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Costs and Benefits of Hepatitis Prophylaxis-Reply

John D. Hamilton, MD
JAMA. 1984;251(21):2794. doi:10.1001/jama.1984.03340450022016.
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In Reply.—  Drs Egilman and Lichty presumably reflect the views of the National Institute for Occupational Safety and Health (NIOSH). Unfortunately, in their zeal to detect violators of OHSA regulations they have failed to understand some vital points.First, there is no mention in my article that "it is necessary" to assess costs prior to implementing a hepatitis B virus (HBV) control program with vaccine. Of course, if you wish to do a cost analysis, you must assess costs.Second, no mention is made of trying to get out of doing the right (and legal) thing by invoking excessive costs as an excuse. After all, the analysis led to a hospital decision to proceed with one of the largest and most successful immunization programs among health care personnel in this country, at hospital expense. Furthermore, our program, which officially began in September 1982, has been accompanied by a reduction in


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