Economic evaluations from middle income regions differed in population studied, outcomes and definitions used. Most findings are in line with evidence from high-income countries highlighting that influenza vaccine is likely to provide value for money. However, serious methodological limitations do not allow drawing conclusions on cost-effectiveness of influenza vaccination in middle income countries. Evidence on cost-effectiveness from low-income countries is lacking altogether, and more information is needed from full economic evaluations that are conducted in a standardized manner.
Women's appraisal of program efficacy and convenience, their disease-related knowledge and perceived Q fever risk seem to be crucial for their intended program uptake. A successful implementation of a Q fever screening and treatment program may thus depend on the benefits and downsides of the program, and on securing that women are aware of the risks of the disease.
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