The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

4023.0: Tuesday, November 18, 2003 - Board 4

Abstract #57926

Cost evaluation of vaccination strategy to prevent vertical mother-to-child Hepatitis B transmission

Nalini abraham1, Mohit sahani2, Kapil Jindal2, Kumudha aruldas1, and Jacob M Puliyel2. (1) Health Domain, Plan India, C 6/6, Safdarjung development area, Delhi, India, 91-11-26968432, nalini.abraham@plan-international.org, (2) Paediatrics, St STephen's Hospital, Tis Hazari, Delhi, India

The immunization project for Plan India was funded by CIDA. In collaboration with St Stephens Hospital, Plan India conducted this study to evaluate costs of Hepatitis B immunization in India where vertical transmission is responsible for over 50% of the carrier rate. 70% of mothers deliver at home and a community-based study vaccinating newborns at home has not been undertaken previously. All mothers delivering in the study area (population 65,000) over a 1-year period, were tested for Hepatitis B (Test sensitivity 99% Specificity 100%) and babies of positive mothers were vaccinated starting at birth. The cost of selective vaccination after testing all mothers was calculated. The national cost of universal vaccination without testing was also calculated from the data. Sensitivity testing, considering economies of scale, was also factored in. 1100 mothers delivered during the study period. 252 were primiparous. The true prevalence of Hepatitis B carrier state was 1.47%. Nation-wide selective vaccination would cost $35 million per year. Universal immunisation without testing, would cost $190 million, using existing infrastructure of immunisation, to deliver the second and third doses. Economies of scale may bring this to $145million/year. Given that 5000 lives are lost to hepatocellular carcinoma yearly, the cost per life saved is $29000.

Learning Objectives:

Keywords: Hepatitis B, Cost Issues

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

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The 131st Annual Meeting (November 15-19, 2003) of APHA