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Health and economic impact of seasonal influenza mass vaccination strategies in European settings: A mathematical modelling and cost-effectiveness analysis

2022-02-23Journal article Open access
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dc.contributor.authorSandmann, Frank
dc.contributor.authorvan Leeuwen, Edwin
dc.contributor.authorBernard-Stoecklin, Sibylle
dc.contributor.authorCasado, Itziar
dc.contributor.authorCastilla, Jesús
dc.contributor.authorDomegan, Lisa
dc.contributor.authorGherasim, Alin
dc.contributor.authorHooiveld, Mariëtte
dc.contributor.authorKislaya, Irina
dc.contributor.authorLarrauri, Amparo
dc.contributor.authorLevy-Bruhl, Daniel
dc.contributor.authorMachado, Ausenda
dc.contributor.authorMarques, Diogo
dc.contributor.authorMartínez-Baz, Iván
dc.contributor.authorMazagatos, Clara
dc.contributor.authorMcMenamin, Jim
dc.contributor.authorMeijer, Adam
dc.contributor.authorMurray, Josephine
dc.contributor.authorNunes, Baltazar
dc.contributor.authorO'Donnell, Joan
dc.contributor.authorReynolds, Arlene
dc.contributor.authorThorrington, Dominic
dc.contributor.authorPebody, Richard
dc.contributor.authorBaguelin, Marc
dc.date.accessioned2023-01-25T11:21:52Z
dc.date.available2023-01-25T11:21:52Z
dc.date.issued2022-02-23
dc.descriptionFree PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861572/pt_PT
dc.description.abstractIntroduction: Despite seasonal influenza vaccination programmes in most countries targeting individuals aged ≥ 65 (or ≥ 55) years and high risk-groups, significant disease burden remains. We explored the impact and cost-effectiveness of 27 vaccination programmes targeting the elderly and/or children in eight European settings (n = 205.8 million). Methods: We used an age-structured dynamic-transmission model to infer age- and (sub-)type-specific seasonal influenza virus infections calibrated to England, France, Ireland, Navarra, The Netherlands, Portugal, Scotland, and Spain between 2010/11 and 2017/18. The base-case vaccination scenario consisted of non-adjuvanted, non-high dose trivalent vaccines (TV) and no universal paediatric vaccination. We explored i) moving the elderly to "improved" (i.e., adjuvanted or high-dose) trivalent vaccines (iTV) or non-adjuvanted non-high-dose quadrivalent vaccines (QV); ii) adopting mass paediatric vaccination with TV or QV; and iii) combining the elderly and paediatric strategies. We estimated setting-specific costs and quality-adjusted life years (QALYs) gained from the healthcare perspective, and discounted QALYs at 3.0%. Results: In the elderly, the estimated numbers of infection per 100,000 population are reduced by a median of 261.5 (range across settings: 154.4, 475.7) when moving the elderly to iTV and by 150.8 (77.6, 262.3) when moving them to QV. Through indirect protection, adopting mass paediatric programmes with 25% uptake achieves similar reductions in the elderly of 233.6 using TV (range: 58.9, 425.6) or 266.5 using QV (65.7, 477.9), with substantial health gains from averted infections across ages. At €35,000/QALY gained, moving the elderly to iTV plus adopting mass paediatric QV programmes provides the highest mean net benefits and probabilities of being cost-effective in all settings and paediatric coverage levels. Conclusion: Given the direct and indirect protection, and depending on the vaccine prices, model results support a combination of having moved the elderly to an improved vaccine and adopting universal paediatric vaccination programmes across the European settings.pt_PT
dc.description.abstractHighlights: Seasonal influenza vaccine programmes usually target at-risk and older individuals; We used an age-structured dynamic-transmission model for eight European settings; Older people benefit from adjuvanted or high-dose trivalent or quadrivalent vaccines; Adopting mass paediatric influenza vaccination is also likely to be cost-effective; Results rest on vaccine costs, willingness to vaccinate and unknown long-term effects.pt_PT
dc.description.sponsorshipI-MOVE+ (Integrated Monitoring of Vaccines in Europe) project, received a grant from the European Commission Horizon 2020 research and innovation programme (grant agreement No 634446).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationVaccine. 2022 Feb 23;40(9):1306-1315. doi: 10.1016/j.vaccine.2022.01.015. Epub 2022 Jan 31.pt_PT
dc.identifier.doi10.1016/j.vaccine.2022.01.015pt_PT
dc.identifier.issn0264-410X
dc.identifier.urihttp://hdl.handle.net/10400.18/8452
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relationI-MOVE+ Integrated Monitoring of Vaccines Effects in Europe: a platform to measure and compare effectiveness and impact of influenza and pneumococcal vaccines and vaccination strategies in the elderly
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S0264410X22000391?via%3Dihubpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectInfluenzapt_PT
dc.subjectVaccinationpt_PT
dc.subjectVaccine Impactpt_PT
dc.subjectCost-effectivenesspt_PT
dc.subjectMathematical Modellingpt_PT
dc.subjectVacina Antigripalpt_PT
dc.subjectEuropept_PT
dc.subjectDeterminantes da Saúde e da Doençapt_PT
dc.titleHealth and economic impact of seasonal influenza mass vaccination strategies in European settings: A mathematical modelling and cost-effectiveness analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleI-MOVE+ Integrated Monitoring of Vaccines Effects in Europe: a platform to measure and compare effectiveness and impact of influenza and pneumococcal vaccines and vaccination strategies in the elderly
oaire.awardURIinfo:eu-repo/grantAgreement/EC/H2020/634446/EU
oaire.citation.endPage1315pt_PT
oaire.citation.issue9pt_PT
oaire.citation.startPage1306pt_PT
oaire.citation.titleVaccinept_PT
oaire.citation.volume40pt_PT
oaire.fundingStreamH2020
person.familyNameKislaya
person.familyNameMachado
person.familyNameNunes
person.givenNameIrina
person.givenNameAusenda
person.givenNameBaltazar
person.identifier.ciencia-idA815-4295-F91D
person.identifier.ciencia-id1217-6076-5D88
person.identifier.ciencia-idAB11-AD48-A8DF
person.identifier.orcid0000-0001-5772-2416
person.identifier.orcid0000-0002-1849-1499
person.identifier.orcid0000-0001-6230-7209
person.identifier.scopus-author-id56442728800
person.identifier.scopus-author-id9133723200
project.funder.identifierhttp://doi.org/10.13039/501100008530
project.funder.nameEuropean Commission
rcaap.embargofctAcesso de acordo com política editorial da revista.pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
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