Salo Heini, Kilpi Terhi, Sintonen Harri, Linna Miika, Peltola Ville, Heikkinen Terho
Department of Vaccines, National Public Health Institute, KTL, 00300 Helsinki, Finland.
Vaccine. 2006 Jun 5;24(23):4934-41. doi: 10.1016/j.vaccine.2006.03.057. Epub 2006 Apr 7.
Influenza vaccination of children 6-23 months of age is recommended in the United States and Canada because of high rates of influenza-associated hospitalisations, but few other countries have adopted similar policies. Most children with influenza are treated in the primary care setting, and the cost-effectiveness of influenza vaccination of children has not been fully established. We used a decision analysis model to assess the cost-effectiveness of influenza vaccination of children 6 months to 13 years of age in Finland. The analyses were based on comprehensive clinical data on virologically confirmed influenza infections, hospital medical records, and national registers. We estimated the impact of influenza on outpatient and hospitalised children and their families, and performed the analyses from the health care provider and societal perspective. Influenza vaccination resulted in savings in all programs including children <or=13 years of age from both the health care provider and societal perspective. Investing 1.7 million euros in vaccination of children <5 years of age yielded savings of 2.7 million euros in health care costs. From the health care provider perspective, the savings per vaccinated child ranged between 5.7 and 12.6 euros in any program including children up to 13 years of age. The vaccination was cost saving in all age groups even with assumed vaccine efficacy of 60%. The results show that influenza vaccination would be cost saving in all children <or=13 years of age in Finland, which advocates reconsideration of the current influenza vaccine recommendations in all countries.
在美国和加拿大,由于与流感相关的住院率很高,因此建议对6至23个月大的儿童进行流感疫苗接种,但其他国家很少采用类似政策。大多数患流感的儿童在初级保健机构接受治疗,儿童流感疫苗接种的成本效益尚未完全确定。我们使用决策分析模型评估了芬兰6个月至13岁儿童流感疫苗接种的成本效益。分析基于病毒学确诊的流感感染的综合临床数据、医院病历和国家登记册。我们估计了流感对门诊和住院儿童及其家庭的影响,并从医疗保健提供者和社会角度进行了分析。从医疗保健提供者和社会角度来看,流感疫苗接种在所有项目中都节省了成本,包括13岁及以下的儿童。投资170万欧元为5岁以下儿童接种疫苗,节省了270万欧元的医疗保健成本。从医疗保健提供者的角度来看,在任何包括13岁以下儿童的项目中,每个接种疫苗的儿童节省的费用在5.7欧元至12.6欧元之间。即使假设疫苗效力为60%,接种疫苗在所有年龄组中都节省了成本。结果表明,在芬兰,对13岁及以下的所有儿童接种流感疫苗都将节省成本,这主张所有国家重新考虑当前的流感疫苗建议。