Abstract
Background: In response to COVID-19, the UK National Health Service (NHS) extended influenza vaccination in 50- to 64-year-olds from at-risk only to all in this age group for the 2020/21 season. The objective of this research is to determine the cost-effectiveness of continuing to vaccinate all with a quadrivalent cell-based vaccine (QIVc) compared to returning to an at-risk only policy after the pandemic resolves. Methods: A dynamic transmission model, calibrated to match infection data from the UK, was used to estimate the clinical and economic impact of vaccination across 10 influenza seasons. The base case effectiveness of QIVc was 63.9% and the list price was GBP 9.94. Results: Vaccinating 50% of all 50- to 64-year-olds with QIVc reduced the average annual number of clinical infections (−682,000), hospitalizations (−5800) and deaths (−740) in the UK. The base case incremental cost per quality-adjusted life-year gained (ICER) of all compared to at-risk only was GBP6000 (NHS perspective). When the cost of lost productivity was considered, vaccinating all 50- to 64-year-olds with QIVc became cost-saving. Conclusion: Vaccinating all 50- to 64-year-olds with QIVc is likely to be cost-effective. The NHS should consider continuing this policy in future seasons.
Highlights
In the United Kingdom (UK), seasonal influenza vaccines have been provided annually to those in a clinical risk group as well as those aged 65 years and above since 2000 [1]
When vaccination with quadrivalent cell-based vaccine (QIVc) is extended from an at-risk only strategy to all individuals aged 50 to 64 years, the morbidity and mortality associated with influenza decreases
With 50% coverage, a reduction of about 1200 hospitalizations annually is seen in the 50- to 64-year-olds, while a reduction in 4600 hospitalizations is seen in other age groups
Summary
In the United Kingdom (UK), seasonal influenza vaccines have been provided annually to those in a clinical risk group as well as those aged 65 years and above since 2000 [1]. The objective of this research is to determine the cost-effectiveness of continuing to provide quadrivalent influenza mammalian cell-based vaccine (QIVc) vaccinations to all individuals aged 50 to 64, including low and at-risk people, once the COVID-19 pandemic has resolved. In response to COVID-19, the UK National Health Service (NHS) extended influenza vaccination in 50- to 64-year-olds from at-risk only to all in this age group for the 2020/21 season. The objective of this research is to determine the cost-effectiveness of continuing to vaccinate all with a quadrivalent cell-based vaccine (QIVc) compared to returning to an at-risk only policy after the pandemic resolves. The NHS should consider continuing this policy in future seasons
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