Y Projected Population Benefit of Increased Effectiveness and Coverage of Influenza Vaccination on Influenza Burden in the United States
Y Projected Population Benefit of Increased Effectiveness and Coverage of Influenza Vaccination on Influenza Burden in the United States
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DOI：
10.1093/cid/ciz676
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发表时间：
2020-06-15
影响因子：
11.8
通讯作者：
Rolfes, Melissa A.
中科院分区：
文献类型：
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作者：
Hughes, Michelle M.;Reed, Carrie;Rolfes, Melissa A.
背景接种疫苗是预防流感的最佳方法;然而，可以获得更大的好处。为了帮助指导研究和政策议程，我们旨在量化通过有针对性地增加疫苗有效性（VE）或疫苗覆盖率（VC）可以预防的流感疾病的严重程度。对于3个流感季节（2011-12，2015-16和2017-18），我们使用数学模型来估计5个年龄组中预防流感相关疾病，医疗护理疾病和住院的数量。与每个季节预防疾病的估计值相比，考虑到观察到的VE和VC，我们探讨了VE或VC绝对增加5%或实现60% VE或70% VC的额外结果的数量。在2017-18赛季，与流感疫苗接种已经预防的负担相比，5%的绝对VE增加将防止额外的1050000例疾病和25000例住院（年龄≥ 65岁的人群中占76%），而实现60%的VE将防止额外的190000例住院。VC增加5%将导致785 000例疾病减少（18-64岁人群中56%）和11 000例住院减少;达到70%将防止额外的39 000例住院。流感疫苗有效性或VC的小幅、可实现的改善可能会大幅额外减少美国的流感负担。VE的改善将对减少≥ 65岁成人的住院率产生最大影响，VC的改善将对减少18-49岁成人的疾病产生最大益处。
Background. Vaccination is the best way to prevent influenza; however, greater benefits could be achieved. To help guide research and policy agendas, we aimed to quantify the magnitude of influenza disease that would be prevented through targeted increases in vaccine effectiveness (VE) or vaccine coverage (VC).Methods. For 3 influenza seasons (2011-12, 2015-16, and 2017-18), we used a mathematical model to estimate the number of prevented influenza-associated illnesses, medically attended illnesses, and hospitalizations across 5 age groups. Compared with estimates of prevented illness during each season, given observed VE and VC, we explored the number of additional outcomes that would have been prevented from a 5% absolute increase in VE or VC or from achieving 60% VE or 70% VC.Results. During the 2017-18 season, compared with the burden already prevented by influenza vaccination, a 5% absolute VE increase would have prevented an additional 1 050 000 illnesses and 25 000 hospitalizations (76% among those aged >= 65 years), while achieving 60% VE would have prevented an additional 190 000 hospitalizations. A 5% VC increase would have resulted in 785 000 fewer illnesses (56% among those aged 18-64 years) and 11 000 fewer hospitalizations; reaching 70% would have prevented an additional 39 000 hospitalizations.Conclusions. Small, attainable improvements in effectiveness or VC of the influenza vaccine could lead to substantial additional reductions in the influenza burden in the United States. Improvements in VE would have the greatest impact in reducing hospitalizations in adults aged >= 65 years, and VC improvements would have the largest benefit in reducing illnesses in adults aged 18-49 years.