Prevention and Control of Influenza, Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Nicole M. Smith, PhD; Joseph S. Bresee, MD; David K. Shay, MD; Timothy M. Uyeki, MD; Nancy J. Cox, PhD; Raymond A. Strikas, MD


Morbidity and Mortality Weekly Report. 2006;55(27):1-41. 

In This Article

Cost-Effectiveness of Influenza Vaccine

Influenza vaccination can reduce both health-care costs and productivity losses associated with influenza illness. Studies of influenza vaccination of persons aged ≥65 years conducted in the United States have reported substantial reductions in hospitalizations and deaths and overall societal costs savings.[15,100,104] Studies of adults aged <65 years have indicated that vaccination can reduce both direct medical costs and indirect costs from work absenteeism.[8,10,11,12,91,116] Reductions of 13%-44% in health-care-provider visits, 18%-45% in lost workdays, 18%-28% in days working with reduced effectiveness, and 25% in antibiotic use for influenza-associated illnesses have been reported.[10,12,117,118] One cost-effectiveness analysis estimated a cost of approximately $60-$4,000/illness averted among healthy persons aged 18-64 years, depending on the cost of vaccination, the influenza attack rate, and vaccine effectiveness against influenza-like illness (ILI).[91] Another cost-benefit economic study estimated an average annual savings of $13.66/person vaccinated.[119] In the second study, 78% of all costs prevented were costs from lost work productivity, whereas the first study did not include productivity losses from influenza illness.

Economic studies specifically evaluating the cost-effectiveness of vaccinating persons aged 50-64 years are not available, and the number of studies that examine the economics of routinely vaccinating children with TIV or LAIV are limited.[8,120,121,122,123] However, in a study of inactivated vaccine that included all age groups, cost utility (i.e., cost per year of healthy life gained) improved with increasing age and among those with chronic medical conditions.[8] Among persons aged ≥65 years, vaccination resulted in a net savings per quality-adjusted life year (QALY) gained, whereas among younger age groups, vaccination resulted in costs of $23-$256/QALY.

In addition to estimating the economic cost associated with influenza disease, studies have assessed the public's perception of preventing influenza morbidity. Less than half of respondents to a survey on public perception of the value of preventing influenza morbidity reported that they would trade any time from their own life to prevent a case of uncomplicated influenza in a hypothetical child.[124] When asked about their willingness to pay to prevent a hypothetical child from having an uncomplicated case of influenza, the median willingness-to-pay amount was $100 for a child aged 14 years and $175 for a child aged 1 year.[124]


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