BACKGROUND: The universal vaccination of children for influenza has recently been recommended in the UK and is being considered in other developed countries. OBJECTIVES: The aim of this study was to explore the potential costs and benefits of childhood influenza vaccination to gain a better understanding of the key drivers of cost-effectiveness. METHODS: As our case study we examined the cost-effectiveness of vaccination in Australian schoolchildren using an age-stratified Susceptible Exposed Infectious Recovered model. RESULTS: The results of this study highlight the critical role that methodological choices play in determining the cost-effectiveness of influenza vaccination. These choices include decisions about the structure of the model (including/excluding herd immunity) and what costs and benefits to include in the analysis. In scenarios where herd protection was included we estimated that the program was likely to be cost-effective. The study also illustrates the importance of the inherent seasonal variability of influenza, which can produce counter-intuitive results, with low transmission seasons being easier to control by vaccination but resulting in fewer benefits. CONCLUSIONS: Universal childhood influenza vaccination is likely to be cost-effective if a substantial herd protection effect can be achieved by the program. However, it is important that decision makers understand the role of seasonal variability and the impact of alternative methodological choices in economic evaluations of influenza vaccination.
BACKGROUND: The universal vaccination of children for influenza has recently been recommended in the UK and is being considered in other developed countries. OBJECTIVES: The aim of this study was to explore the potential costs and benefits of childhood influenza vaccination to gain a better understanding of the key drivers of cost-effectiveness. METHODS: As our case study we examined the cost-effectiveness of vaccination in Australian schoolchildren using an age-stratified Susceptible Exposed Infectious Recovered model. RESULTS: The results of this study highlight the critical role that methodological choices play in determining the cost-effectiveness of influenza vaccination. These choices include decisions about the structure of the model (including/excluding herd immunity) and what costs and benefits to include in the analysis. In scenarios where herd protection was included we estimated that the program was likely to be cost-effective. The study also illustrates the importance of the inherent seasonal variability of influenza, which can produce counter-intuitive results, with low transmission seasons being easier to control by vaccination but resulting in fewer benefits. CONCLUSIONS: Universal childhood influenza vaccination is likely to be cost-effective if a substantial herd protection effect can be achieved by the program. However, it is important that decision makers understand the role of seasonal variability and the impact of alternative methodological choices in economic evaluations of influenza vaccination.
Authors: Julia Brotherton; Han Wang; Andrea Schaffer; Helen Quinn; Robert Menzies; Brynley Hull; Glenda Lawrence; James Wood; Nicholas Wood; Alexander Rosewell; Anthony Newall; Raina MacIntyre; Kristine Macartney; Heather Gidding; Peter McIntyre; Robert Booy Journal: Commun Dis Intell Q Rep Date: 2007-06
Authors: Timo Vesikari; Markus Knuf; Peter Wutzler; Aino Karvonen; Dorothee Kieninger-Baum; Heinz-Josef Schmitt; Frank Baehner; Astrid Borkowski; Theodore F Tsai; Ralf Clemens Journal: N Engl J Med Date: 2011-10-13 Impact factor: 91.245
Authors: Simon Cauchemez; Alain-Jacques Valleron; Pierre-Yves Boëlle; Antoine Flahault; Neil M Ferguson Journal: Nature Date: 2008-04-10 Impact factor: 49.962
Authors: Neil M Ferguson; Derek A T Cummings; Christophe Fraser; James C Cajka; Philip C Cooley; Donald S Burke Journal: Nature Date: 2006-04-26 Impact factor: 49.962
Authors: Nicole E Basta; Dennis L Chao; M Elizabeth Halloran; Laura Matrajt; Ira M Longini Journal: Am J Epidemiol Date: 2009-08-13 Impact factor: 4.897
Authors: Rebecca J Hart; Michelle D Stevenson; Michael J Smith; A Scott LaJoie; Keith Cross Journal: JAMA Pediatr Date: 2018-01-02 Impact factor: 16.193
Authors: Frank Andersohn; Reinhard Bornemann; Oliver Damm; Martin Frank; Thomas Mittendorf; Ulrike Theidel Journal: GMS Health Technol Assess Date: 2014-10-30
Authors: Marisa Holubar; Maria Christina Stavroulakis; Yvonne Maldonado; John P A Ioannidis; Despina Contopoulos-Ioannidis Journal: PLoS One Date: 2017-03-01 Impact factor: 3.240
Authors: Anthony T Newall; Nathorn Chaiyakunapruk; Philipp Lambach; Raymond C W Hutubessy Journal: Influenza Other Respir Viruses Date: 2017-12-27 Impact factor: 4.380