Impact of quadrivalent influenza vaccines in Brazil: a cost-effectiveness analysis using an influenza transmission model

Abstract

Background Influenza epidemics significantly weight on the Brazilian healthcare system and its society. Public health authorities have progressively expanded recommendations for vaccination against influenza, particularly to the pediatric population. However, the potential mismatch between the trivalent influenza vaccine (TIV) strains and those circulating during the season remains an issue. Quadrivalent vaccines improves vaccines effectiveness by preventing any potential mismatch on influenza B lineages. Methods We evaluate the public health and economic benefits of the switch from TIV to QIV for the pediatric influenza recommendation (6mo-5yo) by using a dynamic epidemiological model able to consider the indirect impact of vaccination. Results of the epidemiological model are then imputed in a health-economic model adapted to the Brazilian context. We perform deterministic and probabilistic sensitivity analysis to account for both epidemiological and economical sources of uncertainty.Results Our results show that switching from TIV to QIV in the Brazilian pediatric population would prevent 406.600 symptomatic cases, 11.300 hospitalizations and almost 400 deaths by influenza season. This strategy would save 3400 life-years yearly. Incremental cost-effectiveness ratios for the switch would be R$49.700 per life-year saved and R$26.800 per quality-adjusted life-year gained from a public payer perspective, and even more cost-effective from a societal perspective. Our results are qualitatively similar in our sensitivity analysis.Conclusions Our analysis shows that switching from TIV to QIV to protect children aged 6mo to 5yo in the Brazilian influenza epidemiological context could have a strong public health impact and represent a cost-effective strategy from a public payer perspective, and a highly cost-effective one from a societal perspective.

“Between the cross and the sword”: Brazilian children face an influenza epidemic while still dealing with the COVID-19 pandemic

“…Journal Pre-proof Braziliense, 2021). Estimates by the World Health Organization show that every year at least 650,000 people die from the direct and indirect effects of the influenza virus in the world (Crépey et al, 2020). In fact, a Brazilian study comparing lethality rates between the COVID-19 pandemic and the influenza epidemic in 2009, showed higher rates for influenza (4%) especially in children and adults with comorbidities (Cândido et al, 2020).…”