Economic analysis of promotion of hepatitis B vaccinations among Vietnamese-American children and adolescents in Houston and Dallas

Abstract

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 dollars for media intervention, and by 390 and at 169,561 dollars for community mobilization. Costs per child receiving any dose, per dose, and per completed series were 363 dollars, 101 dollars, and 267 dollars for media intervention and 387 dollars, 136 dollars, and 434 dollars for community mobilization, respectively. For media intervention, the intervention cost per discounted year of life saved was 9954 dollars and 131 years of life were saved; for community mobilization, estimates were 11,759 dollars 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.

Fig 1

HepB doses administered by age of child for Vietnamese children in the media (Houston) and community mobilization intervention (Dallas) areas, 1998–2000.