Cost-effectiveness of hepatitis A vaccination for adults in Belgium

► In low endemic countries, risks of extended HAV outbreaks are a cause for concern. ► Vaccination targeting adults could be an alternative to childhood vaccination. ► Such a strategy is not cost-effective as it would cost 185,000€ per QALY. ► Screening first and vaccination of seronegatives would cost 223,000€ per QALY. ► To be cost-effective risk-groups require a 3.5-4 times higher force of infection.