Q&A: Flu vaccination coverage benefits economy, not just overall health

Kaja Abbas

The CDC recommends influenza vaccination for everyone aged 6 months and older. However, vaccination coverage in the 2016-2017 season fell below the Healthy People 2020 targets of 70%. According to the CDC, only 59% of children aged 6 months to 17 years and 43.3% of adults aged 18 years or older were vaccinated during the last influenza season.

The best time for people to receive vaccination is before influenza viruses begin to circulate in the community, but health care providers should continue to offer vaccinations for as long as the viruses circulate, according to the CDC.

Increasing the number of people who get vaccinated against influenza not only benefits the overall health of a community but also strengthens its economy, according to Kaja Abbas, MS, MPH, PhD, assistant professor in the department of population health sciences at Virginia Tech’s College of Veterinary Medicine.

Infectious Disease News spoke with Abbas to learn more about how maximizing immunity impacts the economy, how human behavior contributes to the severity of a specific influenza season, and the take-home message for clinicians regarding vaccination. – by Savannah Demko

How can increasing influenza vaccination coverage improve economic outcomes in the U.S.?

Based on study estimates from 2007, annual influenza epidemics resulted in an average of 610,660 life-years lost, 3.1 million hospitalized days and 31.4 million outpatient visits. Direct medical costs averaged $10.4 billion annually. Projected lost earnings due to illness and loss of life amounted to $16.3 billion annually. The total economic burden of annual influenza epidemics using projected statistical life values amounted to $87.1 billion. In 2017 terms, this translates broadly to over $10 billion in direct medical costs every year and over $20 billion in indirect productivity loss every year, for a total economic burden of over $100 billion when the lifetime productivity loss is also taken into account.

By increasing influenza vaccination coverage, influenza morbidity and mortality can be reduced, and the corresponding economic impact arising from the direct cost of clinical care for influenza-related health outcomes (deaths, hospitalizations, outpatient visits and patients who are ill but not seeking medical care) and the indirect cost of productivity loss can be reduced.

Influenza vaccination coverage during the 2016-2017 season was 59% for children aged 6 months to 17 years and 43.3% for adults aged 18 years or older. What kind of return on investment are we getting with these rates, and how can we improve coverage?

The return on investment for vaccination will depend on the severity of influenza virulence and transmissibility this season, efficacy of the influenza vaccine and vaccination coverage. In general, influenza vaccination is a cost-saving public health intervention from the societal perspective with a positive return on investment. Also, the return on investment for vaccination increases multifold if we factor in how vaccinated individuals indirectly benefit their community by blocking the chain of transmission.

How does human behavior contribute to the severity of a specific influenza season?

Because influenza is an airborne disease, social behavioral dynamics in a population plays a significant role in the transmission dynamics of influenza. Vaccination provides both direct and indirect benefits. Direct benefit is due to the immune protection gained by effectively vaccinated individuals, and indirect benefit is due to blocking of the influenza transmission by vaccinated individuals to susceptible individuals in their social network. Essentially, vaccinated individuals who develop protective immune response to the prevalent influenza strains cut off transmission pathways to secondary and subsequent individuals. The indirect benefit of vaccinating school children has been found to be significant because of their high levels of social interaction and the significance of their transmission pathways to their households and community.

What is the take-home message for clinicians?

The Advisory Committee on Immunization Practices (ACIP) of CDC recommends seasonal influenza vaccination annually for individuals aged 6 months and older without contraindications to prevent and control seasonal and pandemic influenza. Clinicians can recommend to their patients to get influenza vaccination every year, and their recommendation is an important factor associated with patients getting their influenza vaccination.

References:

CDC. Disease Burden of Influenza. https://www.cdc.gov/flu/about/disease/burden.htm. Accessed on Nov. 15, 2017.

CDC. Flu Vaccination Coverage, United States, 2016-17 Influenza Season. https://www.cdc.gov/flu/fluvaxview/coverage-1617estimates.htm. Accessed November 13, 2017.

Dorratoltaj N, et al. PLOS Comput Biol. 2017;doi:10.1371/journal.pcbi.1005521.

Molinari NAM, et al. Vaccine. 2007;doi:10.1016/j.vaccine.2007.03.046.

Disclosure: Abbas reports no relevant financial disclosures.

Kaja Abbas

The CDC recommends influenza vaccination for everyone aged 6 months and older. However, vaccination coverage in the 2016-2017 season fell below the Healthy People 2020 targets of 70%. According to the CDC, only 59% of children aged 6 months to 17 years and 43.3% of adults aged 18 years or older were vaccinated during the last influenza season.

The best time for people to receive vaccination is before influenza viruses begin to circulate in the community, but health care providers should continue to offer vaccinations for as long as the viruses circulate, according to the CDC.

Increasing the number of people who get vaccinated against influenza not only benefits the overall health of a community but also strengthens its economy, according to Kaja Abbas, MS, MPH, PhD, assistant professor in the department of population health sciences at Virginia Tech’s College of Veterinary Medicine.

Infectious Disease News spoke with Abbas to learn more about how maximizing immunity impacts the economy, how human behavior contributes to the severity of a specific influenza season, and the take-home message for clinicians regarding vaccination. – by Savannah Demko

How can increasing influenza vaccination coverage improve economic outcomes in the U.S.?

Based on study estimates from 2007, annual influenza epidemics resulted in an average of 610,660 life-years lost, 3.1 million hospitalized days and 31.4 million outpatient visits. Direct medical costs averaged $10.4 billion annually. Projected lost earnings due to illness and loss of life amounted to $16.3 billion annually. The total economic burden of annual influenza epidemics using projected statistical life values amounted to $87.1 billion. In 2017 terms, this translates broadly to over $10 billion in direct medical costs every year and over $20 billion in indirect productivity loss every year, for a total economic burden of over $100 billion when the lifetime productivity loss is also taken into account.

By increasing influenza vaccination coverage, influenza morbidity and mortality can be reduced, and the corresponding economic impact arising from the direct cost of clinical care for influenza-related health outcomes (deaths, hospitalizations, outpatient visits and patients who are ill but not seeking medical care) and the indirect cost of productivity loss can be reduced.

Influenza vaccination coverage during the 2016-2017 season was 59% for children aged 6 months to 17 years and 43.3% for adults aged 18 years or older. What kind of return on investment are we getting with these rates, and how can we improve coverage?

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The return on investment for vaccination will depend on the severity of influenza virulence and transmissibility this season, efficacy of the influenza vaccine and vaccination coverage. In general, influenza vaccination is a cost-saving public health intervention from the societal perspective with a positive return on investment. Also, the return on investment for vaccination increases multifold if we factor in how vaccinated individuals indirectly benefit their community by blocking the chain of transmission.

How does human behavior contribute to the severity of a specific influenza season?

Because influenza is an airborne disease, social behavioral dynamics in a population plays a significant role in the transmission dynamics of influenza. Vaccination provides both direct and indirect benefits. Direct benefit is due to the immune protection gained by effectively vaccinated individuals, and indirect benefit is due to blocking of the influenza transmission by vaccinated individuals to susceptible individuals in their social network. Essentially, vaccinated individuals who develop protective immune response to the prevalent influenza strains cut off transmission pathways to secondary and subsequent individuals. The indirect benefit of vaccinating school children has been found to be significant because of their high levels of social interaction and the significance of their transmission pathways to their households and community.

What is the take-home message for clinicians?

The Advisory Committee on Immunization Practices (ACIP) of CDC recommends seasonal influenza vaccination annually for individuals aged 6 months and older without contraindications to prevent and control seasonal and pandemic influenza. Clinicians can recommend to their patients to get influenza vaccination every year, and their recommendation is an important factor associated with patients getting their influenza vaccination.

References:

CDC. Disease Burden of Influenza. https://www.cdc.gov/flu/about/disease/burden.htm. Accessed on Nov. 15, 2017.

CDC. Flu Vaccination Coverage, United States, 2016-17 Influenza Season. https://www.cdc.gov/flu/fluvaxview/coverage-1617estimates.htm. Accessed November 13, 2017.

Dorratoltaj N, et al. PLOS Comput Biol. 2017;doi:10.1371/journal.pcbi.1005521.

Molinari NAM, et al. Vaccine. 2007;doi:10.1016/j.vaccine.2007.03.046.

Disclosure: Abbas reports no relevant financial disclosures.