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Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
- Source :
-
Annals of internal medicine [Ann Intern Med] 2014 May 20; Vol. 160 (10), pp. 684-94. - Publication Year :
- 2014
-
Abstract
- Background: Vaccination for the 2009 pandemic did not occur until late in the outbreak, which limited its benefits. Influenza A (H7N9) is causing increasing morbidity and mortality in China, and researchers have modified the A (H5N1) virus to transmit via aerosol, which again heightens concerns about pandemic influenza preparedness.<br />Objective: To determine how quickly vaccination should be completed to reduce infections, deaths, and health care costs in a pandemic with characteristics similar to influenza A (H7N9) and A (H5N1).<br />Design: Dynamic transmission model to estimate health and economic consequences of a severe influenza pandemic in a large metropolitan city.<br />Data Sources: Literature and expert opinion.<br />Target Population: Residents of a U.S. metropolitan city with characteristics similar to New York City.<br />Time Horizon: Lifetime.<br />Perspective: Societal.<br />Intervention: Vaccination of 30% of the population at 4 or 6 months.<br />Outcome Measures: Infections and deaths averted and cost-effectiveness.<br />Results of Base-Case Analysis: In 12 months, 48 254 persons would die. Vaccinating at 9 months would avert 2365 of these deaths. Vaccinating at 6 months would save 5775 additional lives and $51 million at a city level. Accelerating delivery to 4 months would save an additional 5633 lives and $50 million.<br />Results of Sensitivity Analysis: If vaccination were delayed for 9 months, reducing contacts by 8% through nonpharmaceutical interventions would yield a similar reduction in infections and deaths as vaccination at 4 months.<br />Limitation: The model is not designed to evaluate programs targeting specific populations, such as children or persons with comorbid conditions.<br />Conclusion: Vaccination in an influenza A (H7N9) pandemic would need to be completed much faster than in 2009 to substantially reduce morbidity, mortality, and health care costs. Maximizing non-pharmaceutical interventions can substantially mitigate the pandemic until a matched vaccine becomes available.<br />Primary Funding Source: Agency for Healthcare Research and Quality, National Institutes of Health, and Department of Veterans Affairs.
- Subjects :
- Cities
Cost-Benefit Analysis
Disease Transmission, Infectious prevention & control
Health Care Costs
Humans
Hygiene
Influenza, Human epidemiology
Influenza, Human mortality
Influenza, Human transmission
Models, Theoretical
Monte Carlo Method
Patient Isolation
Influenza A Virus, H7N9 Subtype
Influenza Vaccines administration & dosage
Influenza Vaccines economics
Influenza, Human prevention & control
Pandemics prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1539-3704
- Volume :
- 160
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Annals of internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 24842415
- Full Text :
- https://doi.org/10.7326/M13-2071