Evidence map›Paper›PMID 28299371›Full record

ArticleThe Lancet. Public health2017

Effect of mass paediatric influenza vaccination on existing influenza vaccination programmes in England and Wales: a modelling and cost-effectiveness analysis.

David Hodgson, Marc Baguelin, Edwin van Leeuwen, Jasmina Panovska-Griffiths, Mary Ramsay, Richard Pebody, Katherine E Atkins

Abstract read
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Article in The Lancet. Public health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  17. End of season influenza vaccine effectiveness in adults and children in the United Kingdom in 2017/18.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2019
    Observational
  18. Uptake and effectiveness of influenza vaccine in those aged 65 years and older in the United Kingdom, influenza seasons 2010/11 to 2016/17.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2018
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

David HodgsonCentre for Mathematics, Physics and Engineering in the Life Sciences and Experimental Biology, University College London, London, UK.
Marc BaguelinFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Respiratory Diseases Department, Public Health England, London, UK.
Edwin van LeeuwenRespiratory Diseases Department, Public Health England, London, UK; Department of Infectious Disease Epidemiology, Medical Research Council Centre for Outbreak Analyses and Modelling, School of Public Health, Imperial College London, London, UK.
Jasmina Panovska-GriffithsCentre for Mathematics, Physics and Engineering in the Life Sciences and Experimental Biology, University College London, London, UK; Clinical and Operational Research Unit, Department of Mathematics, University College London, London, UK; Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK.
Mary RamsayImmunisation, Hepatitis and Blood Safety Department, Public Health England, London, UK.
Richard PebodyRespiratory Diseases Department, Public Health England, London, UK.
Katherine E AtkinsFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.

Funding

Medical Research Council MR/J008761/1
6 · The paper itself

Abstract

backgroundIn 2013 England and Wales began to fund a live attenuated influenza vaccine programme for individuals aged 2-16 years. Mathematical modelling predicts substantial beneficial herd effects for the entire population as a result of reduced influenza transmission. With a decreased influenza-associated disease burden, existing immunisation programmes might be less cost-effective. The aim of this study was to assess the epidemiological effect and cost-effectiveness of the existing elderly and risk group vaccination programme under the new policy of mass paediatric vaccination in England.

methodsFor this cost-effectiveness analysis, we used a transmission model of seasonal influenza calibrated to 14 seasons of weekly consultation and virology data in England and Wales. We combined this model with an economic evaluation to calculate the incremental cost-effectiveness ratios, measured in cost per quality-adjusted life-years (QALY) gained.

findingsOur results suggest that well timed administration of paediatric vaccination would reduce the number of low-risk elderly influenza cases to a greater extent than would vaccination of the low-risk elderly themselves if the elderly uptake is achieved more slowly. Although high-risk vaccination remains cost-effective, substantial uncertainty exists as to whether low-risk elderly vaccination remains cost-effective, driven by the choice of cost-effectiveness threshold. Under base case assumptions and a cost-effectiveness threshold of £15 000 per QALY, the low-risk elderly seasonal vaccination programme will cease to be cost-effective with a mean incremental cost-effectiveness ratio of £22 000 per QALY and a probability of cost-effectiveness of 20%. However, under a £30 000 per QALY threshold, the programme will remain cost-effective with 83% probability.

interpretationWith the likely move to decreased cost-effectiveness thresholds, reassessment of existing risk group-based vaccine programme cost-effectiveness in the presence of the paediatric vaccination programme is needed.

fundingNational Institute for Health Research, the Medical Research Council.

Identifiers

PMID28299371
PMCPMC5341148

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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.