Abstract
We assessed the cost-effectiveness of vaccinating pregnant women against seasonal influenza in England and Wales, taking into account the timing of vaccination relative to both the influenza season and trimester of pregnancy. Women were assumed to be vaccinated in their second or third trimester. Vaccination between September and December was found to have an incremental cost-effectiveness ratio of £23,000 per quality adjusted life year (QALY) (95% CI £10,000-£140,000) if it is assumed that infants are partially protected through their mothers, and of £28,000 per QALY gained (95% CI £13,000-£200,000) if infants are not protected. If some vaccine protection lasts for a second season, then the ratio is only £15,000 per QALY gained (95% CI £6,000-£93,000). Most of the benefit of vaccination is in preventing symptomatic episodes, regardless of health care resource use. Extending vaccination beyond December is unlikely to be cost-effective unless there is good protection into a second influenza season. Key sources of uncertainty are the cost of vaccine delivery and the quality of life detriment due to a clinically apparent episode of confirmed influenza. The cost of vaccine purchase itself is relatively low.
Original language | English |
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Pages (from-to) | 115-122 |
Number of pages | 8 |
Journal | Vaccine |
Volume | 29 |
Issue number | 1 |
DOIs | |
Publication status | Published - 10 Dec 2010 |
Bibliographical note
Funding Information:We thank Pauline Kaye, Colin Campbell, Jonathan van Tam and Ahmed Hashim for supplying information from data sources on the risk of intensive care admission in patients hospitalised for influenza during the 2009 H1N1v pandemic. In particular, Pauline Kaye supplied data from the Regional Microbiology Network Laboratories, Colin Campbell supplied data from the Chief Medical Officer's hospitalisation dataset, while Jonathan van Tam and Ahmed Hashim supplied data from FLU-CIN. We thank Doris Otomewo for extracting data from LabBase2. We also thank John Edmunds for helpful discussions, and Douglas Fleming for information on GP consultations. DC, MB and JS were funded by the Policy Research Programme in the Department of Health, England (grant number 039/0031 ). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.
Keywords
- Cost-effectiveness
- Influenza
- Vaccination