Evidence map›Paper›PMID 28890196›Full record

ArticleVaccine2017

Cost-effectiveness and public health impact of alternative influenza vaccination strategies in high-risk adults.

Jonathan M Raviotta, Kenneth J Smith, Jay DePasse, Shawn T Brown, Eunha Shim, Mary Patricia Nowalk, Angela Wateska, Glenson S France, Richard K Zimmerman

Abstract read
In one paragraph

Article in Vaccine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Comparisons in the Health and Economic Assessments of Using Quadrivalent Versus Trivalent Influenza Vaccines: A Systematic Literature Review.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2023
    Pooled it
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  5. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jonathan M RaviottaDepartment of Family Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States. Electronic address: raviottaj@upmc.edu.
Kenneth J SmithDepartment of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Jay DePassePittsburgh Supercomputing Center, Carnegie Mellon University, Pittsburgh, PA, United States.
Shawn T BrownPittsburgh Supercomputing Center, Carnegie Mellon University, Pittsburgh, PA, United States.
Eunha ShimDepartment of Mathematics, Soongsil University, Seoul, South Korea.
Mary Patricia NowalkDepartment of Family Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Angela WateskaDepartment of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Glenson S FranceDepartment of Economics, University of Pittsburgh, Greensburg, PA, United States.
Richard K ZimmermanDepartment of Family Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.

Funding

Future of influenza vaccine strategies given interference and choiceR01GM111121 · NIGMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SMITH, KENNETH J, ZIMMERMAN, RICHARD K · 2014 to 2017
$1.6M
NIGMS NIH HHS R01 GM111121
6 · The paper itself

Abstract

purposeHigh-dose trivalent inactivated influenza vaccine (HD-IIV3) or recombinant trivalent influenza vaccine (RIV) may increase influenza vaccine effectiveness (VE) in adults with conditions that place them at high risk for influenza complications. This analysis models the public health impact and cost-effectiveness (CE) of these vaccines for 50-64year-olds.

methodsMarkov model CE analysis compared 5 strategies in 50-64year-olds: no vaccination; only standard-dose IIV3 offered (SD-IIV3 only), only quadrivalent influenza vaccine offered (SD-IIV4 only); high-risk patients receiving HD-IIV3, others receiving SD-IIV3 (HD-IIV3 & SD-IIV3); and high-risk patients receiving HD-IIV3, others receiving SD-IIV4 (HD-IIV3 & SD-IIV4). In a secondary analysis, RIV replaced HD-IIV3. Parameters were obtained from U.S. databases, the medical literature and extrapolations from VE estimates. Effectiveness was measured as 3%/year discounted quality adjusted life year (QALY) losses avoided.

resultsThe least expensive strategy was SD-IIV3 only, with total costs of $99.84/person. The SD-IIV4 only strategy cost an additional $0.91/person, or $37,700/QALY gained. The HD-IIV3 & SD-IIV4 strategy cost $1.06 more than SD-IIV4 only, or $71,500/QALY gained. No vaccination and HD-IIV3 & SD-IIV3 strategies were dominated. Results were sensitive to influenza incidence, vaccine cost, standard-dose VE in the entire population and high-dose VE in high-risk patients. The CE of RIV for high-risk patients was dependent on as yet unknown parameter values.

conclusionsBased on available data, using high-dose influenza vaccine or RIV in middle-aged, high-risk patients may be an economically favorable vaccination strategy with public health benefits. Clinical trials of these vaccines in this population may be warranted.

Indexed as

Antibodies, ViralCost-Benefit AnalysisHumansIncidenceInfluenza, HumanInfluenza VaccinesMiddle AgedPublic HealthQuality-Adjusted Life YearsVaccinationVaccines, InactivatedAntibodies, ViralInfluenza VaccinesVaccines, InactivatedCost-effectiveness analysisHigh dose influenza vaccineInfluenza vaccination policy

Identifiers

PMID28890196
PMCPMC5624037

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Registered trials

None linked

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.