Health Economics and Outcomes Research, Moderna, Inc, Cambridge, MA, USA.
Real-World Evidence Analytics, Moderna, Inc, Cambridge, MA, USA.
J Med Econ. 2024 Jan-Dec;27(1):1190-1196. doi: 10.1080/13696998.2024.2400852. Epub 2024 Sep 20.
To compare healthcare resource utilization (HCRU) and all-cause medical costs among individuals aged ≥50 years who received influenza and COVID-19 vaccines on the same day and those who received influenza vaccine only.
We conducted a retrospective cohort study leveraging Optum's de-identified Clinformatics DataMart from 8/31/2021 to 7/31/2023. Individuals aged ≥50 years continuously enrolled in health plans for 1 year prior and until 7/31/2023 were included. Two cohorts were formed based on vaccination status between 8/31/2022 and 1/31/2023: co-administered influenza and COVID-19 vaccines (co-admin cohort) and influenza vaccine only (influenza cohort). Associations between vaccination status and all-cause, influenza-related, COVID-related, pneumonia-related, and cardiorespiratory-related hospitalization, outpatient or emergency room visits and all-cause medical costs were estimated by weighted generalized linear models, adjusting for confounding by stabilized inverse probability of treatment weighting.
613,156 (mean age: 71) and 1,340,011 (mean age: 72) individuals were included in the co-admin and influenza cohorts, respectively. After weighting, the baseline characteristics were balanced between cohorts. The co-admin cohort was at statistically significant lower risk of all-cause (RR: 0.95, 95% CI: 0.93-0.96), COVID-19-related (RR: 0.59, 95% CI: 0.56-0.63), cardiorespiratory-related (RR: 0.94, 95% CI: 0.93-0.96) and pneumonia-related (RR: 0.86, 95% CI: 0.83-0.90) hospitalization but not influenza-related hospitalizations (RR: 0.91, 95% CI: 0.81, 1.04) compared with the influenza cohort. Co-administration was associated with 3% lower all-cause medical cost (cost ratio: 0.974, 95% CI: 0.968, 0.979) during the follow-up period compared to receiving influenza vaccine only.
Limitations include the potential residual confounding bias in observational data, measurement errors from claims data, and that the cohort was followed for a single season.
Receiving co-administered COVID-19 and influenza vaccines versus only receiving influenza vaccination reduced the risk of HCRU, especially COVID-19-related hospitalization and all-cause medical costs. Increasing vaccine coverage, particularly for COVID-19, might have public health and economic benefits.
比较在同一天接种流感和 COVID-19 疫苗的≥50 岁人群与仅接种流感疫苗的人群的医疗资源利用（HCRU）和全因医疗费用。
我们利用 Optum 的匿名 Clinformatics DataMart 进行了一项回顾性队列研究，时间范围为 2021 年 8 月 31 日至 2023 年 7 月 31 日。纳入≥50 岁、在研究前 1 年及直至 2023 年 7 月 31 日持续参加健康计划的个体。根据 2022 年 8 月 31 日至 1 月 31 日之间的疫苗接种状态，将个体分为两组：同时接种流感和 COVID-19 疫苗（联合接种组）和仅接种流感疫苗（流感组）。通过加权广义线性模型估计疫苗接种状态与全因、流感相关、COVID-19 相关、肺炎相关和心肺相关住院、门诊或急诊就诊次数和全因医疗费用之间的关联，调整了稳定的逆概率治疗加权处理后的混杂因素。
纳入 613156 名（平均年龄：71 岁）和 1340011 名（平均年龄：72 岁）个体分别进入联合接种组和流感组。加权后，两组之间的基线特征均衡。与流感组相比，联合接种组的全因（RR：0.95，95%CI：0.93-0.96）、COVID-19 相关（RR：0.59，95%CI：0.56-0.63）、心肺相关（RR：0.94，95%CI：0.93-0.96）和肺炎相关（RR：0.86，95%CI：0.83-0.90）住院风险显著降低，但流感相关住院风险无统计学差异（RR：0.91，95%CI：0.81，1.04）。与仅接种流感疫苗相比，联合接种与全因医疗费用降低 3%（成本比：0.974，95%CI：0.968，0.979）。
观察性数据中存在潜在的残余混杂偏倚、索赔数据中的测量误差以及队列仅随访了一个季节等局限性。
与仅接种流感疫苗相比，同时接种 COVID-19 和流感疫苗可降低 HCRU 风险，特别是 COVID-19 相关住院风险和全因医疗费用。增加疫苗接种覆盖率，特别是 COVID-19 疫苗接种率，可能具有公共卫生和经济效益。
