Prioritization of risk groups for influenza vaccination in resource limited settings - A case study from South Africa.
Adolescent
Adult
Aged
Case-Control Studies
Child
Child, Preschool
Cost of Illness
Cost-Benefit Analysis
Female
HIV Infections
/ epidemiology
Health Priorities
Health Resources
Hospitalization
/ economics
Humans
Infant
Influenza Vaccines
/ economics
Influenza, Human
/ mortality
Male
Middle Aged
Pregnancy
Risk Factors
South Africa
Tuberculosis
/ epidemiology
Vaccination
/ economics
Young Adult
Hospitalization
Influenza
Mortality
South Africa
Vaccine policy
Journal
Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899
Informations de publication
Date de publication:
03 01 2019
03 01 2019
Historique:
received:
17
10
2018
accepted:
16
11
2018
pubmed:
26
11
2018
medline:
7
6
2019
entrez:
26
11
2018
Statut:
ppublish
Résumé
Due to competing health priorities, low- and middle-income countries (LMIC) may need to prioritize between different influenza vaccine risk groups. Risk group prioritization may differ in LMIC based upon programmatic feasibility, country-specific prevalence of risk conditions and influenza-associated morbidity and mortality. In South Africa, we collected local disease burden data (both published and unpublished) and published vaccine efficacy data in risk groups and healthy adults. We used these data to aid policy makers with risk group prioritization for influenza vaccination. We used the following formula to assess potential vaccine averted disease in each risk group: rate of influenza-associated hospitalization (or death) per 100,000 population * influenza vaccine efficacy (VE). We further estimated the cost per hospital day averted and the cost per year of life saved by influenza vaccination. Pregnant women, HIV-infected adults, and adults and children with tuberculosis disease had among the highest estimates of hospitalizations averted per 100,000 vaccinated and adults aged 65 years and older had the highest estimated deaths averted per 100,000 vaccinated. However, when assessing both the cost per hospital day averted (range: USD148-1,344) and the cost per year of life saved (range: USD112-1,230); adults and children with TB disease, HIV-infected adults and pregnant women had the lowest cost per outcome averted. An assessment of the potential disease outcomes averted and associated costs may aid policymakers in risk group prioritization for influenza vaccination.
Sections du résumé
BACKGROUND
Due to competing health priorities, low- and middle-income countries (LMIC) may need to prioritize between different influenza vaccine risk groups. Risk group prioritization may differ in LMIC based upon programmatic feasibility, country-specific prevalence of risk conditions and influenza-associated morbidity and mortality.
METHODS
In South Africa, we collected local disease burden data (both published and unpublished) and published vaccine efficacy data in risk groups and healthy adults. We used these data to aid policy makers with risk group prioritization for influenza vaccination. We used the following formula to assess potential vaccine averted disease in each risk group: rate of influenza-associated hospitalization (or death) per 100,000 population * influenza vaccine efficacy (VE). We further estimated the cost per hospital day averted and the cost per year of life saved by influenza vaccination.
RESULTS
Pregnant women, HIV-infected adults, and adults and children with tuberculosis disease had among the highest estimates of hospitalizations averted per 100,000 vaccinated and adults aged 65 years and older had the highest estimated deaths averted per 100,000 vaccinated. However, when assessing both the cost per hospital day averted (range: USD148-1,344) and the cost per year of life saved (range: USD112-1,230); adults and children with TB disease, HIV-infected adults and pregnant women had the lowest cost per outcome averted.
DISCUSSION
An assessment of the potential disease outcomes averted and associated costs may aid policymakers in risk group prioritization for influenza vaccination.
Identifiants
pubmed: 30471956
pii: S0264-410X(18)31573-1
doi: 10.1016/j.vaccine.2018.11.048
pmc: PMC6470296
mid: NIHMS1012564
pii:
doi:
Substances chimiques
Influenza Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
25-33Subventions
Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States
Organisme : NCIRD CDC HHS
ID : U01 IP001048
Pays : United States
Informations de copyright
Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.
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