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Cost-Effectiveness of Influenza Vaccination in Healthy Children: A 10-Year Population-Based Study
Elisa Barbieri1, Yuxi Wang2,3, Anna Cantarutti4,5
1Division of Pediatric Infectious Diseases, Department of Women's and Children's Health, University of Padua, 35100 Padua, Italy.
Insights
Annual influenza vaccination for children is cost-effective, especially when vaccine and virus strains match. This strategy helps manage healthcare costs while protecting pediatric health.
Area of Science:
- Pediatric Public Health
- Health Economics
- Vaccine Cost-Effectiveness
Background:
- Seasonal influenza poses a significant health burden and financial strain on pediatric populations and healthcare systems.
- Influenza vaccination is the primary prevention method, but its cost-effectiveness in healthy children requires assessment.
Purpose of the Study:
- To evaluate the cost-effectiveness of annual influenza vaccination for children aged 6 months to 14 years in Italy.
- To analyze direct medical costs associated with influenza and influenza-like illnesses in vaccinated versus unvaccinated children.
Main Methods:
- Utilized the Pedianet database (2009-2019) to analyze influenza cases, costs, and healthcare utilization in children.
- Employed a static decision-tree model to compare vaccination strategies, calculating incremental cost-effectiveness ratios (ICERs).
- Incorporated quality-adjusted life years (QALYs) and conducted sensitivity analyses.
Main Results:
- Average ICER was EUR 29,831 per QALY when vaccine and virus strains matched, below the Italian National Health Services threshold.
- Influenza vaccination was cost-effective in most years, with averted costs averaging EUR 23 per case.
- Cost-effectiveness varied annually, notably being less favorable in 2009-2010 due to strain mismatch.
Conclusions:
- Influenza vaccination is economically viable for children, particularly when vaccine and circulating virus strains are aligned.
- Vaccination programs can effectively safeguard children's health and reduce overall healthcare expenditures.
- The findings support the implementation of influenza vaccination strategies in pediatric populations.
Abstract:
Background/Objectives: Seasonal influenza annually puts a significant burden on the pediatric population, especially the youngest, causing severe illness and death. Additionally, associated healthcare costs cause a significant financial strain on healthcare systems. While vaccination is the most effective prevention method, its cost-effectiveness for healthy children remains unassessed. Methods: Using the Pedianet database spanning from 2009 to 2019, we analyzed influenza cases among 6-month-olds to 14-year-olds in Italy. Data included influenza-related medical visits, prescriptions, exams, emergency visits, hospitalizations, and costs. Adverse events and quality-adjusted life years (QALYs) were considered from the existing literature. A static decision-tree model compared annual vaccination strategies, assessing probabilities for influenza or influenza-like illnesses by vaccination status. Incremental cost-effectiveness ratios (ICERs) were calculated, along with sensitivity analyses and cost-effectiveness acceptability curve generation. Results: Mean total influenza costs for vaccinated children averaged EUR 18.6 (range 0-3175.9, including EUR 15.79 for the influenza vaccination), whereas costs for unvaccinated children were consistently lower at around EUR 4.6 (range 0-3250.1). The average ICER for years where vaccine and virus strains are matched was EUR 29,831 per QALY, which is below the EUR 40,000 threshold set by the Italian National Health Services. The ICER values range from EUR 13,736 (2017/2018) to EUR 72,153 (2013/2014). Averted influenza costs averaged EUR 23 per case, with fluctuations over the years. In most observed years, influenza vaccination was cost-effective from the healthcare providers' standpoint. The exception was 2009-2010, due to a mismatch between vaccine and virus strains. Conclusions: This study highlights the economic viability of influenza vaccination, especially when virus and vaccine strains align. It demonstrates the potential of vaccination programs in preserving children's health and well-being while managing healthcare costs.
