Maciosek Michael V, Solberg Leif I, Coffield Ashley B, Edwards Nichol M, Goodman Michael J
HealthPartners Research Foundation, Minneapolis, Minnesota, USA.
Am J Prev Med. 2006 Jul;31(1):72-9. doi: 10.1016/j.amepre.2006.03.008.
Influenza causes approximately 36,000 deaths per year in the United States despite the presence of an effective vaccine. This assessment of the value of influenza vaccination to the U.S. population is part of an update to the 2001 ranking of clinical preventive services recommended by the U.S. Preventive Services Task Force. The forthcoming ranking will include the new recommendation of the Advisory Committee on Immunization Practices to extend influenza vaccination to adults aged 50 to 64 years.
This service is evaluated on the two most important dimensions: burden of disease prevented and cost effectiveness. Study methods, described in a companion article, are designed to ensure consistency across many services.
Over the lifetime of a birth cohort of 4 million, it is estimated that about 275,000 quality-adjusted life years (QALYs) would be saved if influenza vaccination were offered annually to all people after age 50. Eighty percent of the QALYs saved (220,000) would be achieved by offering the vaccine only to persons aged 65 and older. In year 2000 dollars, the cost effectiveness of influenza vaccination is $980 per QALY saved in persons aged 65 and older, and $28,000 per QALY saved in persons aged 50 to 64. When the costs of patient time and travel are excluded, the cost effectiveness ratio of vaccinating 50- to 64-year-olds decreases to $7200 per QALY saved, and vaccinating those aged 65 and older saves $17 per person vaccinated.
Influenza vaccination is a high-impact, cost-effective service for persons aged 65 and older. Vaccinations are also cost effective for persons aged 50 to 64.
尽管有有效的疫苗，但在美国每年流感仍导致约36,000人死亡。对美国人群流感疫苗接种价值的评估是美国预防服务工作组2001年推荐的临床预防服务更新排名的一部分。即将发布的排名将包括免疫实践咨询委员会的新建议，即将流感疫苗接种扩展至50至64岁的成年人。
该服务从两个最重要的维度进行评估：预防的疾病负担和成本效益。在一篇配套文章中描述的研究方法旨在确保众多服务之间的一致性。
在一个400万出生队列的一生中，估计如果每年为50岁及以上的所有人提供流感疫苗接种，将挽救约275,000个质量调整生命年（QALY）。通过仅为65岁及以上的人提供疫苗，可实现所挽救QALY的80%（220,000个）。以2000年美元计算，65岁及以上人群流感疫苗接种的成本效益为每挽救一个QALY 980美元，50至64岁人群为每挽救一个QALY 28,000美元。如果排除患者的时间和交通成本，为50至64岁人群接种疫苗的成本效益比降至每挽救一个QALY 7200美元，为65岁及以上人群接种疫苗每人可节省17美元。
流感疫苗接种对65岁及以上人群是一项高影响力、具有成本效益的服务。对50至64岁人群接种疫苗也具有成本效益。
