PUBLIC HEALTH IMPACT AND COST-EFFECTIVENESS OF EXPANDED PAEDIATRIC INFLUENZA IMMUNIZATION WITH LIVE ATTENUATED VACCINE IN FRANCE: A DYNAMIC TRANSMISSION MODEL
Author(s)
Nicolas Capit1, Léa Grangé, PharmD2, Elsa Salmi, PharmD2, Lucile Bellier, PharmD3, Liem Binh Luong, MD4, Pascal Crépey, PhD5, Odile Launay, MD4.
1RWE Manager, AstraZeneca, Courbevoie, France, 2AstraZeneca, Courbevoie, France, 3Patient Access, Paris, France, 4Clinical Investigation Center in Vaccinology, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Paris, France, 5EHESP School of Public Health, Rennes, France.
1RWE Manager, AstraZeneca, Courbevoie, France, 2AstraZeneca, Courbevoie, France, 3Patient Access, Paris, France, 4Clinical Investigation Center in Vaccinology, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Paris, France, 5EHESP School of Public Health, Rennes, France.
OBJECTIVES: In France, paediatric influenza vaccination uptake remains low (<2%). This study evaluated the public health impact and cost-effectiveness of increasing vaccine coverage in children aged 2-17 years by adding intranasal live attenuated influenza vaccine (LAIV) to the current standard of care: inactivated influenza vaccines (IIV).
METHODS: A dynamic transmission model (Susceptible-Exposed-Infected-Recovered) coupled with a decision-analytic model simulated one influenza season across the entire French population. Three co-circulating strains (A/H1N1, A/H3N2, B) were modelled, capturing direct and indirect (herd) protection. The model was calibrated to observed influenza incidence (2022 to 2025 epidemic seasons) using Sentinelles and WHO FluNet data. Vaccine efficacy was derived from published meta-analysis. The base-case compared current observed vaccination rates with IIV only (1.1% 0-17 years, 3.7% 18-65, 54.7% ≥65) with a strategy adding LAIV to achieve 10% coverage in children aged 2-17 years. Cost-effectiveness was assessed from collective and societal perspectives.
RESULTS: Adding LAIV in children averted 1,737,609 infections among which 575,149 symptomatic and 378,962 medically attended, 13,066 hospitalizations, and 1,691 deaths predominantly among older adults through indirect protection yielding 28,307 QALYs gained across the entire population. The strategy generated savings of €25 million (collective perspective) and €790 million (societal) and remained dominant across sensitivity analyses based on alternative contact matrices and real-world vaccine effectiveness estimates. In contrast, increasing IIV coverage by 10 points in adults ≥65 years without paediatric LAIV averted only 118,664 infections and 538 deaths (5,089 QALYs gained), with an incremental cost-effectiveness ratio (ICER) of €7,345/QALY from the collective perspective.
CONCLUSIONS: LAIV availability has been associated with increased paediatric vaccine coverage rates in multiple countries. In France, expanding paediatric uptake with LAIV was estimated to be a dominant strategy, generating substantial herd protection and healthcare cost savings across the entire population, outperforming increased elderly vaccination.
METHODS: A dynamic transmission model (Susceptible-Exposed-Infected-Recovered) coupled with a decision-analytic model simulated one influenza season across the entire French population. Three co-circulating strains (A/H1N1, A/H3N2, B) were modelled, capturing direct and indirect (herd) protection. The model was calibrated to observed influenza incidence (2022 to 2025 epidemic seasons) using Sentinelles and WHO FluNet data. Vaccine efficacy was derived from published meta-analysis. The base-case compared current observed vaccination rates with IIV only (1.1% 0-17 years, 3.7% 18-65, 54.7% ≥65) with a strategy adding LAIV to achieve 10% coverage in children aged 2-17 years. Cost-effectiveness was assessed from collective and societal perspectives.
RESULTS: Adding LAIV in children averted 1,737,609 infections among which 575,149 symptomatic and 378,962 medically attended, 13,066 hospitalizations, and 1,691 deaths predominantly among older adults through indirect protection yielding 28,307 QALYs gained across the entire population. The strategy generated savings of €25 million (collective perspective) and €790 million (societal) and remained dominant across sensitivity analyses based on alternative contact matrices and real-world vaccine effectiveness estimates. In contrast, increasing IIV coverage by 10 points in adults ≥65 years without paediatric LAIV averted only 118,664 infections and 538 deaths (5,089 QALYs gained), with an incremental cost-effectiveness ratio (ICER) of €7,345/QALY from the collective perspective.
CONCLUSIONS: LAIV availability has been associated with increased paediatric vaccine coverage rates in multiple countries. In France, expanding paediatric uptake with LAIV was estimated to be a dominant strategy, generating substantial herd protection and healthcare cost savings across the entire population, outperforming increased elderly vaccination.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH103
Topic
Clinical Outcomes, Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Pediatrics, Vaccines