背景:季节性流感的流行给公众健康和经济带来了巨大的负担,这可以通过接种疫苗来缓解。世界卫生组织(WHO)建议老年人(65岁以上)的疫苗接种率(VCR)为75%,患有慢性病的人,孕妇,6-24个月的儿童和医护人员。然而,没有一个欧洲国家在所有风险群体中都能实现这一目标。在这项研究中,在四个欧洲国家的风险群体中,估计达到75%的流感VCR所实现的潜在公共卫生和经济利益:法国,意大利,西班牙,和英国。
方法:使用静态流行病学模型来估计将2021/2022季节VCR提高到75%的避免的公共卫生和经济负担,使用标准剂量四价流感疫苗的疗效数据。对于每个国家和风险群体,关于人口规模的最新数据,VCR,大流行前流感流行病学,通过系统的文献综述确定了直接医疗费用和缺勤率,辅以手动搜索。结果是:避免了流感病例,全科医生(GP)就诊,住院治疗,死亡病例,损失工作的天数,直接医疗费用和缺勤相关费用。
结果:截至2021/2022赛季,英国在各风险组获得了最高的加权VCR(65%),其次是西班牙(47%),法国(44%)和意大利(44%)。基于建模,2021/2022年的VCR预防了大约190万例流感病例,避免375,200名全科医生就诊,73,200人住院,38,400人死亡。为了实现世卫组织75%的VCR目标,另外还有2400万高危人群需要接种疫苗,其中大多数是老年人和慢性病患者。据估计,这可以避免进一步的918,200例流感病例,332,000名GP访问,这四个国家有16300人住院和6300人死亡,老年人占52%的住院治疗和80%的死亡。总共将节省8400万欧元的直接医疗费用和7900万欧元的缺勤费用,大部分经济利益在法国交付。
结论:老年人代表大多数疫苗可预防的流感病例和死亡,其次是患有慢性病的人。卫生当局应优先为这些人群接种疫苗,以获得最大的公共卫生和经济利益。
BACKGROUND: Seasonal influenza epidemics have a substantial public health and economic burden, which can be alleviated through vaccination. The World Health Organization (WHO) recommends a 75% vaccination coverage rate (VCR) in: older adults (aged ≥ 65 years), individuals with chronic conditions, pregnant women, children aged 6-24 months and healthcare workers. However, no European country achieves this target in all risk groups. In this study, potential public health and economic benefits achieved by reaching 75% influenza VCR was estimated in risk groups across four European countries: France, Italy, Spain, and the UK.
METHODS: A static epidemiological model was used to estimate the averted public health and economic burden of increasing the 2021/2022 season VCR to 75%, using the efficacy data of standard-dose quadrivalent influenza vaccine. For each country and risk group, the most recent data on population size, VCR, pre-pandemic influenza epidemiology, direct medical costs and absenteeism were identified through a systematic literature review, supplemented by manual searching. Outcomes were: averted influenza cases, general practitioner (GP) visits, hospitalisations, case fatalities, number of days of work lost, direct medical costs and absenteeism-related costs.
RESULTS: As of the 2021/2022 season, the UK achieved the highest weighted VCR across risk groups (65%), followed by Spain (47%), France (44%) and Italy (44%). Based on modelling, the 2021/2022 VCR prevented an estimated 1.9 million influenza cases, avoiding 375,200 GP visits, 73,200 hospitalisations and 38,400 deaths. To achieve the WHO 75% VCR target, an additional 24 million at-risk individuals would need to be vaccinated, most of which being older adults and patients with chronic conditions. It was estimated that this could avoid a further 918,200 influenza cases, 332,000 GP visits, 16,300 hospitalisations and 6,300 deaths across the four countries, with older adults accounting for 52% of hospitalisations and 80% of deaths. An additional €84 million in direct medical costs and €79 million in absenteeism costs would be saved in total, with most economic benefits delivered in France.
CONCLUSIONS: Older adults represent most vaccine-preventable influenza cases and deaths, followed by individuals with chronic conditions. Health authorities should prioritise vaccinating these populations for maximum public health and economic benefits.