Zhao Gen-ming, Chen Jian, Zhang Tao, Cai Hua, Wang Dan, Gu Bao-ke, Yu Miao, Chen Xin, Liu Jie, Yuan Zheng-an
Department of Epidemiology, School of Public Health, Fudan University; Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2011 Aug;45(8):737-41.
To evaluate the cost-benefit for the Influenza Type A H1N1 Virus (Influenzae H1N1) vaccination in Shanghai primary and junior schools.
A semi-experiment study was selected to evaluate the cost-benefit for Influenza H1N1 vaccination in primary and junior schools in 6 districts of Shanghai, including 414 636 students in total. According to the voluntary principle, the students were divided into the vaccinated group (233 445 students) and control group (181 191 students). The information of vaccine cost was collected from CDC in 19 districts in Shanghai by questionnaire; and the information of medical treatment cost was collected from questionnaire and abstracts of retrospective medical records, which included 31 mild cases and 15 severe cases. The cost-benefit analysis was conducted by health economic evaluation.
In total, there were 414 636 students enrolled in this study; while 233 445 (56.3%) students were in the vaccinated group and 181 191 in the control group. The attack rate in vaccinated group and control group was 0.61% (1433/233 445) and 1.76% (3166/181 191) respectively. The protection ratio was 65.34% ((1.76 - 0.61)/1.76) in the vaccinated group. The average cost of Influenza H1N1 was 36.81 yuan/person; and the average cost of medical treatment was (358.3 ± 243.6) yuan/mild case and (49 188.4 ± 99 917.3) yuan/severe case. The total benefit of vaccination in schools was 19 155 566.3 yuan, and the net benefit was 10 560 673.7 yuan. Therefore, the benefit-cost ratio was 2.24:1.
Influenza H1N1 vaccine could protect the students from Influenza H1N1 infection, and the cost-benefit analysis showed that the intervention strategy was worth trying.
评估上海市中小学甲型H1N1流感疫苗接种的成本效益。
采用半实验研究方法评估上海市6个区中小学甲型H1N1流感疫苗接种的成本效益，共纳入414636名学生。按照自愿原则，将学生分为接种组（233445名学生）和对照组（181191名学生）。通过问卷调查收集上海市19个区疾控中心的疫苗成本信息；通过问卷调查和回顾性病历摘要收集医疗费用信息，其中包括31例轻症病例和15例重症病例。采用卫生经济学评价方法进行成本效益分析。
本研究共纳入414636名学生；接种组233445名（56.3%），对照组181191名。接种组和对照组的发病率分别为0.61%（1433/233445）和1.76%（3166/181191）。接种组的保护率为65.34%（（1.76 - 0.61）/1.76）。甲型H1N1流感疫苗平均成本为36.81元/人；轻症病例平均医疗费用为（358.3 ± 243.6）元/例，重症病例平均医疗费用为（49188.4 ± 99917.3）元/例。学校接种疫苗的总效益为19155566.3元，净效益为10560673.7元。因此，效益成本比为2.24:1。
甲型H1N1流感疫苗可保护学生免受甲型H1N1流感感染，成本效益分析表明该干预策略值得一试。
