Jing Xu1, Fangjun Zhou2, Carrie Reed3, Sandra S Chaves4, Mark Messonnier5, Inkyu K Kim6. 1. Immunization Service Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: jingxu.emory@gmail.com. 2. Immunization Service Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: faz1@cdc.gov. 3. Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: ggj2@cdc.gov. 4. Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: bev8@cdc.gov. 5. Immunization Service Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: qzm3@cdc.gov. 6. Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA; Battelle Memorial Institute, USA. Electronic address: ddz8@cdc.gov.
Abstract
OBJECTIVE: To evaluate the cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women using data from three recent influenza seasons in the United States. DESIGN, SETTING, AND PARTICIPANTS: We developed a decision-analytic model following a cohort of 5.2 million pregnant women and their infants aged <6 months to evaluate the cost-effectiveness of vaccinating women against seasonal influenza during pregnancy from a societal perspective. The main outcome measures were quality-adjusted life-year (QALY) gained and cost-effectiveness ratios. Data sources included surveillance data, epidemiological studies, and published vaccine cost data. Sensitivity analyses were also performed. All costs and outcomes were discounted at 3% annually. MAIN OUTCOME MEASURES: Total costs (direct and indirect), effects (QALY gains, averted case numbers), and incremental cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women (cost per QALY gained). RESULTS: Using a recent benchmark of 52.2% vaccination coverage among pregnant women, we studied a hypothetical cohort of 2,753,015 vaccinated pregnant women. With an estimated vaccine effectiveness of 73% among pregnant women and 63% among infants <6 months, QALY gains for each season were 305 (2010-2011), 123 (2011-2012), and 610 (2012-2013). Compared with no vaccination, seasonal influenza vaccination during pregnancy was cost-saving when using data from the 2010-2011 and 2012-2013 influenza seasons. The cost-effectiveness ratio was greater than $100,000/QALY with the 2011-2012 influenza season data, when CDC reported a low attack rate compared to other recent seasons. CONCLUSIONS: Influenza vaccination for pregnant women can reduce morbidity from influenza in both pregnant women and their infants aged <6 months. Seasonal influenza vaccination during pregnancy is cost-saving during moderate to severe influenza seasons.
OBJECTIVE: To evaluate the cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women using data from three recent influenza seasons in the United States. DESIGN, SETTING, AND PARTICIPANTS: We developed a decision-analytic model following a cohort of 5.2 million pregnant women and their infants aged <6 months to evaluate the cost-effectiveness of vaccinating women against seasonal influenza during pregnancy from a societal perspective. The main outcome measures were quality-adjusted life-year (QALY) gained and cost-effectiveness ratios. Data sources included surveillance data, epidemiological studies, and published vaccine cost data. Sensitivity analyses were also performed. All costs and outcomes were discounted at 3% annually. MAIN OUTCOME MEASURES: Total costs (direct and indirect), effects (QALY gains, averted case numbers), and incremental cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women (cost per QALY gained). RESULTS: Using a recent benchmark of 52.2% vaccination coverage among pregnant women, we studied a hypothetical cohort of 2,753,015 vaccinated pregnant women. With an estimated vaccine effectiveness of 73% among pregnant women and 63% among infants <6 months, QALY gains for each season were 305 (2010-2011), 123 (2011-2012), and 610 (2012-2013). Compared with no vaccination, seasonal influenza vaccination during pregnancy was cost-saving when using data from the 2010-2011 and 2012-2013 influenza seasons. The cost-effectiveness ratio was greater than $100,000/QALY with the 2011-2012 influenza season data, when CDC reported a low attack rate compared to other recent seasons. CONCLUSIONS: Influenza vaccination for pregnant women can reduce morbidity from influenza in both pregnant women and their infants aged <6 months. Seasonal influenza vaccination during pregnancy is cost-saving during moderate to severe influenza seasons.
Authors: Mark C Steinhoff; Saad B Omer; Eliza Roy; Shams E Arifeen; Rubhana Raqib; Mekibib Altaye; Robert F Breiman; Khalequ Zaman M B B S Journal: N Engl J Med Date: 2010-04-29 Impact factor: 91.245
Authors: Noelle-Angelique M Molinari; Ismael R Ortega-Sanchez; Mark L Messonnier; William W Thompson; Pascale M Wortley; Eric Weintraub; Carolyn B Bridges Journal: Vaccine Date: 2007-04-20 Impact factor: 3.641
Authors: Thomas J Hoerger; Sarah Schillie; John S Wittenborn; Christina L Bradley; Fangjun Zhou; Kathy Byrd; Trudy V Murphy Journal: Diabetes Care Date: 2012-08-28 Impact factor: 19.112
Authors: Deliana Kostova; Carrie Reed; Lyn Finelli; Po-Yung Cheng; Paul M Gargiullo; David K Shay; James A Singleton; Martin I Meltzer; Peng-Jun Lu; Joseph S Bresee Journal: PLoS One Date: 2013-06-19 Impact factor: 3.240
Authors: Andrew J Leidner; Neil Murthy; Harrell W Chesson; Matthew Biggerstaff; Charles Stoecker; Aaron M Harris; Anna Acosta; Kathleen Dooling; Carolyn B Bridges Journal: Vaccine Date: 2018-12-04 Impact factor: 3.641
Authors: Nazila M Dabestani; Andrew J Leidner; Eric E Seiber; Hyoshin Kim; Samuel B Graitcer; Ivo M Foppa; Carolyn B Bridges Journal: Prev Med Date: 2019-05-29 Impact factor: 4.018
Authors: Matthew Biggerstaff; Cheryl Cohen; Carrie Reed; Stefano Tempia; Meredith L McMorrow; Sibongile Walaza; Jocelyn Moyes; Florette K Treurnicht; Adam L Cohen; Paul Hutchinson; Charles Stoecker; Joni Steinberg Journal: Vaccine Date: 2019-09-28 Impact factor: 3.641
Authors: Will Cuningham; Nicholas Geard; James E Fielding; Sabine Braat; Shabir A Madhi; Marta C Nunes; Lisa M Christian; Shin-Yu Lin; Chien-Nan Lee; Koushi Yamaguchi; Hans Bisgaard; Bo Chawes; An-Shine Chao; Geraldine Blanchard-Rohner; Elizabeth P Schlaudecker; Barbra M Fisher; Jodie McVernon; Robert Moss Journal: Influenza Other Respir Viruses Date: 2019-06-05 Impact factor: 4.380
Authors: Simon R Procter; Omar Salman; Clint Pecenka; Bronner P Gonçalves; Proma Paul; Raymond Hutubessy; Philipp Lambach; Joy E Lawn; Mark Jit Journal: Vaccine Date: 2020-08-01 Impact factor: 3.641