In order to optimize the employment of financial resources to be allocated for hepatitis B vaccination programs involving health care workers', two different aspects were studied: the need of a prevaccination screening and the efficacy of low-doses schedules of HBV vaccine by the intradermal (ID) route. The economical analysis (a cost- minimization study) showed that when the prevalence of immune individuals is higher than 11% it is more cost-effective to perform prevaccination screening. This situation was obsemed in the employees group. For students and doctors vaccination without screening was the best approach. Regarding the schedules, 3 doses of HBV vaccine by the intramuscular (IM) route (group A) were compared to first dose by the ID route and second and third doses by the IM route (group B) and to first and second doses by the ID route and the last dose by the IM route (group C). After the third dose, soroconversion rates in groups A and B (92% and 93%, respectively) and geometric mean titers of antiHBs (1278 UI/I and 789.6 UI/l) were similar, and both were different from group A (p< 0.05), showing that alternative vaccination schedules may be cost-effective.
Hepatitis B; Immunization; Hepatitis B vaccine; Health care workers; Health economics