Costs and cost-effectiveness of a universal, school-based hepatitis B vaccination program

Am J Public Health. 1998 Nov;88(11):1638-44. doi: 10.2105/ajph.88.11.1638.


Objectives: This study evaluated the costs and cost-effectiveness of a school-based grade 6 universal vaccination program against hepatitis B.

Methods: We performed a descriptive cost study and cost-effectiveness analysis of British Columbia's vaccination program for 1994 and 1995. Since 1992, public health nurses have administered hepatitis B vaccine to grade 6 students in schools. We measured costs of vaccine, vaccine administration, and net program costs and used a validated Markov model to calculate the cost-effectiveness of the program.

Results: Vaccinating each student cost $44, $24 of which was the cost of vaccine administration. The net cost was $9 per person; considering productivity costs, net savings were $75 per person. Marginal cost per life year gained was $2100. Universal adolescent vaccination is also economically attractive in the United States but less attractive in regions with incidence rates below 3 cases per 100,000 per year.

Conclusions: Hepatitis B vaccine can be delivered in North American schools at a reasonable cost. Adolescent vaccination is economically attractive in North American regions of high and average incidence rates. Our analysis supports vaccination in adolescents who remain at risk for hepatitis B virus infection.

MeSH terms

  • British Columbia
  • Child
  • Cost-Benefit Analysis
  • Health Care Costs / statistics & numerical data*
  • Health Services Research
  • Health Status
  • Hepatitis B / economics
  • Hepatitis B / prevention & control*
  • Humans
  • Incidence
  • Markov Chains
  • Program Evaluation
  • Public Health Nursing
  • School Health Services / economics*
  • Sensitivity and Specificity
  • Vaccination / economics*