Ph.D. Program in Health Policy, Harvard University, Cambridge, Massachusetts, United States of America.
PLoS One. 2011;6(12):e27777. doi: 10.1371/journal.pone.0027777. Epub 2011 Dec 19.
To evaluate community-based values for avoiding pandemic influenza (A) H1N1 (pH1N1) illness and vaccination-related adverse events in adults and children.
Adult community members were randomly selected from a nationally representative research panel to complete an internet survey (response rate = 65%; n = 718). Respondents answered a series of time trade-off questions to value four hypothetical health state scenarios for varying ages (1, 8, 35, or 70 years): uncomplicated pH1N1 illness, pH1N1 illness-related hospitalization, severe allergic reaction to the pH1N1 vaccine, and Guillain-Barré syndrome. We calculated descriptive statistics for time trade-off amounts and derived quality adjusted life year losses for these events. Multivariate regression analyses evaluated the effect of scenario age, as well as respondent socio-demographic and health characteristics on time trade-off amounts.
Respondents were willing to trade more time to avoid the more severe outcomes, hospitalization and Guillain-Barré syndrome. In our adjusted and unadjusted analyses, age of the patient in the scenario was significantly associated with time trade-off amounts (p-value<0.05), with respondents willing to trade more time to prevent outcomes in children versus adults. Persons who had received the pH1N1 vaccination were willing to trade significantly more time to avoid hospitalization, severe allergic reaction, and Guillain-Barré syndrome, controlling for other variables in adjusted analyses.(p-value<0.05)
Community members placed the highest value on preventing outcomes in children, compared with adults, and the time trade-off values reported were consistent with the severity of the outcomes presented. Considering these public values along with other decision-making factors may help policy makers improve the allocation of pandemic vaccine resources.
评估社区对避免大流行性流感(A)H1N1(pH1N1)疾病和成人及儿童与疫苗接种相关的不良事件的价值观念。
从全国代表性的研究小组中随机选择成年社区成员完成一项互联网调查(应答率为 65%;n=718)。受访者回答了一系列时间权衡问题,以评估四个不同年龄(1、8、35 或 70 岁)的假设健康状况场景:单纯 pH1N1 疾病、pH1N1 疾病相关住院、对 pH1N1 疫苗的严重过敏反应和格林-巴利综合征。我们计算了时间权衡量的描述性统计数据,并为这些事件推导了质量调整生命年损失。多元回归分析评估了情景年龄以及受访者社会人口统计学和健康特征对时间权衡量的影响。
受访者愿意用更多的时间来避免更严重的后果,即住院和格林-巴利综合征。在我们的调整和未调整分析中,情景中患者的年龄与时间权衡量显著相关(p 值<0.05),受访者愿意用更多的时间来预防儿童的结果,而不是成人。接种了 pH1N1 疫苗的人愿意用更多的时间来避免住院、严重过敏反应和格林-巴利综合征,这在调整分析中控制了其他变量(p 值<0.05)。
与成年人相比,社区成员更重视预防儿童的结果,并且报告的时间权衡值与所呈现结果的严重程度一致。考虑到这些公众价值观念以及其他决策因素,可能有助于政策制定者改善大流行性疫苗资源的分配。