Public Health and Economic Benefits of Influenza Vaccination of the Population Aged 50 to 59 Years without Risk Factors for Influenza Complications in Mexico: A Cross-Sectional Epidemiological Study

Abstract

The Mexican influenza vaccination program does not include a recommendation for people aged 50–59 years without risk factors for influenza complications, and there are limited data regarding the cost-effectiveness of vaccinating this population. To explore the clinical and economic effects of including this population in the vaccination schedule, we performed a cross-sectional epidemiological study using records (2009–2018) from Mexico’s Influenza Surveillance System (SISVEFLU), death records (2010–2015) from the National Mortality Epidemiological and Statistical System, and discharge and hospitalization records (2010–2015) from the Automated Hospital Discharge System databases. A 1-year decision-analytic model was used to assess cost-effectiveness through a decision-tree based on data from SISVEFLU. The primary outcome was influenza cases avoided; with associated influenza-related events as secondary outcomes. Including the population aged 50–59 years without risk factors in Mexico’s influenza immunization program would have resulted in 199,500 fewer cases; 67,008 fewer outpatient consultations; 33,024 fewer emergency room consultations; 33,091 fewer hospitalizations; 12 fewer deaths. These reductions equate to a substantial public health benefit as well as an economic benefit; yielding net savings of 49.8 million US dollars over a typical influenza season. Expansion of the current Mexican vaccination schedule to include these people would be a cost-saving and dominant strategy.

Influenza and morbidity and mortality risk in patients in Mexico with systemic arterial hypertension alone or with comorbidities: a retrospective, observational, cross-sectional study from 2014 to 2020

“…This has already been recognised by the Mexican health authorities, and even though the recommendation by the collegiate bodies on vaccination includes this group (in those >50 years old), 7 the immunisation policy has yet to include this age group. A similar result was recently reported in a cross-sectional epidemiological study, in which the case fatality and mortality rate in this age group (50-59 years) was similar to that of patients >60 years old, 24 equivalent to an estimated range of 0.3-2.9 million cases per year. The same study also reported that vaccination of this population is cost-effective; thus, implementing vaccination in this age group would be a necessary step.…”

“…[21][22][23] Notably, the absolute number of cases was higher in the group aged 30-50 years (working-age population) who become a source of contagion in their work environment; the negative economic impact that this can have has been previously reported. 24 Regarding comorbidities, obesity and diabetes were the second and third most prevalent comorbidities in this study, after SAH. While a link between risk factors such as obesity, hypertension, diabetes and black/Hispanic ethnicity and the severity of influenza infection has been previously reported, 25 26 the presence of obesity has been suggested to be a possible confounding factor for these associations.…”

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“…1,2 Influenza is considered a self-limiting disease, and most adults present with uncomplicated influenza, a mildto-moderate, self-limited illness with symptoms including high fever, chills, myalgias, and malaise. 3 Still, it can cause serious complications (3-5 million people each year) like pneumonia, myositis, myocarditis, and central nervous system diseases. About 500,000 individuals die from influenza each year worldwide.…”

“…About 500,000 individuals die from influenza each year worldwide. 3 Influenza viruses can cause serious health issues in certain populations, such as pregnant women, the elderly, and infants. 4 Influenza infection is seasonal in temperate countries, with peaks during the winter months, but has sustained activity throughout the year in tropical climates.…”

Low Levels of Influenza Vaccine Uptake among the Diabetic Population in Spain: A Time Trend Study from 2011 to 2020

“…Influenza is a respiratory disease with a high impact on public health and the economy in terms of health system costs and its effect on the workforce [ 1 ]. A number of studies have demonstrated how influenza vaccination decreases absenteeism in the workplace, hospitalizations and mortality [ 2 , 3 ]. The World Health Organization (WHO) has implemented the Global Influenza Program for the development of vaccines and flu pandemic guidelines [ 4 ].…”