The summaries are free for public
use. The Chronic Liver Disease
Foundation will continue to add and
archive summaries of articles deemed
relevant to CLDF by the Board of
Trustees and its Advisors.
Abstract Details
Assessing the cost-utility of universal hepatitis B vaccination among adults
J Infect Dis. 2022 Mar 9;jiac088. doi: 10.1093/infdis/jiac088. Online ahead of print.
Eric W Hall12, Mark K Weng3, Aaron M Harris3, Sarah Schillie4, Noele P Nelson3, Ismael R Ortega-Sanchez4, Elizabeth Rosenthal5, Patrick S Sullivan2, Ben Lopman2, Jeb Jones2, Heather Bradley6, Eli S Rosenberg57
Author information
School of Public Health, Oregon Health & Science University, Portland, Oregon, United States.
Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States.
National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States.
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States.
Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, NY, United States.
Department of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, United States.
New York State Department of Health, Albany, New York, United States.
Abstract
Background: Although effective against hepatitis B virus (HBV) infection, hepatitis B (HepB) vaccination is only recommended for infants, children and adults at higher risk. We conducted an economic evaluation of universal HepB vaccination among US adults.
Methods: Using a decision analytic model with Markov disease progression, we compared current vaccination recommendations (baseline) with either 3-dose or 2-dose universal HepB vaccination (intervention strategies). In simulated modeling of one million adults distributed by age and risk groups, we quantified health benefits (quality-adjusted life years, QALYs) and costs for each strategy. Multivariable probabilistic sensitivity analyses identified key inputs. All costs reported in 2019 US dollars.
Results: With incremental base-case vaccination coverage up to 50% among persons at lower risk and 0% increment among persons at higher risk, each of two intervention strategies averted nearly one quarter of acute HBV infections (3-dose strategy: 24.8%; 2-dose strategy: 24.6%). Societal incremental cost per QALY gained of $152,722 (Interquartile range: $119,113, $235,086) and $155,429 (Interquartile range: $120,302, $242,226) were estimated for 3-dose and 2-dose strategies, respectively. Risk of acute HBV infection showed the strongest influence.
Conclusions: Universal adult vaccination against HBV may be an appropriate strategy for reducing HBV incidence and improving resulting health outcomes.