Abstract
(1) Background: Vaccines for seasonal influenza are a good preventive and cost-effective strategy. However, it is unknown if and how these economic evaluations include the adverse events following immunization (AEFI), and what the impact of such inclusion is on the health economic outcomes. (2) Methods: We searched the literature, up to January 2020, to identify economic evaluations of seasonal influenza vaccines that considered AEFIs. The review protocol was published in PROSPERO (CDR42017058523). (3) Results: A total of 52 economic evaluations considered AEFI-related parameters in their analyses, reflecting 16% of the economic evaluations on seasonal influenza vaccines in the initial study selection. Most studies used the societal perspective (64%) and evaluated vaccination of children (37%). Where considered, studies included direct medical costs of AEFIs (90%), indirect costs (27%), and disutilities/quality-adjusted life years loss due to AEFIs (37%). The majority of these studies accounted for the effects of the costs of AEFI on cost-effectiveness for Guillain–Barré syndrome. In those papers allowing cost share estimation, direct medical cost of AFEIs was less than 2% of total direct costs. (4) Conclusions: Although the overall impact of AEFIs on the cost-effectiveness outcomes was found to be low, we urge their inclusion in economic evaluations of seasonal influenza vaccines to reflect comprehensive reports for the decision makers and end-users of the vaccination strategies.
Highlights
Seasonal influenza spreads very among people from all age groups almost every year [1]
After the first round of title/abstract scanning, we identified 197 potentially suitable papers, which we further explored within their full text for adverse events following immunization (AEFI) inclusion
While the reporting of AEFIs costs was preferred in a matter of direct costs, the indirect/broader costs were not presented in all studies from societal perspective
Summary
Seasonal influenza spreads very among people from all age groups almost every year [1]. Most common are inactivated influenza vaccines (IIVs), available as trivalent influenza vaccines (TIVs) or quadrivalent influenza vaccines (QIVs), and live attenuated influenza vaccines (LAIVs), which are nowadays only available as quadrivalent vaccines (Q-LAIVs). More recent additions to the portfolio of vaccines concern the modification to high-dose and adjuvanted vaccines All of these vaccines are approved for seasonal influenza and may be indicated for different age groups. The seasonal influenza vaccine is generally considered safe, yet it can sometimes cause adverse events following immunization (AEFIs). LAIV is associated with the following AEFI: runny nose or nasal congestion in all ages, fever, wheezing, headache, sore throat, tiredness/weakness, myalgia, cough, chills, and sinusitis, and more serious such as GBS [6,7,8]
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