Cost Effectiveness of Universal Hepatitis B Vaccinations

stethmoney1Published in the  March 2013 issue of Pediatrics, is an argument for the cost effectiveness of universal Hepatitis B vaccination.  What is missing from this analysis is the cost of caring for the additional cases of autism caused by the vaccination of newborns, 2 month olds, and 6 month old infants who were not at risk for hepatitis B but ended up autistic, likely specifically because of the Hepatitis B vaccine.  

JAMA published, in the Feb 13th 2013 issue, an article titled,  “Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children”.  This study of over 85,000 pregnancies in Norway found that those mom’s who took folate during pregnancy, in the years 2002 through 2006, had an autism rate of 1 in 1000.  In the USA, where most mom’s have folate in their prenatal vitamins, the autism rate for that same time period was 1 in 100.  Of  the 4 million births in the USA, the 1 in 100 rate would result in 40,000 new cases of autism.  Reducing the rate to 1 in 1000, as it is in Norway, by not giving universal Hepatitis B vaccines (only give it to those babies at risk), there would only be 4,000 cases of autism in the USA. The cost of caring for that additional 36,000 cases of autism will be in the billions!

Read the full article in Pediatrics here

Below is the abtract from this article

OBJECTIVE: To compare the cost-effectiveness of hepatitis B virus (HBV) control strategies combining universal vaccination with hepatitis B immunoglobulin (HBIG) treatment for neonates of carrier mothers.

METHODS: Drawing on Taiwan’s experience, we developed a decision-analytic model to estimate the clinical and economic outcomes for 4 strategies: (1) strategy V—universal vaccination; (2) strategy S—V plus screening for hepatitis B surface antigen (HBsAg) and HBIG treatment for HBsAg-positive mothers’ neonates; (3) strategy E—V plus screening for hepatitis B e-antigen (HBeAg), HBIG for HBeAg-positive mothers’ neonates; (4) strategy S&E—V plus screening for HBsAg then HBeAg, HBIG for all HBeAg-positive, and some HBeAg-negative/HBsAg-positive mothers’ neonates.

RESULTS: Strategy S averted the most infections, followed by S&E, E, and V. In most cases, the more effective strategies were also more costly. The willingness-to-pay (WTP) above which strategy S was cost-effective rose as carrier rate declined and was <$4000 per infection averted for carrier rates >5%. The WTP below which strategy V was optimal also increased as carrier rate declined, from $1400 at 30% carrier rate to $3100 at 5% carrier rate. Strategies involving E were optimal for an intermediate range of WTP that narrowed as carrier rate declined.

CONCLUSIONS: HBIG treatment for neonates of HBsAg carrier mothers is likely to be a cost-effective addition to universal vaccination, particularly in settings with adequate health care infrastructure. Targeting HBIG to neonates of higher risk HBeAg-positive mothers may be preferred where WTP is moderate. However, in very resource-limited settings, universal vaccination alone is optimal.

 

My conclusion:  Even if it were cost effective (code for saves the government money and theoretically saves the tax payers money), just a little common sense leads one to realize that creating 36,000 new autistic kids and likely hundreds of thousands of less severely but damaged kids, is insanity and can only be promoted by those; with a financial interest in the promotion,  with conflicts of interest, or with their heads so deep in the sand of status quo thinking, that they cannot see the forest for the trees.

Do not give your newborn, 2 month old, or 6 month old the Hepatitis B vaccine if the birth mom does not have Hepatitis B.

 Dr. Paul

 

2 comments

  • Anonymous

    I’m lost, hep b vaccine has been linked to autism? Is there new research I don’t know about?
    The JAMA study only shows that Folic acid has a correlation with lower autism rates, they say nothing about the hep b vaccine at all. The second article does talk about the hep b vaccine but it says nothing about autism. Did he forget to post a link to another study?

    http://jama.jamanetwork.com/article.aspx?articleid=1570279

    Thanks,
    Kit

    • Paul Thomas, M.D.

      Yes, the article talks about Folic acid and autism rates. But the rates of autism for mothers that take Folate during pregnancy (in Norway) are 1 in 1000. The vaccine schedule in Norway is the same as it is here in the USA, with the exception that in Norway, the Hepatitis B vaccine is NOT given to newborns, or young children, unless there is a legitimate concern of exposure.

      The point here is what is between the lines. The only real difference between the USA vaccine schedule and the Norwegian vaccine schedule is….Hep B! Keep in mind that the aluminum in Hep B is a known neurotoxin. And the level in the Hep B is far more than the tolerable amount deemed by the FDA as safe for intake within a 24 hour period for an adult. Why risk giving something like that to a newborn or young child when they are not at risk?

      Hope that helps!

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