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Hepatitis B
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PEDIATRICS Vol. 111 No. 6 June 2003, pp. 1289-1296

Economic Analysis of Promotion of Hepatitis B Vaccinations Among Vietnamese-American Children and Adolescents in Houston and Dallas

Fangjun Zhou, MS, PhD*, Gary L. Euler, MPH, DrPH*, Stephen J. McPhee, MD{ddagger}, Thoa Nguyen{ddagger}, Tram Lam, BS{ddagger}, Ching Wong, BS{ddagger} and Jeremiah Mock, MSc, PhD{ddagger}

* National Immunization Program, CDC, Public Health Service, US Department of Health and Human Services, Atlanta, Georgia
{ddagger} Suc Khoe La Vang! (Health is Gold), the VCHPP, Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California

Objective. To ascertain the cost-effectiveness and benefit-cost ratios of 2 public health campaigns conducted in Dallas and Houston in 1998–2000 for "catch-up" hepatitis B vaccination of Vietnamese-Americans born 1984–1993.

Design. Program evaluation.

Setting. Houston and Dallas, Texas.

Participants. A total of 14 349 Vietnamese-American children and adolescents.

Interventions. Media-led information and education campaign in Houston, and community mobilization strategy in Dallas. Outcomes were compared with a control site: Washington, DC.

Main outcome measures. Receipt of 1, 2, or 3 doses of hepatitis B vaccine before and after the interventions, costs of interventions, cost-effectiveness ratios for intermediate outcomes, intervention cost per discounted year of life saved, and benefit-cost ratio of the interventions.

Results. The number of children who completed the series of 3 hepatitis B vaccine doses increased by 1176 at a total cost of $313 904 for media intervention, and by 390 and at $169 561 for community mobilization. Costs per child receiving any dose, per dose, and per completed series were $363, $101, and $267 for media intervention and $387, $136, and $434 for community mobilization, respectively. For media intervention, the intervention cost per discounted year of life saved was $9954 and 131 years of life were saved; for community mobilization, estimates were $11 759 and 60 years of life. The benefit-cost ratio was 5.26:1 for media intervention and 4.47:1 for community mobilization.

Conclusion. Although the increases in the number of children who completed series of 3 doses were modest for both the Houston and Dallas areas, both media education and, to a lesser degree, community mobilization interventions proved cost-effective and cost-beneficial.

Key Words: cost-effectiveness analysis • benefit-cost analysis • hepatitis B vaccination • media education • community mobilization • Vietnamese-Americans

Abbreviations: HBV, hepatitis B virus • HepB, hepatitis B vaccine • VFC, Vaccines for Children • ACIP, Advisory Committee on Immunization Practices • CDC, Centers for Disease Control and Prevention • API, Asian and Pacific Islander • VCHPP, Vietnamese Community Health Promotion Project • CE, cost-effectiveness

Received for publication Aug 8, 2002; Accepted Nov 20, 2002.


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