Controlling varicella in the healthcare setting: the cost effectiveness of using varicella vaccine in healthcare workers.

OBJECTIVE To determine if varicella vaccination of healthcare workers would result in a net cost savings. DESIGN A Markov-based decision analysis. SETTING The analysis was based on a hypothetical population of healthcare workers. Data were obtained from exposure records of a tertiary-care hospital and from the literature. Workers were considered potentially susceptible if they had no past history of varicella. RESULTS Vaccination of potentially susceptible workers would result in a net cost savings of $59 per person. Serological testing prior to vaccination resulted in smaller net savings. The results were robust across a wide range of assumptions. Importantly, however, the result was very dependent on infection control policy regarding work restrictions for vaccine recipients. If more than 3% of vaccinees were removed from work due to vaccine-associated rash, vaccination no longer would result in a net cost savings. CONCLUSION Varicella vaccination of potentially susceptible healthcare workers can reduce costs and decrease morbidity. Infection control policy regarding work restrictions for vaccine recipients will play a key role in the feasibility of vaccination.