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Published on: August 14, 2019
Values for preventing influenza-related morbidity and vaccine adverse events in children
Lisa A Prosser1, Carolyn Buxton Bridges, Timothy M Uyeki
1Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Ave,, 6th floor, Boston, MA, USA. lprosser@hms.harvard.edu
Insights
Parents expressed low willingness to trade life years for uncomplicated childhood influenza but showed willingness to pay for prevention. They valued preventing severe vaccine side effects more than influenza itself, indicating a preference for safer vaccines.
Area of Science:
- Pediatric Health Economics
- Vaccine Decision Making
- Public Health Policy
Background:
- Influenza vaccination is recommended for young children but not routinely for older, non-high-risk children.
- Data on disease impact, costs, benefits, risks, and community preferences are needed to guide vaccination decisions for different age and risk groups.
- Understanding preferences for health outcomes related to influenza and vaccine adverse events is crucial for optimizing vaccination strategies.
Purpose of the Study:
- To measure parental preferences and willingness-to-pay for health-related quality of life changes associated with uncomplicated influenza in children.
- To assess preferences and willingness-to-pay for rare, vaccination-related adverse events: anaphylaxis and Guillain-Barré syndrome.
- To inform decisions regarding influenza vaccination eligibility and strategies for improving vaccine uptake in children.
Main Methods:
- Telephone interviews were conducted with 112 randomly selected adult members of a large New England HMO.
- Respondents evaluated four health outcomes: uncomplicated influenza in a 1-year-old, uncomplicated influenza in a 14-year-old, anaphylaxis, and Guillain-Barré syndrome.
- Health outcome preferences were measured using time-tradeoff and willingness-to-pay questions, assessing the value placed on avoiding these conditions.
Main Results:
- Median willingness to trade life years to prevent uncomplicated influenza was zero days for both 1-year-old and 14-year-old children.
- Median willingness-to-pay to prevent anaphylaxis was $400 and Guillain-Barré syndrome was $4000.
- Median willingness-to-pay for influenza vaccination without severe risks was $50 for anaphylaxis and $100 for Guillain-Barré syndrome.
Conclusions:
- Adults showed minimal willingness to trade life years to prevent uncomplicated childhood influenza, regardless of age.
- Parents indicated a willingness-to-pay to prevent childhood influenza, with higher amounts for younger children.
- There is a significant willingness to pay a premium for influenza vaccines that eliminate the risk of severe adverse events like anaphylaxis and Guillain-Barré syndrome.
Background:
Influenza vaccination recently has been recommended for children 6-23 months old, but is not currently recommended for routine use in non-high-risk older children. Information on disease impact, costs, benefits, risks, and community preferences could help guide decisions about which age and risk groups should be vaccinated and strategies for improving coverage. The objective of this study was to measure preferences and willingness-to-pay for changes in health-related quality of life associated with uncomplicated influenza and two rarely-occurring vaccination-related adverse events (anaphylaxis and Guillain-Barré syndrome) in children.
Methods:
We conducted telephone interviews with adult members selected at random from a large New England HMO (n = 112). Respondents were given descriptions of four health outcomes: uncomplicated influenza in a hypothetical 1-year-old child of their own, uncomplicated influenza in a hypothetical 14-year-old child of their own, anaphylaxis following vaccination, and Guillain-Barré syndrome. "Uncomplicated influenza" did not require a physician's visit or hospitalization. Preferences (values) for these health outcomes were measured using time-tradeoff and willingness-to-pay questions. Time-tradeoff questions asked the adult to assume they had a child and to consider how much time from the end of their own life they would be willing to surrender to avoid the health outcome in the child.
Results:
Respondents said they would give a median of zero days of their lives to prevent an episode of uncomplicated influenza in either their (hypothetical) 1-year-old or 14-year-old, 30 days to prevent an episode of vaccination-related anaphylaxis, and 3 years to prevent a vaccination-related case of Guillain-Barré syndrome. Median willingness-to-pay to prevent uncomplicated influenza in a 1-year-old was $175, uncomplicated influenza in a 14-year-old was $100, anaphylaxis $400, and Guillain-Barré syndrome $4000. The median willingness-to-pay for an influenza vaccination for their children with no risk of anaphylaxis or Guillain-Barré syndrome was $50 and $100, respectively.
Conclusion:
Most respondents said they would not be willing to trade any time from their own lives to prevent uncomplicated influenza in a child of their own, and the time traded did not vary by the age of the hypothetical affected child. However, adults did indicate a willingness-to-pay to prevent uncomplicated influenza in children, and that they would give more money to prevent the illness in a 1-year-old than in a 14-year-old. Respondents also indicated a willingness to pay a premium for a vaccine without any risk of severe complications.
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