cost effectiveness of live attenuated influenza vaccination among school age children CORD-Papers-2022-06-02 (Version 1)

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