COST-EFFECTIVENESS ANALYSIS OF EXPANDED INFLUENZA VACCINATION COVERAGE WITH LIVE ATTENUATED INFLUENZA VACCINE (LAIV) IN CHILDREN AGED 2-11 YEARS IN CATALONIA (SPAIN)
Author(s)
Mireya Robles- Plaza, MSc1, Clara Prats, PhD2, Antoni Soriano-Arandes, PhD3, Andrés Antón, PhD4, Sofía de Pedro, MSc1, Itziar Oyagüez, MSc1, Margarita Capel Sanchez, MSc5, Ana Rubín, MSc5, Guillermo Sánchez, MSc5.
1Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain, 2Institute for Research and Innovation in Health (IRIS), Universitat Politècnica de Catalunya, Barcelona, Spain, 3Serveis de Salut Integrats del Baix Empordà, Palamós, Girona. Facultad de Medicina, Universitat de Girona, Girona. Infection and Immunity in Children, Vall d’Hebron Research Institute., Barcelona, Spain, 4Department of Microbiology, Vall d’Hebron Institut de Recerca, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas CIBERINFEC, Madrid, Spain, 5AstraZeneca, Madrid, Spain.
1Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain, 2Institute for Research and Innovation in Health (IRIS), Universitat Politècnica de Catalunya, Barcelona, Spain, 3Serveis de Salut Integrats del Baix Empordà, Palamós, Girona. Facultad de Medicina, Universitat de Girona, Girona. Infection and Immunity in Children, Vall d’Hebron Research Institute., Barcelona, Spain, 4Department of Microbiology, Vall d’Hebron Institut de Recerca, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas CIBERINFEC, Madrid, Spain, 5AstraZeneca, Madrid, Spain.
OBJECTIVES: Seasonal influenza immunization in children include inactivated vaccines (IIV) and intranasal live attenuated vaccines (LAIV). Currently, in Catalonia, pediatric vaccination policy recommends LAIV for children aged 2-4 years, as well as IIV for children aged 6-24 months and other at-risk children. This study aimed to assess public health impact and cost-effectiveness of extending LAIV vaccination against the current vaccination strategy.
METHODS: Direct and herd-immunity effects of the vaccination strategies for the whole Catalan population were estimated with a dynamic transmission model linked to a decision-tree model to assess QALYs and costs (€, 2025). Influenza strain-specific circulation (A/H1N1, A/H3N2, B) was modelled over an average seasonal period (2022-2025) within a one-year time horizon. We used primary care clinical diagnoses and hospital microbiological detections to estimate strain-specific cases and considered a vaccination period of 12 weeks. The extended LAIV vaccination implied a higher coverage uptake among children aged 2-4 (from 27.0% to 50.0%) and the inclusion of children aged 5-11 (27.0%). Total costs assumed vaccine acquisition and administration, management of vaccine-related adverse events and symptomatic cases, either outpatient medical visits or hospitalizations. Both perspectives, Catalan Health System and societal (considering productivity losses) were tested. All model inputs were obtained from national or regional sources and validated by local clinical experts. Sensitivity analyses (SA) were performed.
RESULTS: Increasing LAIV vaccination by 165,895 children prevented 140,083 influenza infections, 24,576 in the targeted population and 115,507 in the indirect population. From the Catalan Health system perspective, expanded LAIV vaccination strategy yielded 842 additional QALYs and lower total costs (€-3,831,640) compared with current vaccination strategy, resulting in a dominant strategy. Expanding vaccination with LAIV remained cost-effective in all SA assessed.
CONCLUSIONS: Expanding LAIV vaccination coverage to children aged 2-11 years is a dominant strategy, reducing influenza burden and saving costs for the health system and society.
METHODS: Direct and herd-immunity effects of the vaccination strategies for the whole Catalan population were estimated with a dynamic transmission model linked to a decision-tree model to assess QALYs and costs (€, 2025). Influenza strain-specific circulation (A/H1N1, A/H3N2, B) was modelled over an average seasonal period (2022-2025) within a one-year time horizon. We used primary care clinical diagnoses and hospital microbiological detections to estimate strain-specific cases and considered a vaccination period of 12 weeks. The extended LAIV vaccination implied a higher coverage uptake among children aged 2-4 (from 27.0% to 50.0%) and the inclusion of children aged 5-11 (27.0%). Total costs assumed vaccine acquisition and administration, management of vaccine-related adverse events and symptomatic cases, either outpatient medical visits or hospitalizations. Both perspectives, Catalan Health System and societal (considering productivity losses) were tested. All model inputs were obtained from national or regional sources and validated by local clinical experts. Sensitivity analyses (SA) were performed.
RESULTS: Increasing LAIV vaccination by 165,895 children prevented 140,083 influenza infections, 24,576 in the targeted population and 115,507 in the indirect population. From the Catalan Health system perspective, expanded LAIV vaccination strategy yielded 842 additional QALYs and lower total costs (€-3,831,640) compared with current vaccination strategy, resulting in a dominant strategy. Expanding vaccination with LAIV remained cost-effective in all SA assessed.
CONCLUSIONS: Expanding LAIV vaccination coverage to children aged 2-11 years is a dominant strategy, reducing influenza burden and saving costs for the health system and society.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH101
Topic
Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Pediatrics, Vaccines