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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Economic Value of Seasonal and Pandemic Influenza Vaccination During Pregnancy</title><author><name sortKey="Beigi, Richard H" sort="Beigi, Richard H" uniqKey="Beigi R" first="Richard H." last="Beigi">Richard H. Beigi</name><affiliation><nlm:aff id="A1"> Division of Reproductive Infectious Diseases, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff></affiliation></author><author><name sortKey="Wiringa, Ann E" sort="Wiringa, Ann E" uniqKey="Wiringa A" first="Ann E." last="Wiringa">Ann E. Wiringa</name><affiliation><nlm:aff id="A2"> Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation><affiliation><nlm:aff id="A3"> Department of Epidemiology, Graduate School of Public Health and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation></author><author><name sortKey="Bailey, Rachel" sort="Bailey, Rachel" uniqKey="Bailey R" first="Rachel" last="Bailey">Rachel Bailey</name><affiliation><nlm:aff id="A2"> Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation><affiliation><nlm:aff id="A3"> Department of Epidemiology, Graduate School of Public Health and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation></author><author><name sortKey="Assi, Tina Marie" sort="Assi, Tina Marie" uniqKey="Assi T" first="Tina-Marie" last="Assi">Tina-Marie Assi</name><affiliation><nlm:aff id="A2"> Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation><affiliation><nlm:aff id="A3"> Department of Epidemiology, Graduate School of Public Health and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation></author><author><name sortKey="Lee, Bruce Y" sort="Lee, Bruce Y" uniqKey="Lee B" first="Bruce Y." last="Lee">Bruce Y. Lee</name><affiliation><nlm:aff id="A2"> Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation><affiliation><nlm:aff id="A3"> Department of Epidemiology, Graduate School of Public Health and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19911967</idno><idno type="pmc">2887606</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887606</idno><idno type="RBID">PMC:2887606</idno><idno type="doi">10.1086/649013</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">000563</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000563</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Economic Value of Seasonal and Pandemic Influenza Vaccination During Pregnancy</title><author><name sortKey="Beigi, Richard H" sort="Beigi, Richard H" uniqKey="Beigi R" first="Richard H." last="Beigi">Richard H. Beigi</name><affiliation><nlm:aff id="A1"> Division of Reproductive Infectious Diseases, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff></affiliation></author><author><name sortKey="Wiringa, Ann E" sort="Wiringa, Ann E" uniqKey="Wiringa A" first="Ann E." last="Wiringa">Ann E. Wiringa</name><affiliation><nlm:aff id="A2"> Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation><affiliation><nlm:aff id="A3"> Department of Epidemiology, Graduate School of Public Health and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation></author><author><name sortKey="Bailey, Rachel" sort="Bailey, Rachel" uniqKey="Bailey R" first="Rachel" last="Bailey">Rachel Bailey</name><affiliation><nlm:aff id="A2"> Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation><affiliation><nlm:aff id="A3"> Department of Epidemiology, Graduate School of Public Health and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation></author><author><name sortKey="Assi, Tina Marie" sort="Assi, Tina Marie" uniqKey="Assi T" first="Tina-Marie" last="Assi">Tina-Marie Assi</name><affiliation><nlm:aff id="A2"> Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation><affiliation><nlm:aff id="A3"> Department of Epidemiology, Graduate School of Public Health and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation></author><author><name sortKey="Lee, Bruce Y" sort="Lee, Bruce Y" uniqKey="Lee B" first="Bruce Y." last="Lee">Bruce Y. Lee</name><affiliation><nlm:aff id="A2"> Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation><affiliation><nlm:aff id="A3"> Department of Epidemiology, Graduate School of Public Health and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA</nlm:aff></affiliation></author></analytic><series><title level="j">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">The cost-effectiveness of maternal influenza immunization against laboratory-confirmed influenza has never been studied. The current 2009 H1N1 influenza pandemic provides a timely opportunity to perform such analyses. The study objective was to evaluate the cost-effectiveness of maternal influenza vaccination using both single and two-dosing strategies against laboratory-confirmed influenza secondary to both seasonal epidemics and pandemic influenza outbreaks.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">A cost-effectiveness decision analytic model construct using epidemic and pandemic influenza characteristics from both the societal and third-party payor perspectives. A comparison was made between vaccinating all pregnant women in the United States versus not vaccinating pregnant women. Probabilistic (Monte Carlo) sensitivity analyses were also performed. The main outcome measures were incremental cost-effectiveness ratios (ICERs).</p></sec><sec id="S3"><title>Results</title><p id="P3">Maternal influenza vaccination using either the single or two-dose strategy is a cost-effective approach when influenza prevalence greater than or equal to 7.5% and influenza-attributable mortality is greater than or equal to 1.05% (consistent with epidemic strains). As the prevalence of influenza and/or the severity of the outbreak increases the incremental value of vaccination also increases. At a higher prevalence of influenza (≥30%) the single-dose strategy demonstrates cost-savings while the two-dose strategy remains highly cost-effective (ICER ≤ $6,787.77 per quality adjusted life year).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Maternal influenza immunization is a highly cost-effective intervention at disease rates and severity that correspond to both seasonal influenza epidemics and occasional pandemics. These findings justify ongoing efforts to optimize influenza vaccination during pregnancy from an economic perspective.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9203213</journal-id><journal-id journal-id-type="pubmed-jr-id">1135</journal-id><journal-id journal-id-type="nlm-ta">Clin Infect Dis</journal-id><journal-title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</journal-title><issn pub-type="ppub">1058-4838</issn><issn pub-type="epub">1537-6591</issn></journal-meta><article-meta><article-id pub-id-type="pmid">19911967</article-id><article-id pub-id-type="pmc">2887606</article-id><article-id pub-id-type="doi">10.1086/649013</article-id><article-id pub-id-type="manuscript">NIHMS195081</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Economic Value of Seasonal and Pandemic Influenza Vaccination During Pregnancy</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Beigi</surname><given-names>Richard H.</given-names></name><degrees>MD, MSc</degrees><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Wiringa</surname><given-names>Ann E.</given-names></name><degrees>BS</degrees><xref rid="A2" ref-type="aff">2</xref><xref rid="A3" ref-type="aff">3</xref></contrib><contrib contrib-type="author"><name><surname>Bailey</surname><given-names>Rachel</given-names></name><degrees>MPH</degrees><xref rid="A2" ref-type="aff">2</xref><xref rid="A3" ref-type="aff">3</xref></contrib><contrib contrib-type="author"><name><surname>Assi</surname><given-names>Tina-Marie</given-names></name><degrees>MPH</degrees><xref rid="A2" ref-type="aff">2</xref><xref rid="A3" ref-type="aff">3</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Bruce Y.</given-names></name><degrees>MD, MBA</degrees><xref rid="A2" ref-type="aff">2</xref><xref rid="A3" ref-type="aff">3</xref></contrib></contrib-group><aff id="A1"><label>1</label> Division of Reproductive Infectious Diseases, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center, Pittsburgh, PA</aff><aff id="A2"><label>2</label> Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh, Pittsburgh, PA</aff><aff id="A3"><label>3</label> Department of Epidemiology, Graduate School of Public Health and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA</aff><author-notes><corresp id="FN1">Corresponding author: Richard H. Beigi, MD, MSc., Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Hospital of the University of Pittsburgh, Medical Center, 300 Halket Street, Pittsburgh, PA 15213, P: (412) 641-5403, F: (412) 641-1133, <email>rbeigi@mail.magee.edu</email></corresp><fn id="FN2" fn-type="conflict"><p>No other authors have any conflicts of interest to report.</p></fn></author-notes><pub-date pub-type="nihms-submitted"><day>23</day><month>4</month><year>2010</year></pub-date><pub-date pub-type="ppub"><day>15</day><month>12</month><year>2009</year></pub-date><pub-date pub-type="pmc-release"><day>18</day><month>6</month><year>2010</year></pub-date><volume>49</volume><issue>12</issue><fpage>1784</fpage><lpage>1792</lpage><abstract><sec id="S1"><title>Background</title><p id="P1">The cost-effectiveness of maternal influenza immunization against laboratory-confirmed influenza has never been studied. The current 2009 H1N1 influenza pandemic provides a timely opportunity to perform such analyses. The study objective was to evaluate the cost-effectiveness of maternal influenza vaccination using both single and two-dosing strategies against laboratory-confirmed influenza secondary to both seasonal epidemics and pandemic influenza outbreaks.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">A cost-effectiveness decision analytic model construct using epidemic and pandemic influenza characteristics from both the societal and third-party payor perspectives. A comparison was made between vaccinating all pregnant women in the United States versus not vaccinating pregnant women. Probabilistic (Monte Carlo) sensitivity analyses were also performed. The main outcome measures were incremental cost-effectiveness ratios (ICERs).</p></sec><sec id="S3"><title>Results</title><p id="P3">Maternal influenza vaccination using either the single or two-dose strategy is a cost-effective approach when influenza prevalence greater than or equal to 7.5% and influenza-attributable mortality is greater than or equal to 1.05% (consistent with epidemic strains). As the prevalence of influenza and/or the severity of the outbreak increases the incremental value of vaccination also increases. At a higher prevalence of influenza (≥30%) the single-dose strategy demonstrates cost-savings while the two-dose strategy remains highly cost-effective (ICER ≤ $6,787.77 per quality adjusted life year).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Maternal influenza immunization is a highly cost-effective intervention at disease rates and severity that correspond to both seasonal influenza epidemics and occasional pandemics. These findings justify ongoing efforts to optimize influenza vaccination during pregnancy from an economic perspective.</p></sec></abstract><kwd-group><kwd>Influenza</kwd><kwd>maternal vaccination</kwd><kwd>epidemic</kwd><kwd>pandemic</kwd><kwd>cost-effectiveness</kwd></kwd-group><contract-num rid="GM1">U54 GM088491-01S1
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