Health and Economic Benefits of Early Vaccination and Nonpharmaceutical Interventions for a Human Influenza A (H7N9) Pandemic
Identifieur interne : 000097 ( PascalFrancis/Checkpoint ); précédent : 000096; suivant : 000098Health 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
- Pascal (Inist)
- Wicri :
- topic : Vaccination, Homme, Médecine.
English descriptors
- KwdEn :
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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Hutton</name></author><author><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></author><author><name sortKey="Garber, Alan M" sort="Garber, Alan M" uniqKey="Garber A" first="Alan M." last="Garber">Alan M. Garber</name></author><author><name sortKey="Owens, Douglas K" sort="Owens, Douglas K" uniqKey="Owens D" first="Douglas K." last="Owens">Douglas K. Owens</name></author></analytic><series><title level="j" type="main">Annals of internal medicine</title><title level="j" type="abbreviated">Ann. intern. med.</title><idno type="ISSN">0003-4819</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Annals of internal medicine</title><title level="j" type="abbreviated">Ann. intern. med.</title><idno type="ISSN">0003-4819</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Early</term><term>Health economy</term><term>Human</term><term>Immunoprophylaxis</term><term>Influenza A</term><term>Medicine</term><term>Prevention</term><term>Vaccination</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Immunoprophylaxie</term><term>Economie santé</term><term>Précoce</term><term>Vaccination</term><term>Prévention</term><term>Homme</term><term>Grippe A</term><term>Médecine</term><term>Grippe pandémique</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Vaccination</term><term>Homme</term><term>Médecine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0003-4819</s0></fA01><fA02 i1="01"><s0>AIMEAS</s0></fA02><fA03 i2="1"><s0>Ann. intern. med.</s0></fA03><fA05><s2>160</s2></fA05><fA06><s2>10</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Health and Economic Benefits of Early Vaccination and Nonpharmaceutical Interventions for a Human Influenza A (H7N9) Pandemic</s1></fA08><fA11 i1="01" i2="1"><s1>KHAZENI (Nayer)</s1></fA11><fA11 i1="02" i2="1"><s1>HUTTON (David W.)</s1></fA11><fA11 i1="03" i2="1"><s1>COLLINS (Cassandra I. 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All rights reserved.</s1></fA44><fA45><s0>74 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>14-0163625</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Annals of internal medicine</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>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. 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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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