Public health impact and cost effectiveness of routine childhood vaccination for hepatitis a in Jordan: a dynamic model approach

• Main Authors: Wail A. Hayajneh, Vincent J. Daniels, Cerise K. James, Muhammet Nabi Kanıbir, Matthew Pilsbury, Morgan Marks, Michelle G. Goveia, Elamin H. Elbasha, Erik Dasbach, Camilo J. Acosta
• Format: Article
• Language: English
• Published: BMC 2018-03-01
• Series: BMC Infectious Diseases
• Subjects: Immunization; Hepatitis a; Jordan; Impact; Cost-effectiveness analysis; Simulation
• Online Access: http://link.springer.com/article/10.1186/s12879-018-3034-8

Abstract Background As the socioeconomic conditions in Jordan have improved over recent decades the disease and economic burden of Hepatitis A has increased. The purpose of this study is to assess the potential health and economic impact of a two-dose hepatitis A vaccine program covering one-year old children in Jordan. Methods We adapted an age-structured population model of hepatitis A transmission dynamics to project the epidemiologic and economic impact of vaccinating one-year old children for 50 years in Jordan. The epidemiologic model was calibrated using local data on hepatitis A in Jordan. These data included seroprevalence and incidence data from the Jordan Ministry of Health as well as hospitalization data from King Abdullah University Hospital in Irbid, Jordan. We assumed 90% of all children would be vaccinated with the two-dose regimen by two years of age. The economic evaluation adopted a societal perspective and measured benefits using the quality-adjusted life-year (QALY). Results The modeled vaccination program reduced the incidence of hepatitis A in Jordan by 99%, 50 years after its introduction. The model projected 4.26 million avoided hepatitis A infections, 1.42 million outpatient visits, 22,475 hospitalizations, 508 fulminant cases, 95 liver transplants, and 76 deaths over a 50 year time horizon. In addition, we found, over a 50 year time horizon, the vaccination program would gain 37,502 QALYs and save over $42.6 million in total costs. The vaccination program became cost-saving within 6 years of its introduction and was highly cost-effective during the first 5 years. Conclusion A vaccination program covering one-year old children is projected to be a cost-saving intervention that will significantly reduce the public health and economic burden of hepatitis A in Jordan.