Health and economic benefits of early vaccination and nonpharmaceutical interventions for a human influenza A (H7N9) pandemic: a modeling study.
Ann Intern Med
; 160(10): 684-94, 2014 May 20.
Article
en En
| MEDLINE
| ID: mdl-24842415
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.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).DESIGN:
Dynamic transmission model to estimate health and economic consequences of a severe influenza pandemic in a large metropolitan city. DATA SOURCES Literature and expert opinion. TARGET POPULATION Residents of a U.S. metropolitan city with characteristics similar to New York City. TIME HORIZON Lifetime. PERSPECTIVE Societal. INTERVENTION Vaccination of 30% of the population at 4 or 6 months. OUTCOMEMEASURES:
Infections and deaths averted and cost-effectiveness. RESULTS OF BASE-CASEANALYSIS:
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. RESULTS OF SENSITIVITYANALYSIS:
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.LIMITATION:
The model is not designed to evaluate programs targeting specific populations, such as children or persons with comorbid conditions.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. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality, National Institutes of Health, and Department of Veterans Affairs.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Vacunas contra la Influenza
/
Gripe Humana
/
Pandemias
/
Subtipo H7N9 del Virus de la Influenza A
Tipo de estudio:
Health_economic_evaluation
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Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Ann Intern Med
Año:
2014
Tipo del documento:
Article