| Abstract | dc.description.abstract | Objective. To evaluate the healthcare and economic impact of routine hepatitis A vaccination
of toddlers in Chile.
Methods. We used a dynamic model of hepatitis A infection to evaluate the impact of a twodose
vaccination program, administered at ages 12 and 18 months. The model incorporated the
changing epidemiology of hepatitis A in Chile and the development of vaccine-induced herd
immunity. Our analysis was conducted from the public payer perspective, and an estimation
of the societal perspective was performed. Costs are expressed in 2005 U.S. dollars.
Results. Vaccination of toddlers rapidly reduced the healthcare burden of hepatitis A. In the
base case (95% vaccination coverage, 100-year time horizon, 1% annual decrease in force of
infection), the average number of infections fell by 76.6% annually, and associated deaths fell
by 59.7%. Even at 50% coverage, the program reduced infection rates substantially. Routine
vaccination of toddlers had economic as well as health benefits, saving $4 984 per life-year
gained (base case scenario). The program became cost saving after 6 years, and its overall costeffectiveness
per life-year gained was largely unaffected by changes in disease-related costs,
herd immunity, coverage rate, and annual decrease in force of infection.
Conclusions. Routine vaccination of toddlers will reduce the rates of symptomatic hepatitis
A and associated mortality. The two-dose schedule evaluated here will be less expensive
than disease-related costs in the absence of vaccination from the sixth year of its implementation.
These findings support the establishment of a routine vaccination program for toddlers
in Chile. | en_US |
