ArticlePLoS medicine2010
Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.
Article in PLoS medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Increasing Coverage of Appropriate Vaccinations: A Community Guide Systematic Economic Review.American journal of preventive medicine · 2016Pooled it
- Economic evaluation of vaccines in Canada: A systematic review.Human vaccines & immunotherapeutics · 2016Pooled it
- Microneedle patches: usability and acceptability for self-vaccination against influenza.Vaccine · 2014Trial
- Cost-Utility Analysis of COVID-19 Vaccination Strategies for Endemic SARS-CoV-2.JAMA network open · 2025Article
- Cost-effectiveness of respiratory syncytial virus vaccination strategies for older Canadian adults: A multi-model comparison.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2025Article
- SARS-CoV-2, Tdap, and influenza vaccination during pregnancy from 2019 to 2022 in Ontario, Canada: a population-based retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Respiratory syncytial virus vaccination strategies for older Canadian adults: a cost-utility analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Switching from trivalent to quadrivalent inactivated influenza vaccines in Uruguay: a cost-effectiveness analysis.Human vaccines & immunotherapeutics · 2022Article
- A decision analytic approach for social distancing policies during early stages of COVID-19 pandemic.Decision support systems · 2022Article
- Modelling the population effectiveness of the national seasonal influenza vaccination programme in Scotland: The impact of targeting all individuals aged 65 years and over.Influenza and other respiratory viruses · 2019Article
- [The universal influenza vaccination in children with Vaxigrip TetraJournal of preventive medicine and hygiene · 2018Article
- Effects of seasonal and pandemic influenza on health-related quality of life, work and school absence in England: Results from the Flu Watch cohort study.Influenza and other respiratory viruses · 2018Article
- Economic analysis of pharmacist-administered influenza vaccines in Ontario, Canada.ClinicoEconomics and outcomes research : CEOR · 2018Article
- Cost-effectiveness of switching from trivalent to quadrivalent inactivated influenza vaccines for the at-risk population in Italy.Human vaccines & immunotherapeutics · 2018Article
- National assessment of Canadian pandemic preparedness: Employing InFluNet to identify high-risk areas for inter-wave vaccine distribution.Infectious Disease Modelling · 2017Article
- Review of seasonal influenza in Canada: Burden of disease and the cost-effectiveness of quadrivalent inactivated influenza vaccines.Human vaccines & immunotherapeutics · 2017Review
- The cost-effectiveness of palivizumab in infants with cystic fibrosis in the Canadian setting: A decision analysis model.Human vaccines & immunotherapeutics · 2017Article
- Modelling community-control strategies to protect hospital resources during an influenza pandemic in Ottawa, Canada.PloS one · 2017Article
- Article
- Economic evaluations of vaccines in Canada: a scoping review.Cost effectiveness and resource allocation : C/E · 2017Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundIn July 2000, the province of Ontario, Canada, initiated a universal influenza immunization program (UIIP) to provide free seasonal influenza vaccines for the entire population. This is the first large-scale program of its kind worldwide. The objective of this study was to conduct an economic appraisal of Ontario's UIIP compared to a targeted influenza immunization program (TIIP). METHODS AND
findingsA cost-utility analysis using Ontario health administrative data was performed. The study was informed by a companion ecological study comparing physician visits, emergency department visits, hospitalizations, and deaths between 1997 and 2004 in Ontario and nine other Canadian provinces offering targeted immunization programs. The relative change estimates from pre-2000 to post-2000 as observed in other provinces were applied to pre-UIIP Ontario event rates to calculate the expected number of events had Ontario continued to offer targeted immunization. Main outcome measures were quality-adjusted life years (QALYs), costs in 2006 Canadian dollars, and incremental cost-utility ratios (incremental cost per QALY gained). Program and other costs were drawn from Ontario sources. Utility weights were obtained from the literature. The incremental cost of the program per QALY gained was calculated from the health care payer perspective. Ontario's UIIP costs approximately twice as much as a targeted program but reduces influenza cases by 61% and mortality by 28%, saving an estimated 1,134 QALYs per season overall. Reducing influenza cases decreases health care services cost by 52%. Most cost savings can be attributed to hospitalizations avoided. The incremental cost-effectiveness ratio is Can$10,797/QALY gained. Results are most sensitive to immunization cost and number of deaths averted.
conclusionsUniversal immunization against seasonal influenza was estimated to be an economically attractive intervention.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.