Assessment of the benefits of seasonal influenza vaccination: Elements of a framework to interpret estimates of vaccine effectiveness and support robust decision‐making and communication

Abstract

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Influenza Vaccination Assessment according to a Value-Based Health Care Approach

“…Of the 40 studies included in our systematic review [ 3 , 4 , 5 , 8 , 10 , 11 , 12 , 13 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ], seven (17.5%) had a non-European perspective and were conducted in Canada ( n = 1) [ 18 ], the USA ( n = 3) [ 19 , 21 , 42 ], China ( n = 1) [ 36 ], Iran ( n = 1) [ 49 ], and low-income countries (LICs) ( n = 1) [ 32 ]; ten (25%) had a global perspective [ 5 , 10 , 12 , 20 , 22 , 24 …”

“…Among the European studies, eight (36.4%) were conducted specifically in Italy [ 3 , 4 , 13 , 31 , 38 , 39 , 43 , 47 ]. In addition, of the 40 articles included in our work, 17 (42.5%) were systematic reviews or literature reviews [ 3 , 5 , 10 , 11 , 12 , 22 , 24 , 25 , 28 , 29 , 30 , 31 , 32 , 37 , 41 , 47 , 48 ], ten (25%) were economic evaluations [ 8 , 13 , 19 , 21 , 23 , 26 , 27 , 34 , 44 , 45 ], seven (17.5%) were cross-sectional studies [ 18 , 35 , 36 , 38 , 42 , 43 , 49 ], two studies (5%) were HTA reports [ 4 , 39 ], one study (2.5%) was a nonlinear regression model [ 33 ], and three studies (7.5%) were expert opinions [ 20 , 40 , 46 ]. The main features of the studies are shown in Table 1 .…”

“…Regarding the influenza vaccination target population investigated in the studies included in our systematic review, 11 studies (27.5%) focused on vaccination in the general population [ 5 , 12 , 18 , 20 , 25 , 37 , 39 , 40 , 44 , 46 , 48 ], five (12.5%) on vaccination in the pediatric population [ 3 , 19 , 29 , 33 , 45 ], three (7.5%) on vaccination in the population aged 6 months to over 85 [ 21 , 27 , 28 ], seven (17.5%) on vaccination in elderly individuals (over 65) [ 4 , 11 , 24 , 30 , 31 , 41 , 47 ], two (5%) specifically on adults over 18 [ 38 ] and over 50 [ 26 ], one study (2.5%) specifically on influenza vaccination in elderly individuals and at risk groups [ 22 ], one (2.5%) on the target population for which the WHO recommends flu vaccination [ 8 ], one (2.5%) on customs officers [ 23 ], four (10%) on HCWs [ 10 , 34 , 35 , 36 ], one (2.5%) on workers in general [ 13 ], two (5%) on health care students [ 42 , 43 ], one (2.5%) on pregnant women [ 32 ], and another study (2.5%) on influenza vaccination in the cancer population [ 49 ].…”

“…Of the 40 studies included in the systematic review, 37.5% ( n = 15) also addressed other general features of the influenza vaccination value [ 11 , 24 , 25 , 26 , 33 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 47 , 49 ], with particular reference to the following aspects: the cultural value and social benefits of flu vaccination both from the citizens’ perspective [ 24 ] and from that of health care professionals [ 36 ]; the value of influenza vaccination in specific target populations such as elderly individuals [ 11 , 26 , 41 ], adults [ 47 ], risk groups, such as patients with cardiovascular [ 41 ] and cancer [ 49 ] diseases, and health care students [ 43 ]; the importance of the whole value of flu vaccination [ 25 ] and the need for an appropriate methodology to assess this value and support an evidence-based decision-making process [ 37 ], also thanks to evidence-based tools such as HTA [ 39 ]; the value of surveillance systems for influenza and the need to consider new innovative surveillance methods such as social media [ 33 ]; the value of educational interventions on influenza vaccination for nursing students [ 42 ]; and the value of citizens’ literacy [ 38 ].…”

Anti-Influenza Strategies Based on Nanoparticle Applications

“…The WHO's recommendation for northern and southern hemisphere influenza vaccine composition is predicted and introduced every year independently [71,72]. However, the vaccine's effectiveness is variable between seasons and depends on prediction accuracy [73]. Hence, it is important to create new and faster methods for vaccine production to increase vaccination efficiency.…”