Influenza in the school-aged population in Mexico: burden of disease and cost-effectiveness of vaccination in children

Abstract

Background: The current national influenza vaccination schedule in Mexico does not recommend vaccination in the school-aged population (5-11 years). Currently, there are limited data from middle-income countries analysing the cost-effectiveness of influenza vaccination in this population. We explored the clinical effects and economic benefits of expanding the current national influenza vaccination schedule in Mexico to include the school-aged population.Methods: A static 1-year model incorporating herd effect was used to assess the cost-effectiveness of expanding the current national influenza vaccination schedule of Mexico to include the school-aged population. We performed a cross-sectional epidemiological study using influenza records (

A Call for a Reform of the Influenza Immunization Program in Mexico: Epidemiologic and Economic Evidence for Decision Making

“…In this paper, we generate a series of public policy recommendations on the basis of epidemiological and economic analysis of expanding vaccination coverage for influenza in Mexico, whose methodologies can be found in previous publications [ 21 , 22 ]. We conducted a two-phase study.…”

“…The characterization of the economic analysis was thoroughly described previously [ 21 ]. To assess the cost effectiveness of expanding the influenza vaccination schedule, a decision-tree analytical model was developed [ 30 ].…”

“…Influenza cases were estimated based on the incidence published by the United States CDC [ 28 ], which was applied to the Mexican population structure [ 26 ] for each group of interest: (1) school-aged population (5 to 11 years old) [ 21 ], (2) population aged 12 to 49 years with risk factors, and considering the six most frequent conditions and/or the influenza-related conditions with the highest impact on the health of the Mexican population: diabetes mellitus, uncontrolled hypertension, CRF, morbid obesity, pregnancy and asthma [ 31 , 32 , 33 ], and (3) population aged 50 to 59 years without risk factors [ 22 ]. Each at-risk population group was studied separately without considering the possibility of comorbidities.…”

“…Estimated cases were allocated into the different scenarios, applying the probability of occurrence for each scenario to distribute the cases and to estimate the direct (laboratory diagnosis, medical consultations, drugs, days of hospitalization) and indirect costs (days of medical disability leave, years of life lost) [ 21 ] according to the data recorded in SISVEFLU regarding the treatment provided and the guidelines set forth in the Clinical Practice Guideline [ 34 ] ( Table 3 ).…”

“…We analyzed an expansion strategy for three populations: expanding universal vaccination coverage to all school-aged children (5 to 11 years), increasing vaccination coverage to 75% in people aged 12 to 49 years with risk factors (diabetes mellitus, uncontrolled hypertension, morbid obesity (body mass index ≥40 kg/m 2 ), chronic renal failure (CRF), asthma, pregnancy), and expanding universal vaccination coverage to all adults aged 50 to 59 years. Our analysis is based on the findings of two previous cost-effectiveness studies conducted by the authors of the present manuscript; one of which has been published and the other is in press [ 21 , 22 ].…”