Fitzner K A, Shortridge K F, McGhee S M, Hedley A J
Department of Community Medicine, The University of Hong Kong, 2/F, Patrick Manson Building, South Wing, 7 Sassoon Road, Pokfulam, SAR, Hong Kong, People's Republic of China.
Health Policy. 2001 Jun;56(3):215-34. doi: 10.1016/s0168-8510(00)00140-8.
Recent studies confirm that influenza vaccination confers health benefits and reduces direct and indirect costs associated with the illness. However, these studies did not examine the situation in southern China, a hypothetical influenza epicentre for the emergence of pandemic influenza viruses.
Surveillance data were collected in Hong Kong in 1993/94 and used economic model was used to estimate the medical and social costs associated with influenza-like illness (ILI) and to predict the cost-effectiveness of implementing an influenza prevention programme.
The estimated ILI incidence was 110/1000. It was highest in those between 1 and 25 years of age while the rate of hospitalization was highest in the elderly. Influenza occurred throughout the study period, which was a mild influenza year. The model predicted more than 660000 ILI cases in a non-epidemic year, in which influenza B virus predominated, with an average ILI-associated cost of HK$283/case (US$36) and vaccination-associated costs of HK$74 (US$9.50) per vaccinated individual.
The medical, social and monetary costs of ILI in Hong Kong were not observed to be large when compared with those in more developed countries where there is a clearly defined influenza season and recognized disease burden. From the perspective of a susceptible individual, the vaccine was cost-effective but from the perspective of society it was not, even with the most cost-effective strategy of targeting the elderly. However, if the vaccine were effective in controlling newly emerging and highly virulent strains, targeted vaccination programmes might be highly cost-effective.
近期研究证实，流感疫苗接种对健康有益，并能降低与该疾病相关的直接和间接成本。然而，这些研究未考察中国南方的情况，中国南方是大流行性流感病毒可能出现的假想中心。
收集了1993/94年香港的监测数据，并使用经济模型来估计与流感样疾病（ILI）相关的医疗和社会成本，并预测实施流感预防计划的成本效益。
估计的ILI发病率为110/1000。1至25岁人群的发病率最高，而老年人的住院率最高。在整个研究期间都有流感发生，这是一个流感轻度流行的年份。该模型预测，在非流行年份，乙型流感病毒占主导时，ILI病例超过66万例，ILI相关的平均成本为每例283港元（36美元），每位接种疫苗者的疫苗接种相关成本为74港元（9.50美元）。
与有明确流感季节和公认疾病负担的更发达国家相比，香港ILI的医疗、社会和货币成本并不高。从易感个体的角度来看，疫苗具有成本效益，但从社会角度来看则不然，即使采用针对老年人的最具成本效益的策略也是如此。然而，如果疫苗在控制新出现的高毒株方面有效，有针对性的疫苗接种计划可能具有很高的成本效益。
