PIN46 Cost-Effectiveness and Public Health Impact of Pneumococcal Vaccination in Malaysia

Abstract

OBJECTIVES: Influenza vaccination programs targeted at children have gained increasing attention in recent years. In the US, recommendations for influenza vaccination have expanded over the last decade to include all children aged 6 months to 18 years. However, in most other developed countries childhood influenza vaccination has been restricted to targeted programs for children at risk of influenza complications. METHODS: A literature search was conducted for English-language economic evaluations of influenza vaccination in those aged less than 18 years. Studies evaluating vaccination options exclusively targeted at specific risk groups were excluded. The literature search identified 20 relevant studies which were reviewed. RESULTS: The studies differed widely in terms of the costs and benefits that were included. All but one of the studies were conducted from a societal perspective. The majority of the studies included the value of lost productivity due to caregivers missing work to care for sick children. However, other forms of lost productivity were considered by some studies, including those resulting from being vaccinated, school absenteeism, premature death, and illness in caregivers. Only a small minority of studies also measured benefits in terms of non-monetised utilities such as quality-adjusted life years. Several evaluations, particularly those directly targeted at healthy children, did not include serious influenza complications. Only one of the reviewed studies used a dynamic transmission model able to fully incorporate the indirect herd protection to the wider population. CONCLUSIONS: The conclusions of the studies were generally favourable towards vaccination. Methodological decisions in terms of what costs and benefits to include appeared influential. Many studies applied a wider perspective (i.e. including productivity losses) than the reference case for economic evaluations used in many countries.