Cost-benefit analysis of a nationwide infant immunization programme against hepatitis A in an area of intermediate endemicity

Background/Aims: The availability of safe and effective Hepatitis A vaccines prompts an evaluation of a nationwide infant vaccination campaign to supplement strategies aimed at high-risk groups such as travellers and military personnel. Methods: A spreadsheet model was used to estimate costs and benefits of a nationwide infant immunization programme against Hepatitis A for the period from 1997–2014 in Israel. Results: Immunizing all one year olds in Israel from 1997–2014 would for a cost of $32.0 million to the health services and $42.1 million to society (including $10.1 million lost work and transport costs), reduce the number of cases of Hepatitis A during the next 45 years from 181 000 to 47 000. This would save $57.5 million in health service resources alone, $32.0 million in averted work absences and transport costs in addition to a further $17.0 million in averted premature mortality costs. The health service, resource and societal benefit:cost ratios are 1.80:1, 2.13:1 and 2.54:1, respectively. Conclusions: The recent adoption of a nationwide infant HAV immunisation policy in Israel is both medically and economically justifiable.