Cost-Effectiveness Analysis of an Intranasal Influenza Vaccine for the Prevention of Influenza in Healthy Children

Abstract

ABSTRACT. Objective. Intranasal influenza vaccine has proven clinical efficacy and may be better tolerated by young children and their families than an injectable vaccine. This study determined the potential cost-effectiveness (CE) of an intranasal influenza vaccine among healthy children.Methods. We conducted a CE analysis of data collected between 1996 and 1998 during a prospective 2-year efficacy trial of intranasal influenza vaccine, supplemented with data from the literature. The CE analysis included both direct and indirect costs. We enrolled 1602 healthy children aged 15 to 71 months in year 1, 1358 of whom were enrolled in year 2. One or 2 doses of intranasal influenza vaccine or placebo were administered to measure the cost per febrile influenza-like illness (ILI) day avoided.Results. During the 2-year study period, vaccinated children had an average of 1.2 fewer ILI fever days/child than unvaccinated children. In an individual-based vaccine delivery scenario with vaccine given twice in the first year and once each year thereafter at an assumed base case total cost of $20 for the vaccine and its administration (ie, per dose), CE was approximately $30/febrile ILI day avoided. CE ranged from $10 to $69/febrile ILI day avoided at $10 to $40/dose, respectively. In a groupbased delivery scenario, vaccination was cost saving compared with placebo and remained so if vaccine cost was <$28 (the break-even price per dose). In the individualbased scenario, vaccination was cost saving if vaccine cost was <$5. In this scenario, nearly half of lost productivity in the vaccine group was attributable to vaccine visits, which overshadowed the relatively modest savings in ILI-associated costs averted.Conclusions. Routine use of intranasal influenza vaccine among healthy children may be cost-effective and may be maximized by using group-based vaccination approaches. Pediatrics 2001;108(2). URL: http://www. pediatrics.org/cgi/content/full/108/2/e24; cost-effectiveness, influenza, vaccine, children.

2012/13 influenza vaccine effectiveness against hospitalised influenza A(H1N1)pdm09, A(H3N2) and B: estimates from a European network of hospitals

“…Economic evaluations of vaccinating children have demonstrated a wide range of cost estimates, but have generally found this strategy to be either costsaving or cost-beneficial. [292][293][294][295] A comparison of the economics of vaccinating children with TIV or LAIV found similar cost savings between the two vaccines, with an increased cost for both vaccines for older versus younger children. [296] Analyses of vaccination programs targeting pregnant women show that it is cost-effective.…”

A Pilot Study of the Effectiveness of a School-Based Influenza Vaccination Program

“…13 Administration of vaccines in school settings is a more efficient method of vaccinating large numbers of children, compared with individually appointed office visits. 14 School-based immunization programs have been used in the past to administer influenza vaccines in Japan and Russia. 15,16 Also, school-based settings have been used to administer live attenuated vac-cines, including poliomyelitis, varicella, measles, and rubella, and inactivated vaccines, such as hepatitis B, diphtheria, tetanus, and pertussis.…”

Risk Factors Associated With Severe Influenza Infections in Childhood: Implication for Vaccine Strategy

“…Vaccination was also associated with a reduction in the incidence of otitis media with fever. 14,15 Use of an intranasal vaccine should facilitate more widespread vaccination of children against influenza when it becomes available 16 but so far, the American Food and Drug Administration advisory committee has only recommended its approval for those 5 to 49 years old. 17 To document the burden of illness caused by influenza and to identify groups of children who could benefit from influenza vaccination, we described characteristics of influenza infections in children presenting to the Montreal Children's Hospital (MCH), Quebec, Canada and determined risk factors associated with hospitalization.…”