Controlling Varicella in the Healthcare Setting: The Cost Effectiveness of Using Varicella Vaccine in Healthcare Workers

• Published in: Infection control and hospital epidemiology Vol. 18; no. 7; pp. 504 - 508
• Main Authors: Nettleman, Mary D., Schmid, Marlene
• Format: Journal Article
• Language: English
• Published: Thorofare, NJ SLACK Incorporated 01-07-1997; Slack; Cambridge University Press
• Subjects: Biological and medical sciences; Chickenpox; Chickenpox - economics; Chickenpox - prevention & control; Chickenpox vaccine; Chickenpox Vaccine - economics; Cost of Illness; Cost savings; Cost-Benefit Analysis; Cross Infection - economics; Cross Infection - prevention & control; Decision Support Techniques; Dosage; Epidemiology; Exanthema; Health care; Health care costs; Health care industry; Human viral diseases; Humans; Infection control; Infection Control - economics; Infectious diseases; Iowa; Markov Chains; Medical sciences; Nursing; Personnel, Hospital; Vaccination; Vaccination - economics; Vaccines; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Iowa; Infection; Human; Prevention; Immunoprophylaxis; Costs; Health staff; Health economy; Viral disease; Vaccination; Varicella; Hospital; Public health
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1086/647656

Objective: To determine if varicella vaccination of healthcare workers would result in a net cost savings. Design: A Markov-based decision analysis. Setting: The analysis was based on a hypothetical population of healthcare workers. Data were obtained from exposure records of a tertiary-care hospital and from the literature. Workers were considered potentially susceptible if they had no past history of varicella. Results: Vaccination of potentially susceptible workers would result in a net cost savings of $59 per person. Serological testing prior to vaccination resulted in smaller net savings. The results were robust across a wide range of assumptions. Importantly, however, the result was very dependent on infection control policy regarding work restrictions for vaccine recipients. If more than 3% of vaccinees were removed from work due to vaccine-associated rash, vaccination no longer would result in a net cost savings. Conclusion: Varicella vaccination of potentially susceptible healthcare workers can reduce costs and decrease morbidity. Infection control policy regarding work restrictions for vaccine recipients will play a key role in the feasibility of vaccination.