Exploring the role of mass immunisation in influenza pandemic preparedness: A modelling study for the UK context

Luca Grieco*, Jasmina Panovska-Griffiths, Edwin van Leeuwen, Peter Grove, Martin Utley

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

The nature and timing of the next influenza pandemic is unknown. This makes it difficult for policy makers to assess whether spending money now to prepare for mass immunisation in the event of a pandemic is worthwhile. We used simple epidemiological modelling and health economic analysis to identify the range of pandemic and policy scenarios under which plans to immunise the general UK population would have net benefit if a stockpiled vaccine or, alternatively, a responsively purchased vaccine were used. Each scenario we studied comprised a combination of pandemic, vaccine and immunisation programme characteristics in presence or absence of access to effective antivirals, with the chance of there being a pandemic each year fixed. Monetarised health benefits and cost savings from any influenza cases averted were set against the option, purchase, storage, distribution, administration, and disposal costs relevant for each scenario to give a discounted net present value over 10 years for planning to immunise, accounting for the possibility that there may be no pandemic over the period considered. To support understanding and exploration of model output, an interactive visualisation tool was devised and made available online. We evaluated over 29 million combinations of pandemic and policy characteristics. Preparedness plans incorporating mass immunisation show positive net present value for a wide range of scenarios, predominantly in the absence of effective antivirals. Plans based on the responsive purchase of vaccine have wider benefit than plans reliant on the purchase and maintenance of a stockpile if immunisation can start without extensive delays. This finding is not dependent on responsively purchased vaccine being more effective than stockpiled vaccine, but rather is driven by avoiding the costs of storing and replenishing a stockpile.

Original languageEnglish
Pages (from-to)5163-5170
Number of pages8
JournalVaccine
Volume38
Issue number33
DOIs
Publication statusPublished - 14 Jul 2020

Bibliographical note

Funding Information:
This paper is based on independent research commissioned and funded by the National Institute of Health Research ( NIHR ) Policy Research Programme (Responsive Operational Research facility to support Health Protection Policy, grant number 027/0085 ). The views expressed in the publication are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care, 'arms' length bodies or other government departments. MU was supported in part by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart's Health NHS Trust. JPG was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care North Thames at Bart’s Health NHS Trust (CLAHRC North Thames). EvL was funded by the NIHR Health Protection Research Units (HPRU) in Respiratory infections. The funder of this study (NIHR) had no role in the study design, data collection, data analysis, data interpretation, writing of the report, or decision to submit for publication.

Funding Information:
This paper is based on independent research commissioned and funded by the National Institute of Health Research (NIHR) Policy Research Programme (Responsive Operational Research facility to support Health Protection Policy, grant number 027/0085). The views expressed in the publication are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care, 'arms' length bodies or other government departments. MU was supported in part by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North Thames at Bart's Health NHS Trust. JPG was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care North Thames at Bart's Health NHS Trust (CLAHRC North Thames). EvL was funded by the NIHR Health Protection Research Units (HPRU) in Respiratory infections. The funder of this study (NIHR) had no role in the study design, data collection, data analysis, data interpretation, writing of the report, or decision to submit for publication.

Publisher Copyright:
© 2020 The Authors

Keywords

  • Epidemiological modelling
  • Health economic analysis
  • Influenza pandemic
  • Mass immunisation
  • Preparedness policy

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