+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Effectiveness and cost-benefit of influenza vaccination of healthy working adults: A randomized controlled trial

Effectiveness and cost-benefit of influenza vaccination of healthy working adults: A randomized controlled trial

JAMA 284(13): 1655-1663

Context: Although the cost-effectiveness and cost-benefit of influenza vaccination are well established for persons aged 65 years or older, the benefits for healthy adults younger than 65 years are less clear. Objective: To evaluate the effectiveness and cost-benefit of influenza vaccine in preventing influenzalike illness (ILI) and reducing societal costs of ILI among healthy working adults. Design: Double-blind, randomized, placebo-controlled trial conducted during 2 influenza seasons. Setting and Participants: Healthy adults aged 18 to 64 years and employed full-time by a US manufacturing company (for 1997-1998 season, n=1184; for 1998-1999 season, n=1191). Interventions: For each season, participants were randomly assigned to receive either trivalent inactivated influenza vaccine (n=595 in 1997-1998 and n=587 in 1998-1999) or sterile saline injection (placebo; n=589 in 1997-1998 and n=604 in 1998-1999). Participants in 1997-1998 were rerandomized if they participated in 1998-1999. Main Outcome Measures: Influenzalike illnesses and associated physician visits and work absenteeism reported in biweekly questionnaires by all participants, and serologically confirmed influenza illness among 23% of participants in each year (n=275 in 1997-1998; n=278 in 1998-1999); societal cost of ILI per vaccinated vs unvaccinated person. Results: For 1997-1998 and 1998-1999, respectively, 95% (1130/1184) and 99% (1178/1191) of participants had complete follow-up, and 23% in each year had serologic testing. In 1997-1998, when the vaccine virus differed from the predominant circulating viruses, vaccine efficacy against serologically confirmed influenza illness was 50% (P=.33). In this season, vaccination did not reduce ILI, physician visits, or lost workdays; the net societal cost was dollar sign65.59 per person compared with no vaccination. In 1998-1999, the vaccine and predominant circulating viruses were well matched. Vaccine efficacy was 86% (P=.001), and vaccination reduced ILI, physician visits, and lost workdays by 34%, 42%, and 32%, respectively. However, vaccination resulted in a net societal cost of dollar sign11.17 per person compared with no vaccination. Conclusion: Influenza vaccination of healthy working adults younger than 65 years can reduce the rates of ILI, lost workdays, and physician visits during years when the vaccine and circulating viruses are similar, but vaccination may not provide overall economic benefits in most years.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 010540301

Download citation: RISBibTeXText

PMID: 11015795

Related references

Cost benefit of influenza vaccination in healthy, working adults: An economic analysis based on the results of a clinical trial of trivalent live attenuated influenza virus vaccine. Vaccine 21(17-18): 2207-2217, 2003

Side effects associated with influenza vaccination in healthy working adults. A randomized, placebo-controlled trial. Archives of Internal Medicine 156(14): 1546-1550, 1996

Effectiveness of live, attenuated intranasal influenza virus vaccine in healthy, working adults: a randomized controlled trial. JAMA 282(2): 137-144, 1999

Clinical effectiveness and cost effectiveness of influenza vaccination among healthy working adults. Vaccine 17(Suppl. 1): S67-S73, 1999

Cost effectiveness analysis of elementary school-located vaccination against influenza--results from a randomized controlled trial. Vaccine 31(17): 2156-2164, 2013

Cost effectiveness analysis of Year 2 of an elementary school-located influenza vaccination program-Results from a randomized controlled trial. Bmc Health Services Research 15: 511, 2015

The effectiveness of vaccination against influenza in healthy, working adults. New England Journal of Medicine 333(14): 889-893, 1995

Cost-benefit analysis of a strategy to vaccinate healthy working adults against influenza. Archives of Internal Medicine 161(5): 749-759, 2001

Efficacy and cost savings of influenza vaccination in healthy working adults. Journal of Investigative Medicine 43(Suppl. 3): 447A, 1995

Safety and immunoenhancing effect of a Chlorella-derived dietary supplement in healthy adults undergoing influenza vaccination: randomized, double-blind, placebo-controlled trial. Cmaj 169(2): 111-117, 2003

The cost-effectiveness of influenza vaccination of healthy adults 50-64 years of age. Vaccine 24(7): 1035-1043, 2005

Vaccination versus treatment of influenza in working adults: a cost-effectiveness analysis. American Journal of Medicine 118(1): 68-77, 2005

Cost-benefit and cost-effectiveness analysis of self-management in patients with COPD--a 1-year follow-up randomized, controlled trial. Respiratory Medicine 96(6): 424-431, 2002

Cost-effectiveness of vaccination versus treatment of influenza in healthy adolescents and adults. Clinical Infectious Diseases 33(11): 1879-1885, 2001

Immunogenicity of heterologous H5N1 influenza booster vaccination 6 or 18 months after primary vaccination in adults: a randomized controlled clinical trial. Vaccine 33(4): 559-567, 2015