Abstract
ObjectiveTo evaluate community-based values for avoiding pandemic influenza (A) H1N1 (pH1N1) illness and vaccination-related adverse events in adults and children.MethodsAdult community members were randomly selected from a nationally representative research panel to complete an internet survey (response rate = 65%; n = 718). Respondents answered a series of time trade-off questions to value four hypothetical health state scenarios for varying ages (1, 8, 35, or 70 years): uncomplicated pH1N1 illness, pH1N1 illness-related hospitalization, severe allergic reaction to the pH1N1 vaccine, and Guillain-Barré syndrome. We calculated descriptive statistics for time trade-off amounts and derived quality adjusted life year losses for these events. Multivariate regression analyses evaluated the effect of scenario age, as well as respondent socio-demographic and health characteristics on time trade-off amounts.ResultsRespondents were willing to trade more time to avoid the more severe outcomes, hospitalization and Guillain-Barré syndrome. In our adjusted and unadjusted analyses, age of the patient in the scenario was significantly associated with time trade-off amounts (p-value<0.05), with respondents willing to trade more time to prevent outcomes in children versus adults. Persons who had received the pH1N1 vaccination were willing to trade significantly more time to avoid hospitalization, severe allergic reaction, and Guillain-Barré syndrome, controlling for other variables in adjusted analyses.(p-value<0.05)ConclusionsCommunity members placed the highest value on preventing outcomes in children, compared with adults, and the time trade-off values reported were consistent with the severity of the outcomes presented. Considering these public values along with other decision-making factors may help policy makers improve the allocation of pandemic vaccine resources.
Highlights
In April 2009, the first influenza pandemic in over forty years began in North America; the causative virus was 2009 pandemic influenza (A) H1N1
When pandemic influenza (A) H1N1 (pH1N1) vaccine recommendations were made in the U.S the only studies reporting community values associated with influenza illness and vaccination were based on data from seasonal influenza [2,3,4]
We present in this study estimates of community-based values for avoiding adult and pediatric health events related to pH1N1 illness and vaccination
Summary
In April 2009, the first influenza pandemic in over forty years began in North America; the causative virus was 2009 pandemic influenza (A) H1N1 (pH1N1). A vaccine became available during October 2009, and a program was implemented on an emergency basis to reduce the impact of the expanding pandemic. Vaccination programs, such as the one implemented for pH1N1, involve an inherent trade-off of risks. When pH1N1 vaccine recommendations were made in the U.S the only studies reporting community values associated with influenza illness and vaccination were based on data from seasonal influenza [2,3,4]. We present in this study estimates of community-based values for avoiding adult and pediatric health events related to pH1N1 illness and vaccination
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