Health and Economic Benefits of Early Vaccination

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    Original Research | 20 May 2014
Health and Economic Benefits of Early Vaccination and Nonpharmaceutical Interventions for a Human Influenza A (H7N9) Pandemic: A Modeling Study
Nayer Khazeni, MD, MS; David W. Hutton, MS, PhD; Cassandra I.F. Collins, MPH; Alan M. Garber, MD, PhD; and Douglas K. Owens, MD, MS 

Background: Vaccination for the 2009 pandemic did not occur until late in the outbreak, which limited its benefits. Influenza A (H7N9) is causing increasing morbidity and mortality in China, and researchers have modified the A (H5N1) virus to transmit via aerosol, which again heightens concerns about pandemic influenza preparedness.

Objective: To determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a pandemic with characteristics similar to influenza A (H7N9) and A (H5N1).

Design: Dynamic transmission model to estimate health and economic consequences of a severe influenza pandemic in a large metropolitan city.

Data Sources: Literature and expert opinion.

Target Population: Residents of a U.S. metropolitan city with characteristics similar to New York City.

Time Horizon: Lifetime.

Perspective: Societal.

Intervention: Vaccination of 30% of the population at 4 or 6 months.

Outcome Measures: Infections and deaths averted and cost-effectiveness.

Results of Base-Case Analysis: In 12 months, 48 254 persons would die. Vaccinating at 9 months would avert 2365 of these deaths. Vaccinating at 6 months would save 5775 additional lives and $51 million at a city level. Accelerating delivery to 4 months would save an additional 5633 lives and $50 million.

Results of Sensitivity Analysis: If vaccination were delayed for 9 months, reducing contacts by 8% through nonpharmaceutical interventions would yield a similar reduction in infections and deaths as vaccination at 4 months.

Limitation: The model is not designed to evaluate programs targeting specific populations, such as children or persons with comorbid conditions.

Conclusion: Vaccination in an influenza A (H7N9) pandemic would need to be completed much faster than in 2009 to substantially reduce morbidity, mortality, and health care costs. Maximizing non-pharmaceutical interventions can substantially mitigate the pandemic until a matched vaccine becomes available.

Primary Funding Source: Agency for Healthcare Research and Quality, National Institutes of Health, and Department of Veterans Affairs

http://annals.org/article.aspx?articleID=1872847

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arirish Members Profile Send Private Message Find Members Posts Add to Buddy List Admin Group Joined: June 19 2013 Location: Arkansas Status: Offline Points: 39215	Post Options Post Reply Quote arirish Report Post Thanks(0) Quote Reply Topic: Health and Economic Benefits of Early Vaccination Posted: May 25 2014 at 8:04pm
	Original Research \| 20 May 2014 Health and Economic Benefits of Early Vaccination and Nonpharmaceutical Interventions for a Human Influenza A (H7N9) Pandemic: A Modeling Study Nayer Khazeni, MD, MS; David W. Hutton, MS, PhD; Cassandra I.F. Collins, MPH; Alan M. Garber, MD, PhD; and Douglas K. Owens, MD, MS Background: Vaccination for the 2009 pandemic did not occur until late in the outbreak, which limited its benefits. Influenza A (H7N9) is causing increasing morbidity and mortality in China, and researchers have modified the A (H5N1) virus to transmit via aerosol, which again heightens concerns about pandemic influenza preparedness. Objective: To determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a pandemic with characteristics similar to influenza A (H7N9) and A (H5N1). Design: Dynamic transmission model to estimate health and economic consequences of a severe influenza pandemic in a large metropolitan city. Data Sources: Literature and expert opinion. Target Population: Residents of a U.S. metropolitan city with characteristics similar to New York City. Time Horizon: Lifetime. Perspective: Societal. Intervention: Vaccination of 30% of the population at 4 or 6 months. Outcome Measures: Infections and deaths averted and cost-effectiveness. Results of Base-Case Analysis: In 12 months, 48 254 persons would die. Vaccinating at 9 months would avert 2365 of these deaths. Vaccinating at 6 months would save 5775 additional lives and $51 million at a city level. Accelerating delivery to 4 months would save an additional 5633 lives and $50 million. Results of Sensitivity Analysis: If vaccination were delayed for 9 months, reducing contacts by 8% through nonpharmaceutical interventions would yield a similar reduction in infections and deaths as vaccination at 4 months. Limitation: The model is not designed to evaluate programs targeting specific populations, such as children or persons with comorbid conditions. Conclusion: Vaccination in an influenza A (H7N9) pandemic would need to be completed much faster than in 2009 to substantially reduce morbidity, mortality, and health care costs. Maximizing non-pharmaceutical interventions can substantially mitigate the pandemic until a matched vaccine becomes available. Primary Funding Source: Agency for Healthcare Research and Quality, National Institutes of Health, and Department of Veterans Affairs http://annals.org/article.aspx?articleID=1872847
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