| Title:
|
Cost-effectiveness of live-attenuated influenza vaccination among school-age children |
| Abstract:
|
The current pediatric vaccination program in England and Wales administers Live-Attenuated Influenza Vaccine (LAIV) to children ages 2-16 years old. Annual administration of LAIV to this age group is costly and poses substantial logistical issues. This study aims to evaluate the cost-effectiveness of prioritizing vaccination to age groups within the 2-16 year old age range to mitigate the operational and resource challenges of the current strategy. We performed economic evaluations comparing the influenza vaccination program from 1995-2013 to seven alternative strategies targeted at low risk individuals along the school age divisions Preschool (2-4 years old) Primary school (5-11 years old) and Secondary school (12-16 years old). These extensions are evaluated incrementally on the status quo scenario (vaccinating subgroups at high risk of influenza-related complications and individuals 65+ years old). Impact of vaccination was assessed using a transmission model from a previously published study and updated with new data. At all levels of coverage all strategies had a 100% probability of being cost-effective at the current National Health Service threshold 20000/QALY gained. The incremental analysis demonstrated vaccinating Primary School children was the most cost-efficient strategy compared incrementally against others with an Incremental Cost-Effectiveness Ratio of 639 spent per QALY gained (Net Benefit: 404 M [155 795]). When coverage was varied between 30% 55% and 70% strategies which included Primary school children had a higher probability of being cost-effective at lower willingness-to-pay levels. Although children were the vaccine target the majority of QALY gains occurred in the 25-44 years old and 65+ age groups. Influenza strain A/H3N2 incurred the greatest costs and QALYs lost regardless of which strategy was used. Improvement could be made to the current LAIV pediatric vaccination strategy by eliminating vaccination of 2-4 year olds and focusing on school-based delivery to Primary and Secondary school children in tandem. |
| Published:
|
2020 |
| Journal:
|
Vaccine |
| Author Name:
|
Wenzel Natasha S |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/wenzel_natasha_s |
| Author Name:
|
Atkins Katherine E |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/atkins_katherine_e |
| Author Name:
|
van Leeuwen Edwin |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/van_leeuwen_edwin |
| Author Name:
|
Halloran M Elizabeth |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/halloran_m_elizabeth |
| Author Name:
|
Baguelin Marc |
| Author link:
|
https://covid19-data.nist.gov/pid/rest/local/author/baguelin_marc |
| license:
|
unk |
| license_url:
|
[unknown license] |
| source_x:
|
WHO |
| source_x_url:
|
https://www.who.int/ |
| who_covidence_id:
|
#956592 |
| has_full_text:
|
FALSE |
| G_ID:
|
cost_effectiveness_of_live_attenuated_influenza_vaccination_among_school_age_children |
