甲型肝炎疫苗免疫的成本效益分析

目的　为提高甲型肝炎疫苗接种的经济效益和为制订甲肝疫苗免疫策略提供依据。方法　采用成本效益分析、成本效益平衡点分析和抗体水平平衡点分析等卫生经济学评价方法。结果　发现调查地嘉兴市在甲型肝炎发病率为４１．１５／１０ 万的情况下，甲型肝炎疫苗接种的成本效益比为２．５３ ，成本效益平衡点甲型肝炎的发病率应为１６．２６／１０ 万，对甲型肝炎抗体阳性率５０％ 以上的人群接种时，抗体筛选后再接种能节省费用。结论　开展甲型肝炎疫苗的大规模人群接种具有较高的经济效益，１５ ～２９ 岁的人群为接种的首选对象，对２５ 岁以上人群接种前先进行抗体筛选能节省成本。

Cost-benefit analysis for hepatitis A vaccine

Objective To improve economic benefits of hepatitis A (HA) vaccination and to lay a foundation for formulating an immunization strategy for it. Methods Health economics methods were used for analyzing the cost-benefit ratio, balance point of cost-benefit and balance point of antibody level after HA vaccination. Results The benefit-cost ratio (BCR) for HA vaccine was 2.53 in Jiangxing City of Zhejiang Province with an HA-specific incidence rate of 41.15 per ten thousand. Incidence rate of HA was 16.26 per ten thousand at balance point of cost-benefit of HA vaccine. Cost would be reduced if serum HA antibody was screened before vaccination in the population with more than 50% of seropositive HA antibody. Conclusion It indicated that more economic benefits would be gained if mass HA vaccination strategy was used. Vaccinee of choice was those at ages of 15 to 29 years. HA vaccination after antibody screening in the population aged over 25 years would be more ecomonic than the direct use.