Effectiveness and Cost-Benefit of Influenza Vaccination of Healthy Working Adults

Bridges, Carolyn B.; Thompson, W.; Meltzer, Martin I.; Reeve, Gordon R.; Talamonti, Walter; Cox, Nancy J.; Lilac, Heather A.; Hall, Henrietta; Klimov, Alexander; Fukuda, Keiji

doi:10.1001/jama.284.13.1655

Cited by 617 publications

(410 citation statements)

References 31 publications

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“…Since there were no data for pregnant women, it was assumed that healthy pregnant women had the same risk of clinical influenza as other healthy adults. Five studies [31][32][33][34][35] were identified as being relevant as they were published after 1990, actively followed a cohort of healthy adults for clinical respiratory symptoms and incorporated laboratory confirmation of influenza infection (see Table 1). All five were based in the United States.…”

Section: Deaths the Hes Database Recorded 28 Deaths Between 2001 Andmentioning

confidence: 99%

The cost-effectiveness of vaccinating pregnant women against seasonal influenza in England and Wales

Jit¹,

Cromer²,

Baguelin³

et al. 2010

Vaccine

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We assessed the cost-effectiveness of vaccinating pregnant women against seasonal influenza in England and Wales, taking into account the timing of vaccination relative to both the influenza season and trimester of pregnancy. Women were assumed to be vaccinated in their second or third trimester. Vaccination between September and December was found to have an incremental cost-effectiveness ratio of £23,000 per QALY (95% CI £10,000 -£140,000) if it is assumed that infants are partially protected through their mothers, and of £29,000 per QALY gained (95% CI £14,000 -£200,000) if infants are not protected. If some vaccine protection lasts for a second season, then the ratio is only £15,000 per QALY gained (95% CI £6,000 -£91,000). Most of the benefit of vaccination is in preventing symptomatic episodes, regardless of health care resource use. Extending vaccination beyond December is unlikely to be cost-effective unless there is good protection into a second influenza season. Key sources of uncertainty are the cost of vaccine delivery and the quality of life detriment due to a clinically apparent episode of confirmed influenza. The cost of vaccine purchase itself is relatively low.3

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Section: Deaths the Hes Database Recorded 28 Deaths Between 2001 Andmentioning

confidence: 99%

The cost-effectiveness of vaccinating pregnant women against seasonal influenza in England and Wales

Jit¹,

Cromer²,

Baguelin³

et al. 2010

Vaccine

View full text Add to dashboard Cite

show abstract

“…As influenza evolves from year to year, antigenic differences between previously and currently circulating strains contribute to low vaccine efficacy [1][2][3][4] and high incidence of influenza illness [2,5]. While vaccines regularly undergo reformulation to address this mismatch, vaccines may also affect antigenic evolution.…”

Section: Introductionmentioning

confidence: 99%

The beneficial effects of vaccination on the evolution of seasonal influenza

Wen

Malani

Cobey

2017

Preprint

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Although vaccines against seasonal influenza are designed to protect against currently circulating strains, they may also affect the emergence of antigenically divergent strains and thereby change the rate of antigenic evolution. Such evolutionary effects could change the benefits that vaccines confer to vaccinated individuals and the host population (i.e. private and social benefits). To investigate vaccinations potential evolutionary impacts, we simulated the dynamics of an influenza-like pathogen in an annually vaccinated host population. On average, vaccination decreased the cumulative amount of antigenic evolution of the viral population and the incidence of disease. Vaccination at a 5% random annual vaccination rate (48% cumulative vaccine coverage after 20 years) decreased cumulative evolution by 56% and incidence by 76%. To understand how the evolutionary effects of vaccination might affect its private and social benefits over multiple seasons, we fit linear panel models to simulated infection and vaccination histories. Including the evolutionary effects of vaccination lowered the private benefits by 14% but increased the social benefits by 30% (at a 5% annual vaccination rate) compared to when evolutionary effects were ignored. Thus, in the long term, vaccines' private benefits may be lower and social benefits may be greater than predicted by current measurements of vaccine impact, which do not capture long-term evolutionary effects. These results suggest that conventional vaccines against seasonal influenza could greatly reduce the burden of disease by slowing antigenic evolution like universal vaccines. Furthermore, vaccination's evolutionary effects compound a collective action problem, highlighting the importance on social policies concerning vaccination.

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“…18 and vaccine efficacy can be as high as 86% when the vaccine and circulating viruses are well matched. 19 In our study, each vaccine was well matched with the circulating influenza viruses. 20 The seroprotection rates for A(H1N1) and A(H3N2) in this study increased by 27.7% and 23.5%, respectively, in the year after vaccination (Table 2).…”

Section: Discussionmentioning

confidence: 86%

Hemagglutination inhibiting antibody persistence 1 year after influenza vaccination in Korean children and adolescents

Kang

Eun

Kim

et al. 2017

Human Vaccines & Immunotherapeutics

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This study aimed to assess the 1-y immunogenicity of influenza vaccines and the association between immunogenicity at 1 m and further influenza infections in children aged 6 m to 18 y. Serum hemagglutination inhibition (HI) antibody titers and GMTs were determined for the recommended influenza strains 0, 1, 6, and 12 m post-vaccination. The serological evidence of influenza infections were defined as the increase of HI titer (HI 1:40 and 4-fold rise). The seroprotection rates for strains A(H1N1), A (H3N2), and B were 91.2%, 87.6%, and 87.6%, respectively, at 1 month (n = 174). These rates were 76.5%, 64.7%, and 54.6%, respectively, at 12 m. The seroprotection rates and GMTs for influenza A(H1N1) and A (H3N2) were higher at 12 m than at 0 m (p < 0.05) but not for B. There were 39 subjects (42 cases) of serological influenza infections. Subjects with seroprotection at 1 m post-vaccination had showed fewer serologic A(H1N1) (10.1 vs 54.5%) and A(H3N2) (7.2 vs 38.1%) infections than the ones with HI titer <1:40 during follow-up (P < 0.01). In conclusion, influenza vaccines used during the 2008-09 season induced adequate 1-y immunogenicity for A(H1N1) and A(H3N2). The immunogenicity at one month after vaccination influenced further serological influenza infections.

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Effectiveness and Cost-Benefit of Influenza Vaccination of Healthy Working Adults

Cited by 617 publications

References 31 publications

The cost-effectiveness of vaccinating pregnant women against seasonal influenza in England and Wales

The cost-effectiveness of vaccinating pregnant women against seasonal influenza in England and Wales

The beneficial effects of vaccination on the evolution of seasonal influenza

Hemagglutination inhibiting antibody persistence 1 year after influenza vaccination in Korean children and adolescents

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