Prioritization of risk groups for influenza vaccination in resource limited settings – A case study from South Africa

Autor: Florette K. Treurnicht, Sibongile Walaza, Meredith McMorrow, Shabir A. Madhi, Wayne Ramkrishna, Eduardo Azziz-Baumgartner, Cheryl Cohen, Stefano Tempia
Rok vydání: 2019
Předmět:
Male
Cost-Benefit Analysis
HIV Infections
Disease
South Africa
0302 clinical medicine
Cost of Illness
Pregnancy
Risk Factors
Vaccine policy
030212 general & internal medicine
Child
health care economics and organizations
education.field_of_study
Cost–benefit analysis
Incidence (epidemiology)
Vaccination
Middle Aged
Hospitalization
Infectious Diseases
Influenza Vaccines
Child
Preschool
Health Resources
Molecular Medicine
Female
Adult
Tuberculosis
Adolescent
Influenza vaccine
030231 tropical medicine
Population
Article
Young Adult
03 medical and health sciences
Environmental health
Influenza
Human
medicine
Humans
Mortality
education
Aged
General Veterinary
General Immunology and Microbiology
Health Priorities
business.industry
Public Health
Environmental and Occupational Health
Infant
Vaccine efficacy
medicine.disease
Influenza
Case-Control Studies
business
Zdroj: Vaccine
ISSN: 0264-410X
Popis: Background Due to competing health priorities, low- and middle-income countries (LMIC) may need to prioritize between different influenza vaccine risk groups. Risk group prioritization may differ in LMIC based upon programmatic feasibility, country-specific prevalence of risk conditions and influenza-associated morbidity and mortality. Methods In South Africa, we collected local disease burden data (both published and unpublished) and published vaccine efficacy data in risk groups and healthy adults. We used these data to aid policy makers with risk group prioritization for influenza vaccination. We used the following formula to assess potential vaccine averted disease in each risk group: rate of influenza-associated hospitalization (or death) per 100,000 population * influenza vaccine efficacy (VE). We further estimated the cost per hospital day averted and the cost per year of life saved by influenza vaccination. Results Pregnant women, HIV-infected adults, and adults and children with tuberculosis disease had among the highest estimates of hospitalizations averted per 100,000 vaccinated and adults aged 65 years and older had the highest estimated deaths averted per 100,000 vaccinated. However, when assessing both the cost per hospital day averted (range: USD148-1,344) and the cost per year of life saved (range: USD112-1,230); adults and children with TB disease, HIV-infected adults and pregnant women had the lowest cost per outcome averted. Discussion An assessment of the potential disease outcomes averted and associated costs may aid policymakers in risk group prioritization for influenza vaccination.
Databáze: OpenAIRE
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