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降低季节性呼吸道感染的医院容量需求:以荷兰老年人改用高剂量流感疫苗为例。

Reducing Hospital Capacity Needs for Seasonal Respiratory Infections: The Case of Switching to High-Dose Influenza Vaccine for Dutch Older Adults.

作者信息

Zeevat Florian, Wilschut Jan C, Boersma Cornelis, Postma Maarten J

机构信息

Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.

Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, The Netherlands.

出版信息

Value Health. 2023 Apr;26(4):461-464. doi: 10.1016/j.jval.2022.11.020. Epub 2022 Dec 9.

Abstract

OBJECTIVES

Influenza is responsible for considerable health and economic burden every year. Especially older adults are vulnerable for influenza infection and its complications due to immunosenescence and often-underlying medical conditions. Recently, the innovative quadrivalent high-dose influenza vaccine (QIV-HD) has become available in Europe. Through its enhanced immunogenicity, QIV-HD offers improved protection for older adults against respiratory as well as cardiovascular complications. We estimated the potential impact-specifically in terms of hospital admissions and related costs-of a hypothetical past switch from QIV-Standard dose (SD) to QIV-HD in The Netherlands.

METHODS

Estimates of hospitalizations for the older adults vaccinated with QIV-SD were derived from the seasons 2010/2011-2017/2018. Subsequently, the number of respiratory infections and cardiovascular complications of influenza were estimated for the year 2019/2020 for both QIV-SD and QIV-HD. To calculate the overall corresponding savings, costs for hospital complications, derived from literature, were used.

RESULTS

When QIV-HD would have been used instead of QIV-SD during the season 2019/2020, an additional 220 hospitalizations would have been averted among older adults of 60 years and older in the Netherlands. This corresponds to savings of €1 219 779 (uncertainty interval: 1 089 813-1 348 549), of which 69% is attributable to cardiovascular-related hospitalizations.

CONCLUSIONS

We demonstrate that a relevant improvement in influenza vaccination among older adults in The Netherlands can be achieved by switching from the current QIV-SD to QIV-HD. Not only comes a switch from QIV-SD to QIV-HD with a significant reduction in pressure on hospital capacity but also with notable cost savings.

摘要

目的

流感每年都会造成相当大的健康和经济负担。特别是老年人,由于免疫衰老和常见的基础疾病,易受流感感染及其并发症影响。最近,创新的四价高剂量流感疫苗(QIV-HD)已在欧洲上市。通过增强免疫原性,QIV-HD为老年人提供了更好的保护,预防呼吸道和心血管并发症。我们估计了荷兰过去假设从标准剂量四价流感疫苗(QIV-SD)转换为QIV-HD在住院和相关费用方面的潜在影响。

方法

接种QIV-SD的老年人住院率估计来自2010/2011 - 2017/2018季节。随后,估计了2019/2020年QIV-SD和QIV-HD的流感呼吸道感染和心血管并发症数量。为了计算总体相应节省费用,使用了文献中得出的医院并发症费用。

结果

如果在2019/2020季节使用QIV-HD而非QIV-SD,荷兰60岁及以上老年人中将避免额外220例住院。这相当于节省1219779欧元(不确定区间:10898,13 - 1348549),其中69%归因于心血管相关住院。

结论

我们证明,在荷兰,通过从当前的QIV-SD转换为QIV-HD,可以在老年人流感疫苗接种方面实现显著改善。从QIV-SD转换为QIV-HD不仅能显著减轻医院容量压力,还能节省可观成本。

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