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Vaccine. 2017 Jul 13;35(32):3974-3981. doi: 10.1016/j.vaccine.2017.05.093. Epub 2017 Jun 9.

Does cost-effectiveness of influenza vaccine choice vary across the U.S.? An agent-based modeling study.

Author information

1
Pittsburgh Supercomputing Center, Carnegie Mellon University, Pittsburgh, PA, United States.
2
Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States. Electronic address: tnowalk@pitt.edu.
3
Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
4
Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
5
Department of Mathematics, Soongsil University, Seoul, Republic of Korea.
6
Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States. Electronic address: zimmer@pitt.edu.

Abstract

BACKGROUND:

In a prior agent-based modeling study, offering a choice of influenza vaccine type was shown to be cost-effective when the simulated population represented the large, Washington DC metropolitan area. This study calculated the public health impact and cost-effectiveness of the same four strategies: No Choice, Pediatric Choice, Adult Choice, or Choice for Both Age Groups in five United States (U.S.) counties selected to represent extremes in population age distribution.

METHODS:

The choice offered was either inactivated influenza vaccine delivered intramuscularly with a needle (IIV-IM) or an age-appropriate needle-sparing vaccine, specifically, the nasal spray (LAIV) or intradermal (IIV-ID) delivery system. Using agent-based modeling, individuals were simulated as they interacted with others, and influenza was tracked as it spread through each population. Influenza vaccination coverage derived from Centers for Disease Control and Prevention (CDC) data, was increased by 6.5% (range 3.25%-11.25%) to reflect the effects of vaccine choice.

RESULTS:

Assuming moderate influenza infectivity, the number of averted cases was highest for the Choice for Both Age Groups in all five counties despite differing demographic profiles. In a cost-effectiveness analysis, Choice for Both Age Groups was the dominant strategy. Sensitivity analyses varying influenza infectivity, costs, and degrees of vaccine coverage increase due to choice, supported the base case findings.

CONCLUSION:

Offering a choice to receive a needle-sparing influenza vaccine has the potential to significantly reduce influenza disease burden and to be cost saving. Consistent findings across diverse populations confirmed these findings.

KEYWORDS:

Agent-based modeling; Cost-effectiveness; Influenza; Influenza vaccine; Vaccine choice

PMID:
28606814
PMCID:
PMC5808929
DOI:
10.1016/j.vaccine.2017.05.093
[Indexed for MEDLINE]
Free PMC Article

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