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School‐Based Influenza Vaccination: Health and Economic Impact of Maine's 2009 Influenza Vaccination Program

Identifieur interne : 000693 ( Pmc/Curation ); précédent : 000692; suivant : 000694

School‐Based Influenza Vaccination: Health and Economic Impact of Maine's 2009 Influenza Vaccination Program

Auteurs : Ricardo Basurto-Dávila ; Martin I. Meltzer ; Dora A. Mills ; Garrett R. Beeler Asay ; Bo-Hyun Cho ; Samuel B. Graitcer ; Nancy L. Dube ; Mark G. Thompson ; Suchita A. Patel ; Samuel K. Peasah ; Jill M. Ferdinands ; Paul Gargiullo ; Mark Messonnier ; David K. Shay

Source :

RBID : PMC:5682124

Abstract

Objective

To estimate the societal economic and health impacts of Maine's school‐based influenza vaccination (SIV) program during the 2009 A(H1N1) influenza pandemic.

Data Sources

Primary and secondary data covering the 2008–09 and 2009–10 influenza seasons.

Study Design

We estimated weekly monovalent influenza vaccine uptake in Maine and 15 other states, using difference‐in‐difference‐in‐differences analysis to assess the program's impact on immunization among six age groups. We also developed a health and economic Markov microsimulation model and conducted Monte Carlo sensitivity analysis.

Data Collection

We used national survey data to estimate the impact of the SIV program on vaccine coverage. We used primary data and published studies to develop the microsimulation model.

Principal Findings

The program was associated with higher immunization among children and lower immunization among adults aged 18–49 years and 65 and older. The program prevented 4,600 influenza infections and generated $4.9 million in net economic benefits. Cost savings from lower adult vaccination accounted for 54 percent of the economic gain. Economic benefits were positive in 98 percent of Monte Carlo simulations.

Conclusions

SIV may be a cost‐beneficial approach to increase immunization during pandemics, but programs should be designed to prevent lower immunization among nontargeted groups.


Url:
DOI: 10.1111/1475-6773.12786
PubMed: 29130266
PubMed Central: 5682124

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PMC:5682124

Le document en format XML

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<div type="abstract" xml:lang="en">
<sec id="hesr12786-sec-0001">
<title>Objective</title>
<p>To estimate the societal economic and health impacts of Maine's school‐based influenza vaccination (
<styled-content style="fixed-case">SIV</styled-content>
) program during the 2009 A(H1N1) influenza pandemic.</p>
</sec>
<sec id="hesr12786-sec-0002">
<title>Data Sources</title>
<p>Primary and secondary data covering the 2008–09 and 2009–10 influenza seasons.</p>
</sec>
<sec id="hesr12786-sec-0003">
<title>Study Design</title>
<p>We estimated weekly monovalent influenza vaccine uptake in Maine and 15 other states, using difference‐in‐difference‐in‐differences analysis to assess the program's impact on immunization among six age groups. We also developed a health and economic Markov microsimulation model and conducted Monte Carlo sensitivity analysis.</p>
</sec>
<sec id="hesr12786-sec-0004">
<title>Data Collection</title>
<p>We used national survey data to estimate the impact of the
<styled-content style="fixed-case">SIV</styled-content>
program on vaccine coverage. We used primary data and published studies to develop the microsimulation model.</p>
</sec>
<sec id="hesr12786-sec-0005">
<title>Principal Findings</title>
<p>The program was associated with higher immunization among children and lower immunization among adults aged 18–49 years and 65 and older. The program prevented 4,600 influenza infections and generated $4.9 million in net economic benefits. Cost savings from lower adult vaccination accounted for 54 percent of the economic gain. Economic benefits were positive in 98 percent of Monte Carlo simulations.</p>
</sec>
<sec id="hesr12786-sec-0006">
<title>Conclusions</title>
<p>
<styled-content style="fixed-case">SIV</styled-content>
may be a cost‐beneficial approach to increase immunization during pandemics, but programs should be designed to prevent lower immunization among nontargeted groups.</p>
</sec>
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<journal-id journal-id-type="nlm-ta">Health Serv Res</journal-id>
<journal-id journal-id-type="iso-abbrev">Health Serv Res</journal-id>
<journal-id journal-id-type="doi">10.1111/(ISSN)1475-6773</journal-id>
<journal-id journal-id-type="publisher-id">HESR</journal-id>
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<journal-title>Health Services Research</journal-title>
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<issn pub-type="ppub">0017-9124</issn>
<issn pub-type="epub">1475-6773</issn>
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<publisher-name>John Wiley and Sons Inc.</publisher-name>
<publisher-loc>Hoboken</publisher-loc>
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<article-id pub-id-type="pmid">29130266</article-id>
<article-id pub-id-type="pmc">5682124</article-id>
<article-id pub-id-type="doi">10.1111/1475-6773.12786</article-id>
<article-id pub-id-type="publisher-id">HESR12786</article-id>
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<subject>Public Health Services and Economics</subject>
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<subj-group subj-group-type="heading">
<subject>Public Health Services and Economics</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>School‐Based Influenza Vaccination: Health and Economic Impact of Maine's 2009 Influenza Vaccination Program</article-title>
</title-group>
<contrib-group>
<contrib id="hesr12786-cr-0001" contrib-type="author" corresp="yes">
<name>
<surname>Basurto‐Dávila</surname>
<given-names>Ricardo</given-names>
</name>
<degrees>Ph.D., M.S.</degrees>
<contrib-id contrib-id-type="orcid">http://orcid.org/0000-0001-8589-9884</contrib-id>
<xref ref-type="aff" rid="hesr12786-aff-0001">
<sup>1</sup>
</xref>
<address>
<email>rbasurto@ph.lacounty.gov</email>
</address>
</contrib>
<contrib id="hesr12786-cr-0002" contrib-type="author">
<name>
<surname>Meltzer</surname>
<given-names>Martin I.</given-names>
</name>
<degrees>Ph.D., M.S.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0003" contrib-type="author">
<name>
<surname>Mills</surname>
<given-names>Dora A.</given-names>
</name>
<degrees>M.D., M.P.H.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0003">
<sup>3</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0004" contrib-type="author">
<name>
<surname>Beeler Asay</surname>
<given-names>Garrett R.</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0005" contrib-type="author">
<name>
<surname>Cho</surname>
<given-names>Bo‐Hyun</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0006" contrib-type="author">
<name>
<surname>Graitcer</surname>
<given-names>Samuel B.</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0007" contrib-type="author">
<name>
<surname>Dube</surname>
<given-names>Nancy L.</given-names>
</name>
<degrees>R.N., M.P.H. (ret.)</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0004">
<sup>4</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0008" contrib-type="author">
<name>
<surname>Thompson</surname>
<given-names>Mark G.</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0009" contrib-type="author">
<name>
<surname>Patel</surname>
<given-names>Suchita A.</given-names>
</name>
<degrees>D.O., M.P.H.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0010" contrib-type="author">
<name>
<surname>Peasah</surname>
<given-names>Samuel K.</given-names>
</name>
<degrees>Ph.D., M.P.H., R.Ph.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0005">
<sup>5</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0011" contrib-type="author">
<name>
<surname>Ferdinands</surname>
<given-names>Jill M.</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0012" contrib-type="author">
<name>
<surname>Gargiullo</surname>
<given-names>Paul</given-names>
</name>
<degrees>Ph.D. (ret.)</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0013" contrib-type="author">
<name>
<surname>Messonnier</surname>
<given-names>Mark</given-names>
</name>
<degrees>Ph.D.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="hesr12786-cr-0014" contrib-type="author">
<name>
<surname>Shay</surname>
<given-names>David K.</given-names>
</name>
<degrees>M.D.</degrees>
<xref ref-type="aff" rid="hesr12786-aff-0002">
<sup>2</sup>
</xref>
</contrib>
</contrib-group>
<aff id="hesr12786-aff-0001">
<label>
<sup>1</sup>
</label>
<institution>Los Angeles County Department of Public Health</institution>
<named-content content-type="city">Los Angeles</named-content>
<named-content content-type="country-part">CA</named-content>
</aff>
<aff id="hesr12786-aff-0002">
<label>
<sup>2</sup>
</label>
<institution>Centers for Disease Control and Prevention</institution>
<named-content content-type="city">Atlanta</named-content>
<named-content content-type="country-part">GA</named-content>
</aff>
<aff id="hesr12786-aff-0003">
<label>
<sup>3</sup>
</label>
<institution>University of New England</institution>
<named-content content-type="city">Portland</named-content>
<named-content content-type="country-part">ME</named-content>
</aff>
<aff id="hesr12786-aff-0004">
<label>
<sup>4</sup>
</label>
<institution>Maine Department of Education</institution>
<named-content content-type="city">Augusta</named-content>
<named-content content-type="country-part">ME</named-content>
</aff>
<aff id="hesr12786-aff-0005">
<label>
<sup>5</sup>
</label>
<institution>Mercer University</institution>
<named-content content-type="city">Atlanta</named-content>
<named-content content-type="country-part">GA</named-content>
</aff>
<author-notes>
<corresp id="correspondenceTo">
<label>*</label>
Address correspondence to Ricardo Basurto‐Dávila, Ph.D., M.S., Los Angeles County Department of Public Health, 313 N Figueroa St, Rm 127, Los Angeles, CA 90012; e‐mail:
<email>rbasurto@ph.lacounty.gov</email>
.</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>12</day>
<month>11</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="ppub">
<month>12</month>
<year>2017</year>
</pub-date>
<volume>52</volume>
<issue>Suppl 2</issue>
<issue-id pub-id-type="doi">10.1111/hesr.2017.52.issue-S2</issue-id>
<issue-title content-type="special-issue-title">The Economics of Public Health: Missing Pieces to the Puzzle of Health System Reform</issue-title>
<fpage>2307</fpage>
<lpage>2330</lpage>
<permissions>
<pmc-comment> © Health Research and Educational Trust </pmc-comment>
<copyright-statement content-type="article-copyright">© Health Research and Educational Trust</copyright-statement>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="file:HESR-52-2307.pdf"></self-uri>
<abstract id="hesr12786-abs-0001">
<sec id="hesr12786-sec-0001">
<title>Objective</title>
<p>To estimate the societal economic and health impacts of Maine's school‐based influenza vaccination (
<styled-content style="fixed-case">SIV</styled-content>
) program during the 2009 A(H1N1) influenza pandemic.</p>
</sec>
<sec id="hesr12786-sec-0002">
<title>Data Sources</title>
<p>Primary and secondary data covering the 2008–09 and 2009–10 influenza seasons.</p>
</sec>
<sec id="hesr12786-sec-0003">
<title>Study Design</title>
<p>We estimated weekly monovalent influenza vaccine uptake in Maine and 15 other states, using difference‐in‐difference‐in‐differences analysis to assess the program's impact on immunization among six age groups. We also developed a health and economic Markov microsimulation model and conducted Monte Carlo sensitivity analysis.</p>
</sec>
<sec id="hesr12786-sec-0004">
<title>Data Collection</title>
<p>We used national survey data to estimate the impact of the
<styled-content style="fixed-case">SIV</styled-content>
program on vaccine coverage. We used primary data and published studies to develop the microsimulation model.</p>
</sec>
<sec id="hesr12786-sec-0005">
<title>Principal Findings</title>
<p>The program was associated with higher immunization among children and lower immunization among adults aged 18–49 years and 65 and older. The program prevented 4,600 influenza infections and generated $4.9 million in net economic benefits. Cost savings from lower adult vaccination accounted for 54 percent of the economic gain. Economic benefits were positive in 98 percent of Monte Carlo simulations.</p>
</sec>
<sec id="hesr12786-sec-0006">
<title>Conclusions</title>
<p>
<styled-content style="fixed-case">SIV</styled-content>
may be a cost‐beneficial approach to increase immunization during pandemics, but programs should be designed to prevent lower immunization among nontargeted groups.</p>
</sec>
</abstract>
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