PAEDIATRIC LAIV VACCINATION IN AUSTRIA: A COST-MINIMISATION ANALYSIS OF SCALING COVERAGE AND REDUCING HEALTHCARE BURDEN
Author(s)
Luca Ricci Pacifici, MSc1, Fryderyk Wilczynski, PhD1, Markus Karnthaler, MSc2, Lise Retat, PhD3, Klas Bergenheim, PhD4.
1Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom, 2Medical Affairs, Infectious Disease, AstraZeneca, Vienna, Austria, 3Health Economics & Payer Evidence, Infectious Disease, AstraZeneca, Barcelona, Spain, 4Health Economics & Payer Evidence, Infectious Disease, AstraZeneca, Gothenburg, Sweden.
1Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom, 2Medical Affairs, Infectious Disease, AstraZeneca, Vienna, Austria, 3Health Economics & Payer Evidence, Infectious Disease, AstraZeneca, Barcelona, Spain, 4Health Economics & Payer Evidence, Infectious Disease, AstraZeneca, Gothenburg, Sweden.
OBJECTIVES: Influenza vaccination coverage in Austria is low, particularly among children, yet children are considered key drivers of influenza transmission due to high contact rates and intergenerational mixing. Live attenuated influenza vaccine (LAIV) is licensed for ages 2-17. This analysis estimated the health economic impact of expanding paediatric LAIV coverage and the degree of coverage that minimises overall healthcare costs.
METHODS: A compartmental dynamic transmission model simulated influenza circulation within a population under current vaccination practice and compared to scenarios with increased paediatric vaccination coverage. Clinical and economic outcomes (cases, healthcare resource use and mortality) were estimated via a linked decision tree. Relative to current practice (~9% coverage in 2024/25), LAIV uptake in 2-17-year-olds was increased to between 20% and 100% in 10-percentage-point increments. Costs and quality-adjusted life-years (QALYs) were evaluated from payer and societal perspectives.
RESULTS: Increasing paediatric LAIV coverage reduced influenza burden across all age groups. At 20% coverage (corresponding to 156,537 additional vaccinations), 229,445 infections, 3,131 hospitalisations and 31 deaths were averted, with 1,187 fewer QALYs lost due to influenza, with benefits further increasing at higher coverage levels. From a payer perspective, cost savings peaked at ~60% LAIV coverage, with €30.5M in additional vaccination spend generating €66.8M in non-vaccination medical savings (outpatient visits and hospitalisation), reducing total direct costs from €122.1M under current practice to €85.7M. From a societal perspective, total costs were reduced across all vaccine coverage expansion scenarios.
CONCLUSIONS: Expanding paediatric LAIV coverage is economically favourable. From a payer perspective, expanding vaccination coverage to 60% was estimated to reflect an optimal balance between vaccination investment and avoided treatment costs through direct and indirect vaccination effects. From a societal perspective, increasing coverage was estimated to be cost-saving across all scenarios. Modelled results therefore strongly support substantial expansion of paediatric vaccination on economic and public health grounds.
METHODS: A compartmental dynamic transmission model simulated influenza circulation within a population under current vaccination practice and compared to scenarios with increased paediatric vaccination coverage. Clinical and economic outcomes (cases, healthcare resource use and mortality) were estimated via a linked decision tree. Relative to current practice (~9% coverage in 2024/25), LAIV uptake in 2-17-year-olds was increased to between 20% and 100% in 10-percentage-point increments. Costs and quality-adjusted life-years (QALYs) were evaluated from payer and societal perspectives.
RESULTS: Increasing paediatric LAIV coverage reduced influenza burden across all age groups. At 20% coverage (corresponding to 156,537 additional vaccinations), 229,445 infections, 3,131 hospitalisations and 31 deaths were averted, with 1,187 fewer QALYs lost due to influenza, with benefits further increasing at higher coverage levels. From a payer perspective, cost savings peaked at ~60% LAIV coverage, with €30.5M in additional vaccination spend generating €66.8M in non-vaccination medical savings (outpatient visits and hospitalisation), reducing total direct costs from €122.1M under current practice to €85.7M. From a societal perspective, total costs were reduced across all vaccine coverage expansion scenarios.
CONCLUSIONS: Expanding paediatric LAIV coverage is economically favourable. From a payer perspective, expanding vaccination coverage to 60% was estimated to reflect an optimal balance between vaccination investment and avoided treatment costs through direct and indirect vaccination effects. From a societal perspective, increasing coverage was estimated to be cost-saving across all scenarios. Modelled results therefore strongly support substantial expansion of paediatric vaccination on economic and public health grounds.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE446
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Disease
Pediatrics, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines