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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

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Table 5

Incremental cost-effectiveness ratios for use of inactivated and live attenuated influenza vaccination in varying age and risk groups compared to no vaccination, mean (2.5% and 97.5% bootstrapped percentiles)*

Age group Using inactivated influenza vaccine
Using live, attenuated influenza vaccine†
Children not at high risk Children at high risk Children not at high risk
$ per influenza episode averted‡
6–23 mo 340 (CS–4,690) CS (CS–4,090) 240 (CS–3,890)
2 y 400 (CS–3,990) CS (CS–3,620) 330 (CS–3,340)
3–4 y 440 (10–3,590) 20 (CS–3,410) 440 (CS–3,170)
5–11 y 800 (180–5,850) 210 (CS–5,560) 720 (170–5,290)
12–17 y 1,070 (250–7,780) 310 (CS–7,360) 980 (240–7,070)
$ per hospitalization averted‡
6-23 mo 19,000 (CS–350,000) CS (CS–132,000) 14,000 (CS–287,000)
2 y 37,000 (CS–633,000) CS (CS–232,000) 30,000 (CS–522,000)
3–4 y 84,000 (1,000–2,587,000) 1,000 (CS–750,000) 74,000 (CS–2,227,000)
5–11 y 202,000 (38,000–1,929,000) 9,000 (CS–310,000) 184,000 (35,000–1,629,000)
12–17 y 206,000 (43,000–1,768,000) 10,000 (CS–304,000) 188,000 (40,000–1,575,000)
$ per death averted‡
6–23 mo 22 m (CS–1,109 m) CS (CS–342 m) 16 m (CS–880 m)
2 y 42 m (CS–1,762 m) CS (CS–591 m) 34 m (CS–1,435 m)
3–4 y 98 m (1 m–6,840 m) 1 m (CS–1,873 m) 86 m (CS;5,991 m)
5–11 y 234 m (32 m–5,993 m) 10 m (CS–876 m) 212 m (32 m–5,331 m)
12–17 y 238 m (37 m–5,607 m) 12 m (CS–892 m) 217 m (34 m–5,007 m)
$ per quality-adjusted life-year saved
6–23 mo 12,000 (CS–208,000) CS (CS–85,000) 9,000 (CS–167,000)
2 y 18,000 (CS–217,000) CS (CS–100,000) 15,000 (CS–180,000)
3–4 y 28,000 (1,000–290,000) 1,000 (CS–130,000) 25,000 (CS–236,000)
5–11 y 79,000 (15,000–682,000) 7,000 (CS–260,000) 72,000 (14,000–592,000)
12–17 y 119,000 (24,000–1,040,000) 10,000 (CS–367,000) 109,000 (22,000–888,000)

*CS, cost savings; m, million.
†Numerator does not include productivity losses.
‡Italics indicate that live, attenuated influenza vaccine is not licensed for children <5 y.

*CS, cost savings; m, million.
†Numerator does not include productivity losses.
‡Italics indicate that live, attenuated influenza vaccine is not licensed for children <5 y.

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