Estimating vaccination threshold and impact in the 2017-2019 hepatitis A virus outbreak among persons experiencing homelessness or who use drugs in Louisville, Kentucky, United states.


assuming a vaccine with 90% efficacy. The observed vaccination program was estimated to have averted 30 hospitalizations (95% CI: 19-43), associated with over US$490 000 (95% CI: $310 000-700 000) in hospitalization cost. Greater impact was observed with earlier and faster vaccination implementation.

Vaccination coverage of at least 77% is likely required to prevent outbreaks of HAV among PEH/PWUD in Louisville, assuming a 90% vaccine efficacy. Proactive hepatitis A vaccination programs among PEH/PWUD will maximize health and economic benefits of these programs and reduce the likelihood of another outbreak.

and vaccination impact using epidemic modeling.

and the effect of timing of the vaccination intervention on epidemic and economic outcomes.

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