Health and economic impact of seasonal influenza mass vaccination strategies in European settings: A mathematical modelling and cost-effectiveness analysis.
| Title: | Health and economic impact of seasonal influenza mass vaccination strategies in European settings: A mathematical modelling and cost-effectiveness analysis. |
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| Authors: | Sandmann FG; UK Health Security Agency, London NW9 5EQ, United Kingdom.; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, UK.; van Leeuwen E; UK Health Security Agency, London NW9 5EQ, United Kingdom.; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, UK. Electronic address: Edwin.VanLeeuwen@phe.gov.uk.; Bernard-Stoecklin S; Santé Publique France, Saint Maurice, France.; Casado I; Instituto de Salud Pública de Navarra - IdiSNA, CIBERESP, Pamplona, Spain.; Castilla J; Instituto de Salud Pública de Navarra - IdiSNA, CIBERESP, Pamplona, Spain.; Domegan L; Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland.; Gherasim A; National Centre of Epidemiology/CIBER de Epidemiologia y Salud Pública (CIBERESP). Institute of Health Carlos III, Madrid, Spain.; Hooiveld M; Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.; Kislaya I; Instituto Nacional de Saúde Dr. Ricardo Jorge (INSA), Lisbon, Portugal.; Larrauri A; National Centre of Epidemiology/CIBER de Epidemiologia y Salud Pública (CIBERESP). Institute of Health Carlos III, Madrid, Spain.; Levy-Bruhl D; Santé Publique France, Saint Maurice, France.; Machado A; Instituto Nacional de Saúde Dr. Ricardo Jorge (INSA), Lisbon, Portugal.; Marques DFP; Health Protection Scotland (HPS), Glasgow, UK.; Martínez-Baz I; Instituto de Salud Pública de Navarra - IdiSNA, CIBERESP, Pamplona, Spain.; Mazagatos C; National Centre of Epidemiology/CIBER de Epidemiologia y Salud Pública (CIBERESP). Institute of Health Carlos III, Madrid, Spain.; McMenamin J; Health Protection Scotland (HPS), Glasgow, UK.; Meijer A; Centre for Infectious Disease Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.; Murray JLK; Health Protection Scotland (HPS), Glasgow, UK.; Nunes B; Instituto Nacional de Saúde Dr. Ricardo Jorge (INSA), Lisbon, Portugal.; O'Donnell J; Health Service Executive-Health Protection Surveillance Centre, Dublin, Ireland.; Reynolds A; Health Protection Scotland (HPS), Glasgow, UK.; Thorrington D; Haute Autorité de Santé (HAS), Saint-Denis, France.; Pebody R; UK Health Security Agency, London NW9 5EQ, United Kingdom.; Baguelin M; UK Health Security Agency, London NW9 5EQ, United Kingdom.; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), London, UK; School of Public Health, Imperial College London, London, UK. |
| Source: | Vaccine [Vaccine] 2022 Feb 23; Vol. 40 (9), pp. 1306-1315. Date of Electronic Publication: 2022 Jan 31. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Elsevier Science Country of Publication: Netherlands NLM ID: 8406899 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2518 (Electronic) Linking ISSN: 0264410X NLM ISO Abbreviation: Vaccine Subsets: MEDLINE |
| Imprint Name(s): | Publication: Amsterdam, The Netherlands : Elsevier Science; Original Publication: [Guildford, Surrey, UK] : Butterworths, [c1983- |
| MeSH Terms: | Influenza, Human*/epidemiology ; Influenza, Human*/prevention & control ; Influenza Vaccines*; Aged ; Child ; Cost-Benefit Analysis ; Humans ; Mass Vaccination ; Middle Aged ; Quality-Adjusted Life Years ; Seasons ; Vaccination |
| Abstract: | Introduction: Despite seasonal influenza vaccination programmes in most countries targeting individuals aged ≥ 65 (or ≥ 55) years and high risk-groups, significant disease burden remains. We explored the impact and cost-effectiveness of 27 vaccination programmes targeting the elderly and/or children in eight European settings (n = 205.8 million).; Methods: We used an age-structured dynamic-transmission model to infer age- and (sub-)type-specific seasonal influenza virus infections calibrated to England, France, Ireland, Navarra, The Netherlands, Portugal, Scotland, and Spain between 2010/11 and 2017/18. The base-case vaccination scenario consisted of non-adjuvanted, non-high dose trivalent vaccines (TV) and no universal paediatric vaccination. We explored i) moving the elderly to "improved" (i.e., adjuvanted or high-dose) trivalent vaccines (iTV) or non-adjuvanted non-high-dose quadrivalent vaccines (QV); ii) adopting mass paediatric vaccination with TV or QV; and iii) combining the elderly and paediatric strategies. We estimated setting-specific costs and quality-adjusted life years (QALYs) gained from the healthcare perspective, and discounted QALYs at 3.0%.; Results: In the elderly, the estimated numbers of infection per 100,000 population are reduced by a median of 261.5 (range across settings: 154.4, 475.7) when moving the elderly to iTV and by 150.8 (77.6, 262.3) when moving them to QV. Through indirect protection, adopting mass paediatric programmes with 25% uptake achieves similar reductions in the elderly of 233.6 using TV (range: 58.9, 425.6) or 266.5 using QV (65.7, 477.9), with substantial health gains from averted infections across ages. At €35,000/QALY gained, moving the elderly to iTV plus adopting mass paediatric QV programmes provides the highest mean net benefits and probabilities of being cost-effective in all settings and paediatric coverage levels.; Conclusion: Given the direct and indirect protection, and depending on the vaccine prices, model results support a combination of having moved the elderly to an improved vaccine and adopting universal paediatric vaccination programmes across the European settings.; (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
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| Contributed Indexing: | Keywords: Economic evaluation; Influenza; Mathematical model; Policy; Public health; Vaccination |
| Substance Nomenclature: | 0 (Influenza Vaccines) |
| Entry Date(s): | Date Created: 20220203 Date Completed: 20220310 Latest Revision: 20220311 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC8861572 |
| DOI: | 10.1016/j.vaccine.2022.01.015 |
| PMID: | 35109968 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't