Cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women.

OBJECTIVE

To evaluate the cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women using data from three recent influenza seasons in the United States.

DESIGN, SETTING, AND PARTICIPANTS: We developed a decision-analytic model following a cohort of 5.2 million pregnant women and their infants aged <6 months to evaluate the cost-effectiveness of vaccinating women against seasonal influenza during pregnancy from a societal perspective. The main outcome measures were quality-adjusted life-year (QALY) gained and cost-effectiveness ratios. Data sources included surveillance data, epidemiological studies, and published vaccine cost data. Sensitivity analyses were also performed. All costs and outcomes were discounted at 3% annually.

MAIN OUTCOME MEASURES

Total costs (direct and indirect), effects (QALY gains, averted case numbers), and incremental cost-effectiveness of seasonal inactivated influenza vaccination among pregnant women (cost per QALY gained).

RESULTS

Using a recent benchmark of 52.2% vaccination coverage among pregnant women, we studied a hypothetical cohort of 2,753,015 vaccinated pregnant women. With an estimated vaccine effectiveness of 73% among pregnant women and 63% among infants <6 months, QALY gains for each season were 305 (2010-2011), 123 (2011-2012), and 610 (2012-2013). Compared with no vaccination, seasonal influenza vaccination during pregnancy was cost-saving when using data from the 2010-2011 and 2012-2013 influenza seasons. The cost-effectiveness ratio was greater than $100,000/QALY with the 2011-2012 influenza season data, when CDC reported a low attack rate compared to other recent seasons.

CONCLUSIONS

Influenza vaccination for pregnant women can reduce morbidity from influenza in both pregnant women and their infants aged <6 months. Seasonal influenza vaccination during pregnancy is cost-saving during moderate to severe influenza seasons.