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 » Hepatitis A antibodies were determined in 2,325 Dutch marines ; other input data were retrieved from published and unpublished sources.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.
Mots-clés Pascal : Hépatite virale A, Virose, Infection, Vaccin, Dépistage, Immunoprophylaxie, Personnel, Militaire, Néerlandais, Analyse coût efficacité, Homme, Appareil digestif pathologie, Foie pathologie, Vaccination, Organisation santé, Prévention
Mots-clés Pascal anglais : Viral hepatitis A, Viral disease, Infection, Vaccine, Medical screening, Immunoprophylaxis, Personnel, Military, Dutch, Cost efficiency analysis, Human, Digestive diseases, Hepatic disease, Vaccination, Public health organization, Prevention
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0409324
Code Inist : 002B05A02. Création : 25/01/1999.