Does cost-effectiveness of influenza vaccine choice vary across the US? An agent-based modeling study
Authored by Shawn T Brown, Richard K Zimmerman, Kenneth J Smith, Jonathan M Raviotta, Jay V DePasse, Eunha Shim, Mary Patricia Nowalk
Date Published: 2017
DOI: 10.1016/j.vaccine.2017.05.093
Sponsors:
United States National Institutes of Health (NIH)
Platforms:
Framework for Reconstructing Epidemiological Dynamics (FRED)
Model Documentation:
Other Narrative
Model Code URLs:
Model code not found
Abstract
Background: In a prior agent-based modeling study, offering a choice of
influenza vaccine type was shown to be cost-effective when the simulated
population represented the large, Washington DC metropolitan area. This
study calculated the public health impact and cost-effectiveness of the
same four strategies: No Choice, Pediatric Choice, Adult Choice, or
Choice for Both Age Groups in five United States (U.S.) counties
selected to represent extremes in population age distribution.
Methods: The choice offered was either inactivated influenza vaccine
delivered intramuscularly with a needle (IIV-IM) or an age-appropriate
needle-sparing vaccine, specifically, the nasal spray (LAIV) or
intradermal (IIV-ID) delivery system. Using agent-based modeling,
individuals were simulated as they interacted with others, and influenza
was tracked as it spread through each population. Influenza vaccination
coverage derived from Centers for Disease Control and Prevention (CDC)
data, was increased by 6.5\% (range 3.25\%-11.25\%) to reflect the
effects of vaccine choice.
Results: Assuming moderate influenza infectivity, the number of averted
cases was highest for the Choice for Both Age Groups in all five
counties despite differing demographic profiles. In a cost-effectiveness
analysis, Choice for Both Age Groups was the dominant strategy.
Sensitivity analyses varying influenza infectivity, costs, and degrees
of vaccine coverage increase due to choice, supported the base case
findings.
Conclusion: Offering a choice to receive a needle-sparing influenza
vaccine has the potential to significantly reduce influenza disease
burden and to be cost saving. Consistent findings across diverse
populations confirmed these findings. (C) 2017 Elsevier Ltd. All rights
reserved.
Tags
Simulation
Agent-based modeling
cost-effectiveness
preferences
Influenza
acceptability
immunization
Pandemic influenza
Strategies
Seasonal influenza
United-states
Influenza vaccine
Vaccine choice
Disease burden
Acceptance