Cost-effectiveness of hepatitis A vaccine in prevention of secondary hepatitis A infection

Using a decision-tree based model, we investigated the cost-effectiveness of several vaccination strategies for household, day care center and nursery/primary school contacts of primary cases of hepatitis A in France. Depending on the age groups vaccinated, the cost per symptomatic case avoided varied between Euro 700 and 1300 ( Euro 1 = US$ 0.93) for household contacts. Vaccination of contacts in day care centers and schools resulted in cost-savings. However, these findings are contingent on the limited and controversial data available on vaccine protective efficacy. In particular, the question of the relative efficacy of vaccination as compared with the use of immunoglobulins needs further study. (C) 2003 Elsevier Ltd. All rights reserved.