Reply to: Estimating the Full Value of High‐Dose Influenza Vaccine

Raviotta, Jonathan M.; DePasse, Jay V.; Brown, Shawn T.; Shim, Eunha; Nowalk, Mary Patricia; Zimmerman, Richard K.

doi:10.1111/jgs.14976

Cited by 1 publication

(1 citation statement)

References 7 publications

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“…High dose vaccine is considerably more expensive than the standard dose vaccine but has been shown elsewhere to be economically reasonable compared with the standard dose vaccine in older adults. 17,18 Moreover, this analysis did not consider other costs that could occur with compressed vaccination: costs of implementing, publicizing, and maintaining this policy change; and potential costs to patients and practices to ensure that vaccination occurs if early vaccination is not available. If compressed vaccination is contemplated, further research on the cost aspects of this policy will be necessary.…”

Section: Limitationsmentioning

confidence: 99%

Compressed Influenza Vaccination in U.S. Older Adults: A Decision Analysis

Nowalk

Raviotta

DePasse

et al. 2019

American Journal of Preventive Medicine

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Introduction: Tradeoffs exist between efforts to increase influenza vaccine uptake, including early season vaccination, and potential decreased vaccine effectiveness if protection wanes during influenza season. U.S. older adults increasingly receive vaccination before October. Influenza illness peaks vary from December to April.Methods: A Markov model compared influenza likelihood in older adults with: (1) status quo vaccination (August-May) to maximize vaccine uptake, or (2) vaccination compressed to October-May (to decrease waning vaccine effectiveness impact). The Centers for Disease Control and Prevention data were used for influenza incidence and vaccination parameters. Prior analyses showed absolute vaccine effectiveness decreased by 6%-11% per month, favoring later season vaccination. However, compressed vaccination could decrease overall vaccine uptake. Influenza incidence was based on average monthly incidence with earlier and later peaks also examined. Influenza strain distributions from two seasons were modeled in separate scenarios. Sensitivity analyses were performed to test result robustness. Data were collected and analyzed in 2018.Results: Compressed vaccination would avert ≥11,400 influenza cases in older adults during a typical season if it does not decrease vaccine uptake. However, if compressed vaccination decreases vaccine uptake or there is an early season influenza peak, more influenza can result. In probabilistic sensitivity analyses, compressed vaccination was never favored if it decreased absolute vaccine uptake by >5.5% in any scenario; when influenza peaked early, status quo vaccination was favored.

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Section: Limitationsmentioning

confidence: 99%