Cost-benefit analysis of active vaccination campaigns against hepatitis A among daycare centre personnel in Israel

Objective: To evaluate, in economic terms, active vaccination campaigns aga inst hepatitis A in comparison with the use of nonspecific immune globulin for the prevention of the disease among daycare centre employees in Israel. Setting: Hypothetical analysis of che costs and benefits related to vaccina tion campaigns of workers currently employed in daycare centres in Israel. Methods: A cost-benefit analysis was performed, comparing mass and selectiv e active vaccination strategies for the daycare centre working force. Direc t and indirect costs of diagnosis, treatment and immunisation as well as pr oductivity loss were considered. A Markov-based model was developed using d ata from previous epidemiological studies and literature. Results: The benefit-to-cost ratios of selective and mass active vaccinatio n strategies were 1.50 (net present value (NPV) $US606 396] and 0.04 (NPV - $US2.36 million), respectively (2000 values). Conclusion: Under these study assumptions, the practice of administering he patitis A active vaccine to serologically proven non-immune daycare centre workers has a cost-benefit justification, and should be widely considered i n countries with a similar hepatitis A epidemiology to that in this study.