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We conducted a cost utility analysis to evaluate approaches for implementing that recommendation in selected high\u2010risk settings: community outreach events with a large proportion of immigrants, syringe service programs, substance use treatment centres, sexually transmitted infection (STI) clinics, tuberculosis (TB) clinics and jails. We utilized a decision tree framework with a Markov disease progression model to compare quality adjusted life\u2010years and cost in 2021 United States dollars from four strategies: a 3\u2010dose vaccination regimen with prevaccination screening and testing (PVST; baseline comparison); PVST at the initial encounter followed by a 2\u2010dose series (Intervention 1); PVST with the first dose of a 2\u2010dose vaccination series at the initial encounter (Intervention 2); and a 2\u2010dose vaccination series without PVST (Intervention 3). In all settings, Intervention 1 resulted in worse health outcomes compared with the baseline strategy. Intervention 2 averted incident chronic HBV infections in all settings (range \u22129.4% in TB clinics, \u221214.8% in syringe service programs) and was a cost\u2010saving approach in settings with higher risk of infection (i.e. jails, \u2212$266 per person; syringe service programs, \u2212$597; substance use treatment centres, \u2212$130). Providing a 2\u2010dose vaccination series without any screening (Intervention 3) averted incident HBV infections and was cost\u2010saving in all settings but resulted in more HBV\u2010related deaths in settings with higher HBV prevalence. These results demonstrate a 2\u2010dose vaccine series is a cost\u2010effective approach in these high\u2010impact settings, even if prevaccination testing is not possible.<\/jats:p>","DOI":"10.1111\/jvh.13759","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T07:33:55Z","timestamp":1665041635000},"page":"1115-1126","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluating the cost\u2010effectiveness of hepatitis B vaccination strategies in high\u2010impact settings for adults"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0244-7458","authenticated-orcid":false,"given":"Eric W.","family":"Hall","sequence":"first","affiliation":[{"name":"School of Public Health Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8600-0348","authenticated-orcid":false,"given":"Prabhu","family":"Gounder","sequence":"additional","affiliation":[{"name":"Acute Communicable Disease Control Program Los Angeles County Department of Public Health  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Angles","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health University at Albany  Rensselaer New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noele P.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eli S.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health University at Albany  Rensselaer New York USA"},{"name":"New York State Department of Health  Albany New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark K.","family":"Weng","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31991"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6701a1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7113a1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6643a3"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.22388"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6933a1"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss7003a1"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2018.05.111"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.27577"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2020.10.067"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-020-00942-2"},{"key":"e_1_2_8_13_1","unstructured":"Bureau of Labor Statistics (BLS).Consumer Price Index for All Urban Consumers (CPI\u2010U): US city average by expenditure category January 2021.2021."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiac088"},{"key":"e_1_2_8_15_1","unstructured":"Centers for Disease Control and Prevention.CDC vaccine price list.2021. 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