The economics of vaccinating restaurant workers against hepatitis A

The economics of vaccinating restaurant workers against hepatitis A were st udied using Monte Carlo simulation models, one with a restaurant-owner pers pective, and one with a societal perspective. The restaurant model allowed for a different size, number of employees and employee turnover rate. Benef its were the avoidance of loss of business (including the possibility of ba nkruptcy) after publicity linking the restaurant to an outbreak associated with a case of hepatitis A in a food handler. Additional benefits in the so cietal model included reductions in costs of food handler-associated cases of hepatitis A. The outcome used was Net Present Value (NPV), allowing comp arison between models. Regardless of the cost of vaccination ($50-140/emplo yee), for a restauranteur to ensure that all employees were vaccinated at a ll times substantial costs were involved (i.e. negative NPV). Even a 75% pr obability of bankruptcy still resulted in negative NPVs at the 95th percent iles. For society, vaccination was only cost-saving (i.e. positive NPV) if done only during epidemics and if it cost < $20/employee. Vaccinating resta urant employees is unlikely to be economical from either the restaurant own er or the societal perspective, even during hepatitis A epidemics. Publishe d by Elsevier Science Ltd.