Details:

Alternative Title:
BMC Health Serv Res
Personal Author:
Yoo, Byung-Kwang ; Humiston, Sharon G. ; Szilagyi, Peter G. ; Schaffer, Stanley J. ; Long, Christine ; ... More +
Yoo, Byung-Kwang ; Humiston, Sharon G. ; Szilagyi, Peter G. ; Schaffer, Stanley J. ; Long, Christine ; Kolasa, Maureen Less -
Description:
Background

School-located vaccination against influenza (SLV-I) has the potential to improve current suboptimal influenza immunization coverage for U.S. school-aged children. However, little is known about SLV-I’s cost-effectiveness. The objective of this study is to establish the cost-effectiveness of SLV-I based on a two-year community-based randomized controlled trial (Year 1: 2009–2010 vaccination season, an unusual H1N1 pandemic influenza season, and Year 2: 2010–2011, a more typical influenza season).

Methods

We performed a cost-effectiveness analysis on a two-year randomized controlled trial of a Western New York SLV-I program. SLV-I clinics were offered in 21 intervention elementary schools (Year 1 n = 9,027; Year 2 n = 9,145 children) with standard-of-care (no SLV-I) in control schools (Year 1 n = 4,534 (10 schools); Year 2 n = 4,796 children (11 schools)). We estimated the cost-per-vaccinated child, by dividing the incremental cost of the intervention by the incremental effectiveness (i.e., the number of additionally vaccinated students in intervention schools compared to control schools).

Results

In Years 1 and 2, respectively, the effectiveness measure (proportion of children vaccinated) was 11.2 and 12.0 percentage points higher in intervention (40.7 % and 40.4 %) than control schools. In year 2, the cost-per-vaccinated child excluding vaccine purchase ($59.88 in 2010 US $) consisted of three component costs: (A) the school costs ($8.25); (B) the project coordination costs ($32.33); and (C) the vendor costs excluding vaccine purchase ($16.68), summed through Monte Carlo simulation. Compared to Year 1, the two component costs (A) and (C) decreased, while the component cost (B) increased in Year 2. The cost-per-vaccinated child, excluding vaccine purchase, was $59.73 (Year 1) and $59.88 (Year 2, statistically indistinguishable from Year 1), higher than the published cost of providing influenza vaccination in medical practices ($39.54). However, taking indirect costs (e.g., averted parental costs to visit medical practices) into account, vaccination was less costly in SLV-I ($23.96 in Year 1, $24.07 in Year 2) than in medical practices.

Conclusions

Our two-year trial’s findings reinforced the evidence to support SLV-I as a potentially favorable system to increase childhood influenza vaccination rates in a cost-efficient way. Increased efficiencies in SLV-I are needed for a sustainable and scalable SLV-I program.


Subjects:
[+]
Adolescent Child Child, Preschool Commerce Cost-Benefit Analysis Humans Immunization Programs Influenza, Human Influenza A Virus, H1N1 Subtype Influenza Vaccines Male Monte Carlo Method Parents Residence Characteristics School Health Services Seasons Students Vaccination
Source:
BMC Health Serv Res. 15.
Pubmed ID:
26573461
Pubmed Central ID:
PMC4647510
Document Type:
Journal Article
Place as Subject:
New York
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:1da44d4d7ee1cb3e3dee19918b69134e323b4ffeaf4c3088503b6e4160b27b80
Download URL:
https://stacks.cdc.gov/view/cdc/35767/cdc_35767_DS1.pdf
File Type:

Supporting Files

• 	12913_2015_Article_1169.nxml	bin
  	license.txt	txt

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