The cost of influenza vaccination and influenza infections was evaluated in a controlled study among healthy municipal homemakers. Acute respiratory infections were followed clinically and with laboratory samples for 8 months. Full follow-up was achieved in 351 persons in the intervention group, of whom 47% obtained vaccination, and 492 controls. Influenza infection was confirmed in 10 employees (8 of these in the control group) and other viral infections in 6 employees (5 of them controls). All infections occurred in non-vaccinated persons. The relative risk of infection in the control group was 2.9 (95% CI 0.6-13.4) for influenza and 3.1 (0.9-10.8) for all respiratory infections. The mean sick leave for influenza was 4.9 days. The cost per immunization was FIM 141, and the average cost per influenza infection FIM 1183. The cost per infection averted was FIM 6270, and the equivalent cost for immunization FIM 26.52. Influenza vaccination had a slight protective effect against both influenza and other respiratory infections. The cost of vaccination programmes exceeded the benefit from averted infections. Optimal vaccination strategies for healthy adults need to be planned individually with minimal loss of working time.

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