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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.

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