RELATIVE BENEFITS ON HOSPITALIZATION AND AVERTED HOSPITALIZATION COSTS OF LIVE ATTENUATED INFLUENZA VACCINE (LAIV) PREFERENTIAL POLICY FOR CHILDREN, AGES 2-8

Purpose:

To estimate relative  differences in influenza-assocaited hospitalizations and costs in the setting of a preferential policy for the use of  live attenuated influenza vaccine (LAIV) in children compared with the current US vaccine policy.

Method:

The vaccine impact model published in 2013 by Kostova et al. was used to estimate relative benefits influenza vaccination programs based on two policies - the current recommendation (no preference for LAIV vs IIV) and a preferential recommendation to use LAIV vaccines among healthy children aged 2–8 years old. Given vaccination coverage estimates (44%, from National Health Interview Survey), vaccine efficacy (80% for LAIV and 44% for TIV), and hospitalization rate from FluSurv-NET, the model produces estimates on hospitalization cases in the presence and the absence of influenza vaccination. LAIV preferential recommendation would result in  a situation of increased  vaccination coverage rates for  LAIV compared with IIV. Relative benefits are measured as comparisons of influenza-related hospitalization averted, defined as the difference between hospitalization cases with vaccination and without vaccination, under two different recommendations. Hospitalization costs averted were calculated from multiplying hospitalization averted by hospitalization costs per patient. Hospitalization costs were directly estimated from MarketScan database to reflect influenza-related hospitalization costs.  We estimated the effects of the policy using data from the 2010-11 influenza season.

Result:

While the current recommendation (observed as 12% for LAIV and 32.6% for TIV) with no preference for LAIV prevented 2,825 hospitalizations compared with no vaccination, an LAIV preferential recommendation (assumed LAIV rate = 32.6% and TIV rate = 12%) in children would prevent 4,006 hospitalizations. Average hospitalization costs associated influenza were $7,174 for children who received LAIV vaccination and $8,506 for children who received TIV   vaccination. An LAIV-preferred policy can prevent 1,181 (42%) more influenza-associated hospitalizations compared with  the current policy. In terms of influenza-related hospitalizations, an LAIV preferential policy for children lead to reducing $30,070,746, while the current recommendation can reduce $23,016,806.   

Conclusion:

An LAIV preferential recommendation for children 2-8 years can produce more health benefits and cost-savings in terms of hospitalization averted.