Simulation studies to assess the long-term effects of Japan’s change from trivalent to quadrivalent influenza vaccination
Simulation studies to assess the long-term effects of Japan’s change from trivalent to quadrivalent influenza vaccination
复制标题
模拟研究评估日本从三价流感疫苗改为四价流感疫苗的长期影响
DOI：
10.1016/j.vaccine.2017.12.058
复制
发表时间：
2018
期刊：
影响因子：
5.5
通讯作者：
Eichner Martin
中科院分区：
文献类型：
--
作者：
Tsuzuki Shinya;Schwehm Markus;Eichner Martin
自2013/2014年以来，WHO一直推荐四价流感疫苗（QIV）来预防季节性流感。2015年，日本用QIV取代了三价流感疫苗（TIV）。我们使用计算机模拟来计算这是如何影响的流行病学，并评估其成本效益。MethodsWe模拟了季节性传播的四种流感病毒株A（H1N1），A（H3 N2），B/山形和B/维多利亚与个人为基础的模拟工具4流感，使用官方人口统计数据和日本的接触模式。该模型考虑了母体保护、免疫增强、新的漂移变体以及自然获得和疫苗衍生免疫的不同免疫持续时间。从2015/16赛季开始，模拟评估了20年，使用TIV或QIV与报告的疫苗接种覆盖率。成本和年的生命挽救（YOLSs）计算和贴现率为2%，使用2015年为基准year.ResultsQIV每年防止平均548例流感病例（4.7%的情况下发生时使用TIV; 11.9%的流感B），1.62住院和0.078每10万人死亡。在日本的1.2535亿人口中，每年通过QIV获得91.51个YOL，节省1075万美元（社会视角）。从支付者的角度来看，ICER是3698美元/YOLS.ConclusionsQIV是成本效益（支付者的角度），甚至节省成本（社会的角度）在日本。
BackgroundSince 2013/2014, the WHO has been recommending quadrivalent influenza vaccines (QIV) to prevent seasonal influenza. In 2015, Japan replaced trivalent influenza vaccines (TIV) by QIV. We used computer simulations to calculate how this impacted the epidemiology and to assess its cost-effectiveness.MethodsWe simulated the seasonal transmission of the four influenza strains A(H1N1), A(H3N2), B/Yamagata and B/Victoria with the individual-based simulation tool 4Flu, using official demographic data and Japanese contact patterns. The model considered maternal protection, immunity boosting, new drift variants and different immunity durations for naturally acquired and vaccination-derived immunity. Starting with the 2015/16 season, simulations were evaluated for 20 years, using either TIV or QIV with the reported vaccination coverage. Costs and years of life saved (YOLSs) were calculated and discounted at 2%, using 2015 as base year.ResultsQIV annually prevents on average 548 influenza cases (4.7% of cases which occur when using TIV; 11.9% of influenza B), 1.62 hospitalizations and 0.078 deaths per 100,000 individuals. In Japan’s population of 125.35 million, annually 91.51 YOLSs are gained by QIV and 10.75 million USD are saved (societal perspective). From payer perspective, the ICER is 3698 USD/YOLS.ConclusionsQIV is cost-effective (payer perspective) or even cost-saving (societal perspective) in Japan.