Abstract
Limited information is available to determine the effectiveness of Mexico’s national influenza vaccination guidelines and inform policy updates. We aim to propose reforms to current influenza vaccination policies based on our analysis of cost-effectiveness studies. This cross-sectional epidemiological study used influenza case, death, discharge and hospitalization data from several influenza seasons and applied a one-year decision-analytic model to assess cost-effectiveness. The primary health outcome was influenza cases avoided; secondary health outcomes were influenza-related events associated with case reduction. By increasing vaccination coverage to 75% in the population aged 12–49 years with risk factors (diabetes, high blood pressure, morbid obesity, chronic renal failure, asthma, pregnancy), and expanding universal vaccination coverage to school-aged children (5–11 years) and adults aged 50–59 years, 7142–671,461 influenza cases; 1–15 deaths; 7615–262,812 healthcare visits; 2886–154,143 emergency room admissions and 2891–97,637 hospitalizations could be prevented (ranges correspond to separate age and risk factor groups), with a net annual savings of 3.90 to 111.99 million USD. Such changes to the current vaccination policy could potentially result in significant economic and health benefits. These data could be used to inform the revision of a vaccination policy in Mexico with substantial social value.
Highlights
Every year, influenza affects millions of people of all ages around the world, which results in an economic burden of approximately 87,100 million (95% confidence interval (CI): 47,200–149,500) US dollars (USD) due to direct and indirect costs, which include healthcare visits, hospitalization days and productivity loss due to the disease [1]
Lethality rate was defined as the proportion of deaths among people having a confirmed case of influenza, whereas PLLY was defined as the estimate of the average years a person would have lived if this person had not died prematurely, which was based on the age group of a deceased person
To estimate direct medical costs, we considered public unit costs of each of the institutions that comprise the Mexican Health System, and weighed them by the proportion of the population affiliated with each institution for the influenza seasons from 2009–2010 to 2018–2019
Summary
Influenza affects millions of people of all ages around the world, which results in an economic burden of approximately 87,100 million (95% confidence interval (CI): 47,200–149,500) US dollars (USD) due to direct and indirect costs, which include healthcare visits, hospitalization days and productivity loss due to the disease [1]. As of 2010, Mexico’s national vaccination schedule recommends yearly influenza immunization in several target groups: children aged 6 to months, adults aged ≥ years, pregnant women, at-risk individuals aged 5 to 59 years and health professionals [8]. These target groups are eligible to receive the vaccine free of charge at any public health facility during the influenza immunization season (October to April); people not included in these groups can only access influenza vaccines in the private sector. Vaccine coverage rates within the aforementioned groups included in the vaccination program vary between 9.9%
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