles / Q000276:immunology*; D008459:Measles virus / Q000276:immunology; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D013030:Spain; D013742:Tetanus / Q000276:immunology*; D014611:Vaccination / Q000191:economics*
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D006508:Hepatitis Antibodies