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Influenza in the school-aged population in Mexico: burden of disease and cost-effectiveness of vaccination in children

BACKGROUND: The current national influenza vaccination schedule in Mexico does not recommend vaccination in the school-aged population (5–11 years). Currently, there are limited data from middle-income countries analysing the cost-effectiveness of influenza vaccination in this population. We explore...

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Autores principales: Falcón-Lezama, Jorge Abelardo, Saucedo-Martínez, Rodrigo, Betancourt-Cravioto, Miguel, Alfaro-Cortes, Myrna María, Bahena-González, Roberto Isaac, Tapia-Conyer, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085158/
https://www.ncbi.nlm.nih.gov/pubmed/32197591
http://dx.doi.org/10.1186/s12879-020-4948-5
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author Falcón-Lezama, Jorge Abelardo
Saucedo-Martínez, Rodrigo
Betancourt-Cravioto, Miguel
Alfaro-Cortes, Myrna María
Bahena-González, Roberto Isaac
Tapia-Conyer, Roberto
author_facet Falcón-Lezama, Jorge Abelardo
Saucedo-Martínez, Rodrigo
Betancourt-Cravioto, Miguel
Alfaro-Cortes, Myrna María
Bahena-González, Roberto Isaac
Tapia-Conyer, Roberto
author_sort Falcón-Lezama, Jorge Abelardo
collection PubMed
description BACKGROUND: The current national influenza vaccination schedule in Mexico does not recommend vaccination in the school-aged population (5–11 years). Currently, there are limited data from middle-income countries analysing the cost-effectiveness of influenza vaccination in this population. We explored the clinical effects and economic benefits of expanding the current national influenza vaccination schedule in Mexico to include the school-aged population. METHODS: A static 1-year model incorporating herd effect was used to assess the cost-effectiveness of expanding the current national influenza vaccination schedule of Mexico to include the school-aged population. We performed a cross-sectional epidemiological study using influenza records (2009–2018), death records (2010–2015), and discharge and hospitalisation records (2010–2016), from the databases of Mexico’s Influenza Surveillance System (SISVEFLU), the National Mortality Epidemiological and Statistical System (SEED), and the Automated Hospital Discharge System (SAEH), respectively. Cost estimates for influenza cases were based on 7 scenarios using data analysed from SISVEFLU; assumptions for clinical management of cases were defined according to Mexico’s national clinical guidelines. The primary health outcome for this study was the number of influenza cases avoided. A sensitivity analysis was performed using conservative and optimistic parameters (vaccination coverage: 30% / 70%, Vaccine effectiveness: 19% / 68%). RESULTS: It was estimated that expanding the influenza immunisation programme to cover school-aged population in Mexico over the 2018–2019 influenza season would result in 671,461 cases of influenza avoided (50% coverage and 50% effectiveness assumed). Associated with this were 262,800 fewer outpatient consultations; 154,100 fewer emergency room consultations; 97,600 fewer hospitalisations, and 15 fewer deaths. Analysis of cases avoided by age-group showed that 55.4% of them were in the school-aged population, and the decrease in outpatient consultations was largest in this population. There was an overall decrease in the economic burden for the Mexican health care system of 111.9 million US dollars; the immunization programme was determined to be cost-saving in the base, conservative and optimistic scenarios. CONCLUSIONS: Vaccinating school-aged population in Mexico would be cost-effective; expansion of the current national vaccination schedule to this age group is supported.
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spelling pubmed-70851582020-03-23 Influenza in the school-aged population in Mexico: burden of disease and cost-effectiveness of vaccination in children Falcón-Lezama, Jorge Abelardo Saucedo-Martínez, Rodrigo Betancourt-Cravioto, Miguel Alfaro-Cortes, Myrna María Bahena-González, Roberto Isaac Tapia-Conyer, Roberto BMC Infect Dis Research Article BACKGROUND: The current national influenza vaccination schedule in Mexico does not recommend vaccination in the school-aged population (5–11 years). Currently, there are limited data from middle-income countries analysing the cost-effectiveness of influenza vaccination in this population. We explored the clinical effects and economic benefits of expanding the current national influenza vaccination schedule in Mexico to include the school-aged population. METHODS: A static 1-year model incorporating herd effect was used to assess the cost-effectiveness of expanding the current national influenza vaccination schedule of Mexico to include the school-aged population. We performed a cross-sectional epidemiological study using influenza records (2009–2018), death records (2010–2015), and discharge and hospitalisation records (2010–2016), from the databases of Mexico’s Influenza Surveillance System (SISVEFLU), the National Mortality Epidemiological and Statistical System (SEED), and the Automated Hospital Discharge System (SAEH), respectively. Cost estimates for influenza cases were based on 7 scenarios using data analysed from SISVEFLU; assumptions for clinical management of cases were defined according to Mexico’s national clinical guidelines. The primary health outcome for this study was the number of influenza cases avoided. A sensitivity analysis was performed using conservative and optimistic parameters (vaccination coverage: 30% / 70%, Vaccine effectiveness: 19% / 68%). RESULTS: It was estimated that expanding the influenza immunisation programme to cover school-aged population in Mexico over the 2018–2019 influenza season would result in 671,461 cases of influenza avoided (50% coverage and 50% effectiveness assumed). Associated with this were 262,800 fewer outpatient consultations; 154,100 fewer emergency room consultations; 97,600 fewer hospitalisations, and 15 fewer deaths. Analysis of cases avoided by age-group showed that 55.4% of them were in the school-aged population, and the decrease in outpatient consultations was largest in this population. There was an overall decrease in the economic burden for the Mexican health care system of 111.9 million US dollars; the immunization programme was determined to be cost-saving in the base, conservative and optimistic scenarios. CONCLUSIONS: Vaccinating school-aged population in Mexico would be cost-effective; expansion of the current national vaccination schedule to this age group is supported. BioMed Central 2020-03-20 /pmc/articles/PMC7085158/ /pubmed/32197591 http://dx.doi.org/10.1186/s12879-020-4948-5 Text en © The Author(s). 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Falcón-Lezama, Jorge Abelardo
Saucedo-Martínez, Rodrigo
Betancourt-Cravioto, Miguel
Alfaro-Cortes, Myrna María
Bahena-González, Roberto Isaac
Tapia-Conyer, Roberto
Influenza in the school-aged population in Mexico: burden of disease and cost-effectiveness of vaccination in children
title Influenza in the school-aged population in Mexico: burden of disease and cost-effectiveness of vaccination in children
title_full Influenza in the school-aged population in Mexico: burden of disease and cost-effectiveness of vaccination in children
title_fullStr Influenza in the school-aged population in Mexico: burden of disease and cost-effectiveness of vaccination in children
title_full_unstemmed Influenza in the school-aged population in Mexico: burden of disease and cost-effectiveness of vaccination in children
title_short Influenza in the school-aged population in Mexico: burden of disease and cost-effectiveness of vaccination in children
title_sort influenza in the school-aged population in mexico: burden of disease and cost-effectiveness of vaccination in children
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085158/
https://www.ncbi.nlm.nih.gov/pubmed/32197591
http://dx.doi.org/10.1186/s12879-020-4948-5
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