Clinical and economic impact of various strategies for varicella immunity screening and vaccination of health care personnel

Gio Baracco, S. Eisert, S. Saavedra, P. Hirsch, M. Marin, I. R. Ortega-Sanchez

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background Exposure to patients with varicella or herpes zoster causes considerable disruption to a health care facility's operations and has a significant health and economic impact. However, practices related to screening for immunity and immunization of health care personnel (HCP) for varicella vary widely. Methods A decision tree model was built to evaluate the cost-effectiveness of 8 different strategies of screening and vaccinating HCP for varicella. The outcomes are presented as probability of acquiring varicella, economic impact of varicella per employee per year, and cost to prevent additional cases of varicella. Monte Carlo simulations and 1-way sensitivity analyses were performed to address the uncertainties inherent to the model. Alternative epidemiologic and technologic scenarios were also analyzed. Results Performing a clinical screening followed by serologic testing of HCP with negative history diminished the cost impact of varicella by >99% compared with not having a program. Vaccinating HCP with negative screen cost approximately $50,000 per case of varicella prevented at the current level of U.S. population immunity, but was projected to be cost-saving at 92% or lower immunity prevalence. Improving vaccine acceptance rates and using highly sensitive assays also optimize cost-effectiveness. Conclusion Strategies relying on screening and vaccinating HCP for varicella on employment were shown to be cost-effective for health care facilities and are consistent with current national guidelines for varicella prevention.

Original languageEnglish (US)
Pages (from-to)1053-1060
Number of pages8
JournalAmerican Journal of Infection Control
Volume43
Issue number10
DOIs
StatePublished - Oct 1 2015

Keywords

  • Immunization
  • Model
  • Occupational exposure
  • Occupational health
  • Screening
  • Varicella

ASJC Scopus subject areas

  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • Epidemiology
  • Health Policy

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