Cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women

Jing Xu; Fangjun Zhou; Carrie Reed; Sandra S Chaves; Mark Messonnier; Inkyu K Kim

doi:10.1016/j.vaccine.2016.04.057

Cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women

Vaccine. 2016 Jun 8;34(27):3149-3155. doi: 10.1016/j.vaccine.2016.04.057. Epub 2016 May 6.

Authors

Jing Xu¹, Fangjun Zhou², Carrie Reed³, Sandra S Chaves⁴, Mark Messonnier⁵, Inkyu K Kim⁶

Affiliations

¹ Immunization Service Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: jingxu.emory@gmail.com.
² Immunization Service Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: faz1@cdc.gov.
³ Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: ggj2@cdc.gov.
⁴ Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: bev8@cdc.gov.
⁵ Immunization Service Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA. Electronic address: qzm3@cdc.gov.
⁶ Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, USA; Battelle Memorial Institute, USA. Electronic address: ddz8@cdc.gov.

Abstract

Objective: To evaluate the cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women using data from three recent influenza seasons in the United States.

Design, setting, and participants: We developed a decision-analytic model following a cohort of 5.2 million pregnant women and their infants aged <6 months to evaluate the cost-effectiveness of vaccinating women against seasonal influenza during pregnancy from a societal perspective. The main outcome measures were quality-adjusted life-year (QALY) gained and cost-effectiveness ratios. Data sources included surveillance data, epidemiological studies, and published vaccine cost data. Sensitivity analyses were also performed. All costs and outcomes were discounted at 3% annually.

Main outcome measures: Total costs (direct and indirect), effects (QALY gains, averted case numbers), and incremental cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women (cost per QALY gained).

Results: Using a recent benchmark of 52.2% vaccination coverage among pregnant women, we studied a hypothetical cohort of 2,753,015 vaccinated pregnant women. With an estimated vaccine effectiveness of 73% among pregnant women and 63% among infants <6 months, QALY gains for each season were 305 (2010-2011), 123 (2011-2012), and 610 (2012-2013). Compared with no vaccination, seasonal influenza vaccination during pregnancy was cost-saving when using data from the 2010-2011 and 2012-2013 influenza seasons. The cost-effectiveness ratio was greater than $100,000/QALY with the 2011-2012 influenza season data, when CDC reported a low attack rate compared to other recent seasons.

Conclusions: Influenza vaccination for pregnant women can reduce morbidity from influenza in both pregnant women and their infants aged <6 months. Seasonal influenza vaccination during pregnancy is cost-saving during moderate to severe influenza seasons.

Keywords: Cost-effectiveness analysis; Pregnancy; Seasonal influenza vaccination.

MeSH terms

Cost-Benefit Analysis
Female
Humans
Infant
Infant, Newborn
Influenza Vaccines / economics
Influenza Vaccines / therapeutic use*
Influenza, Human / economics
Influenza, Human / prevention & control*
Models, Statistical
Pregnancy
Quality-Adjusted Life Years
United States
Vaccination / economics*

Substances

Influenza Vaccines

Grants and funding

CC999999/ImCDC/Intramural CDC HHS/United States