Health and Economic Benefits of Early Vaccination and Nonpharmaceutical Interventions for a Human Influenza A (H7N9) Pandemic
Identifieur interne : 001088 ( Main/Exploration ); précédent : 001087; suivant : 001089Health and Economic Benefits of Early Vaccination and Nonpharmaceutical Interventions for a Human Influenza A (H7N9) Pandemic
Auteurs : Nayer Khazeni [États-Unis] ; David W. Hutton ; Cassandra I. F. Collins ; Alan M. Garber ; Douglas K. OwensSource :
- Annals of internal medicine [ 0003-4819 ] ; 2014.
Descripteurs français
- KwdFr :
- Analyse coût-bénéfice, Coûts des soins de santé, Grippe humaine (), Grippe humaine (mortalité), Grippe humaine (transmission), Grippe humaine (épidémiologie), Humains, Hygiène, Isolement du patient, Modèles théoriques, Méthode de Monte-Carlo, Pandémies (), Sous-type H7N9 du virus de la grippe A, Transmission de maladie infectieuse (), Vaccins antigrippaux (administration et posologie), Vaccins antigrippaux (économie), Villes.
- MESH :
- administration et posologie : Vaccins antigrippaux.
- mortalité : Grippe humaine.
- économie : Grippe humaine, Vaccins antigrippaux.
- épidémiologie : Grippe humaine.
- Pascal (Inist)
- Analyse coût-bénéfice, Coûts des soins de santé, Grippe humaine, Humains, Hygiène, Immunoprophylaxie, Economie santé, Isolement du patient, Modèles théoriques, Méthode de Monte-Carlo, Pandémies, Précoce, Sous-type H7N9 du virus de la grippe A, Transmission de maladie infectieuse, Vaccination, Prévention, Homme, Grippe A, Médecine, Grippe pandémique, Villes.
- Wicri :
- topic : Vaccination, Homme, Médecine.
English descriptors
- KwdEn :
- Cities, Cost-Benefit Analysis, Disease Transmission, Infectious (prevention & control), Early, Health Care Costs, Health economy, Human, Humans, Hygiene, Immunoprophylaxis, Influenza A, Influenza A Virus, H7N9 Subtype, Influenza Vaccines (administration & dosage), Influenza Vaccines (economics), Influenza, Human (epidemiology), Influenza, Human (mortality), Influenza, Human (prevention & control), Influenza, Human (transmission), Medicine, Models, Theoretical, Monte Carlo Method, Pandemics (prevention & control), Patient Isolation, Prevention, Vaccination.
- MESH :
- chemical , administration & dosage : Influenza Vaccines.
- chemical , economics : Influenza Vaccines.
- epidemiology : Influenza, Human.
- mortality : Influenza, Human.
- prevention & control : Disease Transmission, Infectious, Influenza, Human, Pandemics.
- transmission : Influenza, Human.
- Cities, Cost-Benefit Analysis, Health Care Costs, Humans, Hygiene, Influenza A Virus, H7N9 Subtype, Models, Theoretical, Monte Carlo Method, Patient Isolation.
Abstract
Background: Vaccination for the 2009 pandemic did not occur until late in the outbreak, which limited its benefits. Influenza A (H7N9) is causing increasing morbidity and mortality in China, and researchers have modified the A (H5N1) virus to transmit via aerosol, which again heightens concerns about pandemic influenza preparedness. Objective: To determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a pandemic with characteristics similar to influenza A (H7N9) and A (H5N1). Design: Dynamic transmission model to estimate health and economic consequences of a severe influenza pandemic in a large metropolitan city. Data Sources: Literature and expert opinion. Target Population: Residents of a U.S. metropolitan city with characteristics similar to New York City. Time Horizon: Lifetime. Perspective: Societal. Intervention: Vaccination of 30% of the population at 4 or 6 months. Outcome Measures: Infections and deaths averted and cost-effectiveness. Results of Base-Case Analysis: In 12 months, 48 254 persons would die. Vaccinating at 9 months would avert 2365 of these deaths. Vaccinating at 6 months would save 5775 additional lives and $51 million at a city level. Accelerating delivery to 4 months would save an additional 5633 lives and $50 million. Results of Sensitivity Analysis: If vaccination were delayed for 9 months, reducing contacts by 8% through nonpharmaceutical interventions would yield a similar reduction in infections and deaths as vaccination at 4 months. Limitation: The model is not designed to evaluate programs targeting specific populations, such as children or persons with comorbid conditions. Conclusion: Vaccination in an influenza A (H7N9) pandemic would need to be completed much faster than in 2009 to substantially reduce morbidity, mortality, and health care costs. Maximizing nonpharmaceutical interventions can substantially mitigate the pandemic until a matched vaccine becomes available.
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Le document en format XML
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Influenza A (H7N9) is causing increasing morbidity and mortality in China, and researchers have modified the A (H5N1) virus to transmit via aerosol, which again heightens concerns about pandemic influenza preparedness. Objective: To determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a pandemic with characteristics similar to influenza A (H7N9) and A (H5N1). Design: Dynamic transmission model to estimate health and economic consequences of a severe influenza pandemic in a large metropolitan city. Data Sources: Literature and expert opinion. Target Population: Residents of a U.S. metropolitan city with characteristics similar to New York City. Time Horizon: Lifetime. Perspective: Societal. Intervention: Vaccination of 30% of the population at 4 or 6 months. Outcome Measures: Infections and deaths averted and cost-effectiveness. Results of Base-Case Analysis: In 12 months, 48 254 persons would die. Vaccinating at 9 months would avert 2365 of these deaths. Vaccinating at 6 months would save 5775 additional lives and $51 million at a city level. Accelerating delivery to 4 months would save an additional 5633 lives and $50 million. Results of Sensitivity Analysis: If vaccination were delayed for 9 months, reducing contacts by 8% through nonpharmaceutical interventions would yield a similar reduction in infections and deaths as vaccination at 4 months. Limitation: The model is not designed to evaluate programs targeting specific populations, such as children or persons with comorbid conditions. Conclusion: Vaccination in an influenza A (H7N9) pandemic would need to be completed much faster than in 2009 to substantially reduce morbidity, mortality, and health care costs. Maximizing nonpharmaceutical interventions can substantially mitigate the pandemic until a matched vaccine becomes available.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Californie</li><li>Massachusetts</li><li>Michigan</li></region><settlement><li>Cambridge (Massachusetts)</li></settlement><orgName><li>Université Harvard</li></orgName></list><tree><noCountry><name sortKey="Collins, Cassandra I F" sort="Collins, Cassandra I F" uniqKey="Collins C" first="Cassandra I. F." last="Collins">Cassandra I. F. Collins</name><name sortKey="Garber, Alan M" sort="Garber, Alan M" uniqKey="Garber A" first="Alan M." last="Garber">Alan M. Garber</name><name sortKey="Hutton, David W" sort="Hutton, David W" uniqKey="Hutton D" first="David W." last="Hutton">David W. Hutton</name><name sortKey="Owens, Douglas K" sort="Owens, Douglas K" uniqKey="Owens D" first="Douglas K." last="Owens">Douglas K. Owens</name></noCountry><country name="États-Unis"><region name="Californie"><name sortKey="Khazeni, Nayer" sort="Khazeni, Nayer" uniqKey="Khazeni N" first="Nayer" last="Khazeni">Nayer Khazeni</name></region><name sortKey="Khazeni, Nayer" sort="Khazeni, Nayer" uniqKey="Khazeni N" first="Nayer" last="Khazeni">Nayer Khazeni</name><name sortKey="Khazeni, Nayer" sort="Khazeni, Nayer" uniqKey="Khazeni N" first="Nayer" last="Khazeni">Nayer Khazeni</name><name sortKey="Khazeni, Nayer" sort="Khazeni, Nayer" uniqKey="Khazeni N" first="Nayer" last="Khazeni">Nayer Khazeni</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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