Abstract
BackgroundInfluenza epidemics significantly weight on the Brazilian healthcare system and its society. Public health authorities have progressively expanded recommendations for vaccination against influenza, particularly to the pediatric population. However, the potential mismatch between the trivalent influenza vaccine (TIV) strains and those circulating during the season remains an issue. Quadrivalent vaccines improves vaccines effectiveness by preventing any potential mismatch on influenza B lineages.MethodsWe evaluate the public health and economic benefits of the switch from TIV to QIV for the pediatric influenza recommendation (6mo-5yo) by using a dynamic epidemiological model able to consider the indirect impact of vaccination. Results of the epidemiological model are then imputed in a health-economic model adapted to the Brazilian context. We perform deterministic and probabilistic sensitivity analysis to account for both epidemiological and economical sources of uncertainty.ResultsOur results show that switching from TIV to QIV in the Brazilian pediatric population would prevent 406,600 symptomatic cases, 11,300 hospitalizations and almost 400 deaths by influenza season. This strategy would save 3400 life-years yearly for an incremental direct cost of R$169 million per year, down to R$86 million from a societal perspective. Incremental cost-effectiveness ratios for the switch would be R$49,700 per life-year saved and R$26,800 per quality-adjusted life-year gained from a public payer perspective, and even more cost-effective from a societal perspective. Our results are qualitatively similar in our sensitivity analysis.ConclusionsOur analysis shows that switching from TIV to QIV to protect children aged 6mo to 5yo in the Brazilian influenza epidemiological context could have a strong public health impact and represent a cost-effective strategy from a public payer perspective, and a highly cost-effective one from a societal perspective.
Highlights
Influenza epidemics significantly weight on the Brazilian healthcare system and its society
Influenza incidences estimated by the model reflect relatively closely the observed incidence, with variations possibly due to the nature of influenza epidemics in Brazil
Our analysis shows that the switch to quadrivalent influenza vaccines (QIV) would prevent ~ 406,600 symptomatic influenza B cases and ~ 400 deaths yearly, which could be translated into ~ 3400 life-years saved
Summary
Influenza epidemics significantly weight on the Brazilian healthcare system and its society. In the past years, influenza vaccines have been criticized for the variability of their effectiveness, partially related to mismatch between the vaccine strains annually recommended by WHO, and the influenza strains circulating during the influenza season To mitigate this issue, new quadrivalent influenza vaccines (QIV) have been developed. In Brazil, the public health and economic benefits of QIV have been demonstrated using various methodologies, but all relying on a “static model” approach, not accounting for the indirect impact of vaccination [12, 13] While these approaches are recommended by WHO guidelines for economic evaluation of vaccination programs targeting individuals with high risk of severe complications, they are not well suited when vaccination targets age-groups “likely to change population disease transmission substantially” [14]. The purpose of the current analysis is to evaluate the public health and economic value of switching the pediatric influenza recommendation (6mo-5yo) from TIV to QIV using a dynamic epidemiological model able to consider the indirect impact of vaccination
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
