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Hepatitis A is a prevalent disease that is largely preventable by vaccine usage. The vaccine for this illness is highly underused in most regions. In an attempt to find the strategies that are most beneficial in regard to quality-adjusted life years (QALYs) and cost in current environments, the purpose of this paper is to conduct cost-effectiveness analyses to investigate vaccination strategies in a more economically developed country (MEDC), generally known as a “developed” area: the USA, and a less economically developed country (LEDC), generally known as a “developing” area: the state of Rio de Janeiro, Brazil.

This study used a dynamic transmission model for comparative effectiveness analyses. The model ran two different scenarios. The two regions studied have different policies and strategies for Hepatitis A vaccination currently, and also used different strategies in 2009. In the USA, a universal vaccination policy was modeled, along with a scenario in which it was removed. In Rio de Janeiro, a no vaccination policy was modeled, along with a scenario in which a universal vaccination policy was effected.

The comparison of resulting incremental cost-effectiveness ratio values to accepted threshold values showed universal vaccination to be cost-effective in both the USA and Rio de Janeiro as compared to no vaccination. When episode and vaccination costs and vaccination efficacy were varied, this still remained true. Universal vaccination was found to result in lower incidence of Hepatitis A in both the USA and Rio de Janeiro. Over the twenty-year time horizon, universal vaccination is projected to prevent 506,945 cases of symptomatic Hepatitis A in the USA and 42,318 cases of Hepatitis A in Rio de Janeiro. Other benefits include a projected increase in cumulative QALYs through the use of universal vaccination.

This analysis showed universal vaccination to be cost-effective as compared to no vaccination, and portions of the study’s approach had not previously been applied in tandem to investigate Hepatitis A interventions. The results may help foster higher compliance rates for Hepatitis A vaccination and even greater per-person economic benefits of universal vaccination, particularly in the USA. The purpose of this study is also to encourage elevated levels of surveillance on age of infection in developing regions and consistent reevaluation utilizing dynamic transmission models in both the USA and Brazil, as well as other rapidly developing regions, in order to prevent future epidemics and costs associated with the disease.

The environmental and demographic characteristics of closed institutions, particularly prisons, precipitate morbidity during hepatitis A virus (HAV) outbreaks. Given the high prevalence of chronic liver disease and other risk factors in the prison setting, the purpose of this paper is to examine HAV-immunity and its associated factors in this population.

The cross-sectional study was conducted in 2009: a serology screening for HAV IgG was carried out among 116 inmates in Switzerland’s largest pre-trial prison. Other participant characteristics were collected through a structured face-to-face questionnaire with a physician.

In terms of significant demographics, Africa (53.5 percent) and the Balkans/Eastern Europe (36.2 percent) were the main regions of origin; a minority of inmates were from Western Europe (6.9 percent), Latin America (2.6 percent) or Asia (0.9 percent). The authors identified hepatitis A antibody-negative serology (lack of immunity) in five out of 116 prisoners (4.3 percent, 95 percent CI 1.4-9.7). Among participants of European origin alone, five out of 50 inmates were hepatitis A antibody-negative (10 percent, 95 percent CI 3.3-21.8), whereas the 66 inmates from other all continents were hepatitis A antibody-positive (immune) (p=0.026).

In this prison population composed of mostly African migrants, hepatitis A immunity was high. This reaffirms that region of origin is highly associated with childhood immunity against HAV. HAV vaccination should take into account a patient’s area of origin and his/her risk factors for systemic complications, if ever infected. This targeted strategy would offer herd immunity, and seek out the most vulnerable individuals who are potentially at risk of new exposure in this precarious setting.

This paper aims to describe the strategies being put in place to develop blood borne virus (BBV) services across prisons in Wales, UK, in response to the recommendations for prisons within the Welsh Government's Blood Borne Viral Hepatitis Action Plan for Wales.

A task and finish group was established to ensure multidisciplinary engagement between healthcare and custody staff. A service improvement package was developed focusing on awareness raising and/or development of clinical services for prisoners, prison officers and prison healthcare staff.

Prison healthcare staff have undergone training in BBVs and are being supported to deliver clinical services to prisoners. Training has been delivered in pre/post test discussion and dried blood spot testing; care pathways have been established between prison and community specialists for treatment referrals. An e‐learning module is being rolled out to raise awareness amongst custody staff and encourage occupational hepatitis B vaccination. Literature on “liver health” has been produced to be given to every prisoner across Wales.

It is envisaged that BBV services will become a routine part of prison care in Wales. Data on activity are being collected for evaluation and it is hoped that tackling BBVs in prisons will help reduce rates of infection both within prisons and in the wider community.

This paper describes new initiatives that have been established to tackle BBVs across Welsh prisons and will be relevant to any prison healthcare staff looking to develop similar services.

The prevalence of hepatitis B, hepatitis C and HIV in a representative sample of the Armenian male adult prison population has been determined and prisoners and staff were anonymously asked on risk behaviours (542 prisoners) and on knowledge, attitude and behaviour towards infectious diseases (348 staff members) Prisoners’ knowledge about the sources of transmission of HIV is quite poor, most of the wrong answers relate to activities in the daily prison life. The acceptance of HIV‐infected inmates tends towards extremely negative attitudes. The reported rate of intravenous drug use was 13.3%, and 51% among those are current injectors. Of the ‘ever injectors’, between 15% and 30% reported high‐risk behaviour. Of particular interest was the fact that the self‐reported HIV test results did not correlate at all with the results of the saliva tests. In the study the prevalence of HIV was 2.4%, a rate which is 27 times higher than in the general population. The prevalence rate for hepatitis B among prisoners is 3.7% and for hepatitis C 23.8%. The most important risk factor for contracting an HCV infection was drug use and the second, time spent in prison within the last 10 years, which is an independent risk factor. A substantial number of prison employees perceive their working condition as risky and themselves as at risk for TB, hepatitis B/C or HIV, but large groups had no idea about infection rates. Regarding HIV and hepatitis, knowledge is poor and patchy. While staff show quite good knowledge regarding the main transmission routes via blood and unprotected sex, a low level of knowledge becomes obvious when considering everyday‐life situations, which may cause fears in such a closed setting like prison. Standards including confidentiality and non‐segregation are not accepted in respect of HIV positive prisoners. Here, attitudes range between ‘inclusion’ and ‘exclusion’, which might express uncertainty and insecurity about the risks HIV‐positive persons carry. The provision of sterile needles for tattooing and sterile syringes and needles for injecting drugs users to prevent the spread of infectious diseases are not agreed by the majority of prison staff.

Many world regions are developing quickly and experiencing increasing levels of sanitation, causing an epidemiological shift of hepatitis A in these areas. The shift occurs when children avoid being infected with the disease until a later age due to cleaner water sources, food, and hygiene practices in their environment; but if they are infected at later age, the disease is much more severe and lost productivity costs are higher. The purpose of this paper is to examine what could occur if an epidemiological shift of the disease continues in these regions, and what type of future burden hepatitis A may have in a hypothetical rapidly developing country.

Initially, annual hepatitis A mortality was regressed on the Human Development Index (HDI) for each country classified as an emerging and growth-leading economy (EAGLE) to provide an overview of how economic development and hepatitis A mortality related. Data from the various EAGLE countries were also fit to a model of hepatitis A mortality rates in relation to HDI, which were both weighted by each country’s 1995–2010 population of available data, in order to create a model for a hypothetical emerging market country. A second regression model was fit for the weighted average annual hepatitis A mortality rate of all EAGLE countries from the years 1995 to 2010. Additionally, hepatitis A mortality rate was regressed on year.

Regression results show a constant decline of mortality as HDI increased. For each increase of one in HDI value in this hypothetical country, mortality rate declined by 2.3016 deaths per 100,000 people. The hypothetical country showed the HDI value increasing by 0.0073 each year. Also, results displayed a decrease in hepatitis A mortality rate of 0.0168 per 100,000 people per year. Finally, the mortality rate for hepatitis A in this hypothetical country is projected to be down to 0.11299 deaths per 100,000 people by 2030 and its economic status will fall just below the HDI criteria for a developed country by 2025.

The hypothetical country as a prototype model was created from the results of regressed data from EAGLE countries. It is aimed to display an example of the health and economic changes occurring in these rapidly developing regions in order to help understand potential hepatitis A trends, while underscoring the importance of informed and regular policy updates in the coming years. The author believes this regression provides insight into the patterns of hepatitis A mortality and HDI as these EAGLE countries undergo rapid development.

This study aimed to determine the prevalence and risk factors of hepatitis B virus (HBV) infection among medical laboratory science students (MLSSs) in the University of Health and Allied Sciences (UHAS), Ghana.

A cross-sectional study design was employed to recruit a total of 178 students into the study. A self-administered questionnaire was used to gather relevant information on risk factors, and a hepatitis B diagnostic test kit was used to test for HBV infection. Descriptive, chi-square test, bivariate and multiple logistic regression statistical analysis were computed. Significance was observed at p < 0.05.

The prevalence of HBV infection among MLSSs was 6.7%. Torn gloves and splash of blood and body fluids contributed to 43.0% and 28.0% of all the risk factors of HBV infection, respectively. Also, 43.3% of students had received at least one dose of the hepatitis B vaccination. Sharp object-related injury and torn gloves increased the odds of HBV infection, while vaccination decreased the odds of HBV infection.

This study reveals the prevalence of HBV among MLSSs, who are recognized as being among the high-risk student populations aside from student nurses.

Payment for healthcare services in the USA has shifted from fee for service to compensation based on value and quality. The indicators used for payments are a variety of clinical measures, including administration of vaccines to patients. The purpose of this paper is to describe the implementation of programs in health systems to improve vaccination rates and patient outcomes.

A search of the literature was conducted to find examples of vaccine programs in US health systems, and also to identify policies to improve immunization rates.

Successful programs for improving vaccination rates require advocacy and support of leadership, a systematic and multidisciplinary approach, and an evaluation of local resources and capacity. Numerous examples exist of medical, nursing, and pharmacy led programs that improve vaccination rates. The department in charge has relied on the support of other groups to ensure the success.

Mandatory vaccination of healthcare personnel (HCP) in the health system has been a growing trend in the USA. Although there has been some resistance to mandatory vaccinations for HCP, the standards and requirements have resulted in improved rates in health systems, which ultimately improve efficiency and protects patients.

This review describes considerations for implementing a successful vaccination program in a health system and provides examples of specific strategies. An overview of mandatory vaccinations for HCP is also described.

This paper aims to estimate the delay or timely effects of the national vaccination strategy for COVID-19 on Italian gross domestic product (GDP). By adopting a knowledge management lens, the study highlights the importance of “time” for Italian recovery. Indeed, recovering an adequate growth rate is crucial for the future of employment, well-being and management of Italian public debt.

This study applies an epidemiological model of a universal access vaccination programme against COVID-19. The economic model is based on the time-shift of available quarterly projections deriving from the expected delay or acceleration of the national vaccination plan against COVID-19.

The basic concept underlying the scenario analysis is that the sustainability of the expected recovery of the Italian economy due to the COVID-19 shock, and consequently the growth of the GDP, is time-dependent on the rollout of the national vaccination plan.

A delay in the vaccination campaign could have a twofold negative impact on the growth of the Italian gross product: it reduces the quarterly growth over the previous year in the short term and it delays the quarterly upwards trend over the next two years. Policymakers and practitioners are called to promptly face new dynamic scenarios due to public and economic policies to fight the COVID-19 crisis.

To the best of the authors’ knowledge, this is the first attempt of research that focuses attention on the synchrony between the economic time necessary for recovery and the real-time necessary to achieve vaccination coverage for the restart of production activities.

Repeated influenza outbreaks are surprisingly rare in prison settings worldwide, a factor that has made it superfluous, to date, to develop contingency plans for responding to prison‐based influenza epidemics. However, the influenza outbreak that occurred in an Australian prison in 2000 has highlighted the appropriateness of developing an outbreak plan, not least because of the security implications of a widespread prison influenza epidemic. Using reported attack rates and morbidity profiles of the 2000 Australian prison influenza outbreak to develop scenarios, the authors estimated the cost ‐ benefit of mass vaccination and antiviral chemotherapy approaches for the control of hypothetical widespread influenza outbreaks in New South Wales prisons, occurring at an average frequency of once every 10 years. It was concluded that, from the perspectives of maintaining prison security as well as health care services’ provision to prisoners, early antiviral chemotherapy for symptomatic individuals will have more favourable cost ‐ benefit ratios than a mass vaccination approach for controlling prison‐based influenza outbreaks that occur in line with this model.

The purpose of this paper is to describe the history of pharmacist involvement as vaccine providers in the USA and discuss examples of growing interests in other parts of the world.

Literature searches were performed in PubMed as well as pharmacy-related journals.

Pharmacists have been involved with the storage and management of vaccines for more than a century. Based on the unmet needs in meeting national goals for vaccination rates among adults in the USA, efforts led to training and recognizing pharmacists as vaccine providers which is now within the scope of practice for a pharmacist in all US states and territories. Pharmacists complete a comprehensive training program in vaccine sciences, regulatory considerations, as well as demonstration of skills in administering vaccines. Over 300,000 pharmacists have been trained in vaccine delivery and this represents the majority of the pharmacist workforce in the USA. There are examples of the beneficial impact of pharmacist involvement as vaccine providers in community pharmacy settings.

This review is based on a thorough review of the literature but was not conducted in a systematic fashion.

This review provides a historical perspective and evidence of the benefit of pharmacists as vaccine providers.