Cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women |
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| Affiliation: | 1. Immunization Service Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA;2. Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA;3. Battelle Memorial Institute, USA;1. School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, 6009, Australia;2. Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Subiaco, Western Australia, 6008, Australia;3. Rollins School of Public Health, Emory University, Atlanta, GA, 30322, United States;4. Communicable Disease Control Directorate, Western Australia Department of Health, Perth, WA, 6008, Australia;1. Department of Healthcare Management and Policy, School of Public Health, Seoul National University, Seoul, South Korea;2. Department of Epidemiology, Human Genetics, & Environmental Sciences, University of Texas School of Public Health, Houston, TX, USA;3. Department of Economics and Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA;4. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA;5. Department of Health Systems and Policy, Rutgers School of Public Health, Rutgers University, Piscataway, NJ, USA;1. Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium;2. Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT), Hasselt University, Hasselt, Belgium;3. Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium;4. School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia;1. Department of Medicine, McMaster University, Hamilton, ON, Canada;2. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada;3. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada;4. Michael G. DeGroote Institute for Infectious Diseases Research, McMaster University, Hamilton, ON, Canada;5. Department of Family Medicine (Midwifery), McMaster University, Hamilton, ON, Canada;6. Agence de Médecine Preventive, Paris, France;7. Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland;1. Institute of Health Policy, Management & Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6, Canada;2. Program of Child Health Evaluative Sciences, The Hospital for Sick Children Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, ON M5G 0A4, Canada;3. AstraZeneca Canada Inc., 1004 Middlegate Road, Mississauga, ON L4Y 1M4, Canada;4. Public Health Ontario, #300 - 480 University Avenue, Toronto, ON M5G 1V2, Canada |
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| Abstract: | ObjectiveTo evaluate the cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women using data from three recent influenza seasons in the United States.Design, setting, and participantsWe developed a decision-analytic model following a cohort of 5.2 million pregnant women and their infants aged <6 months to evaluate the cost-effectiveness of vaccinating women against seasonal influenza during pregnancy from a societal perspective. The main outcome measures were quality-adjusted life-year (QALY) gained and cost-effectiveness ratios. Data sources included surveillance data, epidemiological studies, and published vaccine cost data. Sensitivity analyses were also performed. All costs and outcomes were discounted at 3% annually.Main outcome measuresTotal costs (direct and indirect), effects (QALY gains, averted case numbers), and incremental cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women (cost per QALY gained).ResultsUsing a recent benchmark of 52.2% vaccination coverage among pregnant women, we studied a hypothetical cohort of 2,753,015 vaccinated pregnant women. With an estimated vaccine effectiveness of 73% among pregnant women and 63% among infants <6 months, QALY gains for each season were 305 (2010–2011), 123 (2011–2012), and 610 (2012–2013). Compared with no vaccination, seasonal influenza vaccination during pregnancy was cost-saving when using data from the 2010–2011 and 2012–2013 influenza seasons. The cost-effectiveness ratio was greater than $100,000/QALY with the 2011–2012 influenza season data, when CDC reported a low attack rate compared to other recent seasons.ConclusionsInfluenza vaccination for pregnant women can reduce morbidity from influenza in both pregnant women and their infants aged <6 months. Seasonal influenza vaccination during pregnancy is cost-saving during moderate to severe influenza seasons. |
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| Keywords: | Seasonal influenza vaccination Cost-effectiveness analysis Pregnancy |
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