COMMUNITY-BASED VALUES FOR H1N1 INFLUENZA ILLNESSES AND VACCINATION-RELATED ADVERSE EVENTS

Purpose: To evaluate community-based values for adult and pediatric health outcomes related to 2009 pandemic influenza A (H1N1) (pH1N1) illness and vaccination-related adverse events.

Method: Adult community members were randomly selected from a nationally representative research panel to complete an internet survey.  Survey respondents answered a series of time trade-off (TTO) questions to value hypothetical scenarios describing four health states related to pH1N1 illness and vaccination: uncomplicated pH1N1 illness, pH1N1 illness-related hospitalization, severe allergic reaction to the pH1N1 vaccine, and Guillain-Barré syndrome.  Each health state scenario referenced a hypothetical person aged 1, 8, 35, or 70 years.  Respondents were also asked socio-demographic and health questions regarding themselves and their family members.  We calculated descriptive statistics for TTO values, including means, medians, percentiles, and confidence intervals.  Regression analyses evaluated the effect of scenario age, socio-demographic characteristics, pH1N1 vaccination status, and health state experience on TTO amounts. 

Result: 65% of those invited to participate completed the survey.  9% of respondents were eliminated from the primary analysis due to missing or invalid responses, leaving a final analysis sample size of 659.  In TTO questions, respondents reported that they would be willing to trade a mean of 415 (95% CI: 268,668) days from the end of their life to prevent uncomplicated pH1N1 illness in a 1 year old child and a mean of 85 (95% CI: 59,126) days to prevent this outcome in a 70 year old adult.  When valuing vaccination-related adverse events, respondents reported that they would be willing to trade a mean of 527 (95% CI:  391,774) days from the end of their life to prevent Guillain-Barré syndrome in a 1 year old child, and a mean of 158 (95% CI: 122,244) days to prevent this adverse event in a 70 year old adult.  In multivariate regression analyses, younger scenario ages (1 and 8 years) were significantly associated with greater TTO amounts in all four health states, as was having less than a college education. Vaccination status was also significantly associated with TTO amounts in three of the four health states.  Having a child under 18 was never significantly associated with TTO responses. 

Conclusion: Community members were willing to trade substantial amounts of time to avoid pH1N1 illness-related outcomes and vaccine-related adverse events, particularly in children.