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Peer reviewedOpen accessInfluenza

Health and economic impact of seasonal influenza mass vaccination strategies in European settings: A mathematical modelling and cost-effectiveness analysis

Vaccine·

Frank G. Sandmann, Edwin van Leeuwen, Sibylle Bernard-Stoecklin, Itziar Casado, Jesús Castilla, Lisa Domegan, Alin Gherasim, Mariëtte Hooiveld, Irina Kislaya, Amparo Larrauri, Daniel Levy-Bruhl, Ausenda Machado, Diogo F.P. Marques, Iván Martínez-Baz, Clara Mazagatos, Jim McMenamin, Adam Meijer, Josephine L.K. Murray, Baltazar Nunes, Joan O'Donnell, Arlene Reynolds, Dominic Thorrington, Richard Pebody, Marc Baguelin

DOI
10.1016/j.vaccine.2022.01.015
PMID
35109968
PMCID
PMC8861572
OpenAlex
W4210253805
Study type
Mathematical modelling
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

Despite existing vaccination programs targeting older adults and high-risk groups, substantial influenza burden persists in Europe. The findings suggest that combined strategies using improved vaccines for the elderly and universal pediatric vaccination may offer direct and indirect protection that is cost-effective across diverse European settings, supporting broader policy considerations for seasonal influenza control.

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Structured evidence summary

Research question

The study examined the health and economic impact of 27 seasonal influenza vaccination strategies targeting elderly and/or pediatric populations across eight European settings.

Study design

The authors used an age-structured dynamic transmission model calibrated to data from eight European countries between 2010/11 and 2017/18. They compared base-case non-adjuvanted trivalent vaccination in the elderly with strategies involving improved elderly vaccines, mass pediatric vaccination, and combinations thereof, estimating costs and quality-adjusted life years from a healthcare perspective.

Population and setting

The analysis covered approximately 205.8 million people in England, France, Ireland, Navarra, The Netherlands, Portugal, Scotland, and Spain. The modeled strategies targeted individuals aged 65 years and older and/or children.

Main findings

Moving elderly populations to improved trivalent vaccines reduced infections by a median of 261.5 per 100,000, while quadrivalent vaccines yielded 150.8 fewer infections per 100,000. Mass pediatric vaccination at 25% uptake provided indirect protection to the elderly, preventing approximately 234 to 267 infections per 100,000 depending on vaccine type, with health gains across all age groups. At a willingness-to-pay threshold of €35,000 per QALY, combining improved elderly vaccines with universal pediatric quadrivalent vaccination provided the highest net benefits and cost-effectiveness probabilities in all settings.

Public-health relevance

Despite existing vaccination programs targeting older adults and high-risk groups, substantial influenza burden persists in Europe. The findings suggest that combined strategies using improved vaccines for the elderly and universal pediatric vaccination may offer direct and indirect protection that is cost-effective across diverse European settings, supporting broader policy considerations for seasonal influenza control.

Important limitations

Cost-effectiveness conclusions depend on vaccine pricing. This summary is limited to the supplied single-article abstract and metadata; decision-grade interpretation requires review of the original paper, including detailed assumptions about transmission parameters, calibration validity across heterogeneous settings, and sensitivity analyses.

GIDS interpretation

The article addresses vaccination strategy and policy questions in a European context and was indexed under health policy, transmission dynamics, and vaccination topics. It provides modeling evidence relevant to seasonal influenza control but does not report outbreak surveillance data or describe an emerging epidemiological signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 10 auditable classifier relationships to diseases, places, topics, and study design.

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