Cost-Effectiveness Modelling of Birth and Infant Dose Vaccination Against Hepatitis B Virus in Ontario from 2020 to 2050

Mia J. Biondi PhD NP-PHC, Chris Estes MPH, Devin Razavi-Shearer MPH, Kanwar Sahdra,
Nechama Lipton, Hemant Shah MD MScCH, Camelia Capraru MD, Harry L.A. Janssen MD PhD,
Homie Razavi PhD, Jordan J. Feld MD MPH

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Summary

The World Health Organization recommends universal birth dose vaccination for hepatitis B virus (HBV), yet only 3 provinces and territories in Canada provide birth dose vaccination, and Canadian-born children in Ontario are acquiring HBV before adolescent vaccination. We sought to determine whether birth and/or infant HBV vaccination is cost-effective. We used a dynamic HBV model that incorporates population by year, disease stage, sex and the influence of immigration to quantify the disease and economic burden of chronic HBV infection in Ontario from 2020 to 2050. We compared 4 vaccination scenarios, which included a birth dose vaccine and variations of the 2 subsequent doses (either alone or as a part of the hexavalent vaccine) and a hexavalent-only strategy in infancy with the current adolescent vaccination strategy. Our costing estimates were based on values from 2020.