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Prosser LA, Bridges CB, Uyeki TM, Rêgo VH, Ray GT, Meltzer MI, Schwartz B, Thompson WW, Fukuda K, Lieu TA. Values for preventing influenza-related morbidity and vaccine adverse events in children. Health Qual Life Outcomes 2005; 3:18. [PMID: 15780143 PMCID: PMC1083419 DOI: 10.1186/1477-7525-3-18] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2004] [Accepted: 03/21/2005] [Indexed: 11/25/2022] Open
Abstract
Background Influenza vaccination recently has been recommended for children 6–23 months old, but is not currently recommended for routine use in non-high-risk older children. Information on disease impact, costs, benefits, risks, and community preferences could help guide decisions about which age and risk groups should be vaccinated and strategies for improving coverage. The objective of this study was to measure preferences and willingness-to-pay for changes in health-related quality of life associated with uncomplicated influenza and two rarely-occurring vaccination-related adverse events (anaphylaxis and Guillain-Barré syndrome) in children. Methods We conducted telephone interviews with adult members selected at random from a large New England HMO (n = 112). Respondents were given descriptions of four health outcomes: uncomplicated influenza in a hypothetical 1-year-old child of their own, uncomplicated influenza in a hypothetical 14-year-old child of their own, anaphylaxis following vaccination, and Guillain-Barré syndrome. "Uncomplicated influenza" did not require a physician's visit or hospitalization. Preferences (values) for these health outcomes were measured using time-tradeoff and willingness-to-pay questions. Time-tradeoff questions asked the adult to assume they had a child and to consider how much time from the end of their own life they would be willing to surrender to avoid the health outcome in the child. Results Respondents said they would give a median of zero days of their lives to prevent an episode of uncomplicated influenza in either their (hypothetical) 1-year-old or 14-year-old, 30 days to prevent an episode of vaccination-related anaphylaxis, and 3 years to prevent a vaccination-related case of Guillain-Barré syndrome. Median willingness-to-pay to prevent uncomplicated influenza in a 1-year-old was $175, uncomplicated influenza in a 14-year-old was $100, anaphylaxis $400, and Guillain-Barré syndrome $4000. The median willingness-to-pay for an influenza vaccination for their children with no risk of anaphylaxis or Guillain-Barré syndrome was $50 and $100, respectively. Conclusion Most respondents said they would not be willing to trade any time from their own lives to prevent uncomplicated influenza in a child of their own, and the time traded did not vary by the age of the hypothetical affected child. However, adults did indicate a willingness-to-pay to prevent uncomplicated influenza in children, and that they would give more money to prevent the illness in a 1-year-old than in a 14-year-old. Respondents also indicated a willingness to pay a premium for a vaccine without any risk of severe complications.
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Affiliation(s)
- Lisa A Prosser
- Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Ave., 6th floor, Boston, MA, USA
- Center for Child Health Care Studies, Harvard Pilgrim Health Care, Boston, MA, USA
| | - Carolyn Buxton Bridges
- National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Timothy M Uyeki
- National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Virginia H Rêgo
- Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Ave., 6th floor, Boston, MA, USA
| | - G Thomas Ray
- Division of Research, Kaiser Permanente, Oakland, CA USA
| | - Martin I Meltzer
- National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Benjamin Schwartz
- National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - William W Thompson
- National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Keiji Fukuda
- National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tracy A Lieu
- Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Ave., 6th floor, Boston, MA, USA
- Center for Child Health Care Studies, Harvard Pilgrim Health Care, Boston, MA, USA
- Division of General Pediatrics, Children's Hospital, Boston, MA, USA
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Moriuchi H, Oshima T, Komatsu S, Katsushima N, Kitame F, Nakamura K, Numazaki Y. The herald waves of influenza virus infections detected in Sendai and Yamagata cities in 1985-1990. Microbiol Immunol 1991; 35:375-88. [PMID: 1943849 DOI: 10.1111/j.1348-0421.1991.tb01568.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The community surveillance of respiratory virus infections performed during 1985-1987 in Sendai and 1988-1990 in Yamagata has identified a total of five herald waves of influenza virus infections: A/H3N2 virus infections in 1985 and 1989, A/H1N1 virus infections in 1986 and 1988, and type B virus infections in 1989. To investigate the antigenic and genetic relationships between the herald wave and epidemic strains, influenza A/H1N1 viruses isolated during the 1986 and 1988 herald waves were compared with those isolated during the 1986-1987 and 1988-1989 epidemic seasons, respectively, utilizing hemagglutination inhibition tests with anti-hemagglutinin monoclonal antibodies and oligonucleotide mapping of total viral RNAs. The results showed that multiple variants differing in antigenic and genetic properties were cocirculating during the 1986 herald wave as well as during each of the two epidemics (only one strain was isolated in the 1988 herald wave). It was also observed that viruses which had the antigenic and/or genetic characteristics closely similar to those of the viruses circulating in the 1986 and 1988 herald waves, were isolated during the winters of 1986-1987 and 1988-1989, respectively.
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Affiliation(s)
- H Moriuchi
- Virus Research Center, Sendai National Hospital, Miyagi
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Abstract
The aims of influenza surveillance have changed over the years. The early detection of epidemics is essential for practical decisions on vaccine development, strategy of vaccine prophylaxis, chemoprophylaxis or chemotherapy. A new surveillance system is presented which combines the classical specific data related to the isolations, direct detection of virus as well as serological findings, with non-specific indices. The rationale for definition and elaboration of such indices is discussed: selected parameters deal with medical activity of a panel of sentinel doctors (general practitioners and pediatricians), notifications of diagnosed acute respiratory viral infections, measure of emergency doctors activity, absence from work (as seen by physicians, insurance agencies or industrial personnel), selected drug prescription and consumption, hospital admissions. The sentinel physicians also cooperate in taking samples from cases, thereby extending the field of specific surveillance since they have contact with standard cases of the disease and not only hospitalized patients. A weekly comparison of time variations of specific and non-specific indices should permit a reliable evaluation of the epidemic situation and therefore be of great help for practical decisions. The system has operated since 1984, and the initial hypothesis of the sensitivity of some of the indices has already been verified.
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Affiliation(s)
- C Hannoun
- National Influenza Reference Centre, Institut Pasteur, Paris, France
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