November 7, 2017

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Influenza vaccines in pediatric ERs likely cost-effective

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(HealthDay)—Influenza vaccination in the pediatric emergency department (PED) setting appears to be a cost-effective strategy, according to a study published online Nov. 6 in JAMA Pediatrics.

Rebecca J. Hart, M.D., from the University of Louisville in Kentucky, and compared the cost-effectiveness of four strategies for PED-based influenza vaccine: offering vaccine to all patients, only to patients <5 years, only to high-risk patients (all ages), or to no patients. Estimates were based on visits among a hypothetical cohort of children during flu season to a tertiary, urban, freestanding PED with an estimated 60,000 visits per year.

The researchers found that offering influenza vaccine to all eligible patients had the lowest cost ($114.45 per case of influenza averted). This strategy saved $33.51 per case averted versus no vaccination and averaged 27 fewer cases of influenza per 1,000 patients. Offering vaccine to all resulted in 0.72 days (95 percent confidence interval, 0.18 to 1.78) of quality-adjusted life-years lost, while offering vaccines to none resulted in 0.91 days (95 percent confidence interval, 0.25 to 2.2) of quality-adjusted life-years lost. This strategy remained robustly cost-effective across a wide range of assumptions in sensitivity analyses. Routine vaccination in the PED also results in a net societal monetary benefit under many circumstances.

"Although few PEDs routinely offer influenza vaccination, doing so appears to be cost-effective, with the potential to significantly reduce the economic (and patient) burden of pediatric influenza," conclude the authors.

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