economic analysis finds the added cost to the health care system
of mass vaccination of children to be about $8,300 at an incidence
a. The selective immunization approach for an adolescent would
produce a cost savings if the incidence approached 4%.
b. Strengths of the study include broad societal perspective,
data based decision tree, and sensitivity analysis.
c. Weaknesses include estimates of immunization costs that are
high, because the authors assumed three shots, not the currently
recommended two and underestimated the length of immunity provided
by the vaccine. Disease costs appear too low; a case of fulminant
hepatitis requiring liver transplant is estimated at less than
ACIP (Advisory Committee on Immunization Practices) is in agreement
with the CDC recommendations, but also recommends considering
immunization of children in areas where the incidence of hepatitis
A is >10 per 100,000.3
reports a study in which 66.2% of an estimated 44,982 children
in Butte County, CA received at least one shot of Hep A vaccine.
The incidence decreased from 57 cases in 1995 to 4 in 2000. The
incidence of 1.9 per 100,000 was the lowest for any county in