Complete control of HBV infection in high-risk populations probably will continue to be impeded, regardless of the source of vaccine, by the difficulties inherent in getting vaccine to those who need it most (e.g., health care workers entering the workforce and young, newly active homosexual men). Moreover, for reasons discussed above, control of HBV infection in the United States probably will not be achieved as long as the target population remains limited to high-risk groups. Thus, the long-term goal for control of hepatitis B in the United States, as in the highly endemic areas of the world, is the development of a vaccine that can be used universally in childhood.

The scope and purpose of the calculations included below are described in Chapters 4 and 7. These calculations are based on certain simplifying procedures and assumptions that have been judged not to compromise their utility for the purposes of this disease comparison. The total costs should be taken only as an approximation of the direct cost of this disease.