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Volume 12, Number 10—October 2006
Research

Health Benefits, Risks, and Cost-Effectiveness of Influenza Vaccination of Children

Lisa A. Prosser*†Comments to Author , Carolyn Buxton Bridges‡, Timothy M. Uyeki‡, Virginia L. Hinrichsen*†, Martin I. Meltzer‡, Noelle-Angelique M. Molinari‡, Benjamin Schwartz‡, William W. Thompson‡, Keiji Fukuda‡, and Tracy A. Lieu*†§
Author affiliations: *Harvard Medical School, Boston, Massachusetts, USA; †Harvard Pilgrim Health Care, Boston, Massachusetts, USA; ‡Centers for Disease Control and Prevention, Atlanta, Georgia, USA; §Children's Hospital, Boston, Massachusetts, USA

Main Article

Table 4

Health benefits, risks, and costs of influenza vaccination of varying age and risk groups per 1,000 children vaccinated, means* (95% CI†)

Net costs, $‡ Influenza events averted (all) Influenza hospitalizations averted Deaths averted Vaccine adverse events incurred§ QALYs gained
Using inactivated influenza vaccine
Non-high risk
6–23 mo 37,000 (–119,000 to 98,000) 108 (16–276) 2 (0.2–6) 0.002 (0–0.007) 21 (8–47) 3.0 (0.4–9.0)
2 y 43,000 (–40,000 to 83,000) 107 (15–276) 1.2 (0.1–4.2) 0.001 (0–0.005) 14 (5–30) 2.4 (0.3–7.3)
3–4 y 47,000 (2,000–78,000) 107 (15–276) 0.6 (0–2.3) 0.0005 (0–0.0025) 10 (3–24) 1.7 (0.2–5.2)
5–11 y 44,000 (21,000–68,000) 55 (8–142) 0.2 (0–0.7) 0.0002 (0– 0.0008) 5 (2–11) 0.6 (0.1–1.7)
12–17 y 44,000 (22,000– 68,000) 41 (6–104) 0.2 (0–0.6) 0.0002 (0–0.0008) 3 (1–8) 0.4 (0–1.1)
High risk
6–23 mo –74,000) (–552,000 to 83,000) 108 (16–276) 5.5 (0.5–6.5) 0.005 (0–0.020) 32 (11–56) 7.2 (0.8–23.2)
2 y –22,000) (–292,000 to 72,000) 107 (15–276) 3.5 (0.2–11.4) 0.003 (0–0.013) 25 (7–44) 5.4 (0.6–17.2)
3–4 y 2,000 (–212,000 to 70,000) 107 (15–276) 2.2 (0.1–9.1) 0.002 (0–0.010) 19 (5–37) 4.0 (0.4–13.1)
5–11 y 12,000 (–125,000 to 59,000) 55 (8–142) 1.3 (0.1–3.9) 0.001 (0–0.005) 9 (3–24) 1.6 (0.2–5.6)
12–17 y 13,000 (–120,000 to 59,000) 41 (6–104) 1.3 (0.1–3.9) 0.001 (0–0.005) 6 (1–15) 1.3 (0.1–4.5)
Using LAIV¶
Non-high risk
6–23 mo 32,000 (–155,000 to 99,000) 132 (20–319) 2.4 (0.3–7.2) 0.002 (0–0.009) 13 (3–32) 3.7 (0.5–10.5)
2 y 42,000 (–59,000 to 85,000) 130 (20–322) 1.4 (0.1–4.9) 0.001 (0–0.005) 11 (2–26) 2.9 (0.4–8.5)
3–4 y 50,000 (–3,000 to 83,000) 130 (20–322) 0.7 (0–2.7) 0.0006 (0–0.0029) 9 (2–23) 2.1 (0.3–6.1)
5–11 y 48,000 (22,000–73,000) 67 (10–166) 0.3 (0–0.8) 0.0002 (0–0.0010) 4 (1–10) 0.7 (0.1–1.9)
12–17 y 49,000 (23,000–73,000) 50 (8–120) 0.3 (0–0.7) 0.0002 (0–0.0010) 3 (0–7) 0.5 (0.1–1.3)

*CI, confidence interval; QALYs, quality-adjusted life years; LAIV, live, attenuated influenza vaccine.
†Bootstrapped.
‡Net costs = costs of vaccination minus savings from disease averted.
§Includes medically attended injection site reactions, systemic reactions, anaphylaxis, and Guillain-Barré syndrome.
¶Italics indicate that LAIV is not licensed for children <5 y.

*CI, confidence interval; QALYs, quality-adjusted life years; LAIV, live, attenuated influenza vaccine.
†Bootstrapped.
‡Net costs = costs of vaccination minus savings from disease averted.
§Includes medically attended injection site reactions, systemic reactions, anaphylaxis, and Guillain-Barré syndrome.
¶Italics indicate that LAIV is not licensed for children <5 y.

Main Article

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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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