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. 2019 Apr;56(4):e135-e141.
doi: 10.1016/j.amepre.2018.11.015. Epub 2019 Feb 14.

Compressed Influenza Vaccination in U.S. Older Adults: A Decision Analysis

Kenneth J Smith  1 , Glenson France  2 , Mary Patricia Nowalk  3 , Jonathan M Raviotta  3 , Jay DePasse  4 , Angela Wateska  5 , Eunha Shim  6 , Richard K Zimmerman  3
Affiliations

Compressed Influenza Vaccination in U.S. Older Adults: A Decision Analysis

Kenneth J Smith et al. Am J Prev Med. 2019 Apr.

Abstract

Introduction: Tradeoffs exist between efforts to increase influenza vaccine uptake, including early season vaccination, and potential decreased vaccine effectiveness if protection wanes during influenza season. U.S. older adults increasingly receive vaccination before October. Influenza illness peaks vary from December to April.

Methods: A Markov model compared influenza likelihood in older adults with (1) status quo vaccination (August-May) to maximize vaccine uptake or (2) vaccination compressed to October-May (to decrease waning vaccine effectiveness impact). The Centers for Disease Control and Prevention data were used for influenza incidence and vaccination parameters. Prior analyses showed that absolute vaccine effectiveness decreased by 6%-11% per month, favoring later season vaccination. However, compressed vaccination could decrease overall vaccine uptake. Influenza incidence was based on average monthly incidence with earlier and later peaks also examined. Influenza strain distributions from two seasons were modeled in separate scenarios. Sensitivity analyses were performed to test result robustness. Data were collected and analyzed in 2018.

Results: Compressed vaccination would avert ≥11,400 influenza cases in older adults during a typical season if it does not decrease vaccine uptake. However, if compressed vaccination decreases vaccine uptake or there is an early season influenza peak, more influenza can result. In probabilistic sensitivity analyses, compressed vaccination was never favored if it decreased absolute vaccine uptake by >5.5% in any scenario; when influenza peaked early, status quo vaccination was favored.

Conclusions: Compressed vaccination could decrease waning vaccine effectiveness and decrease influenza cases in older adults. However, this positive effect is negated when early season influenza peaks occur and diminished by decreased vaccine uptake that could occur with shortening the vaccination season.

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Figure 1.
Figure 1.
Two-way sensitivity analysis (February influenza illness peak).
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References

    1. Smith NM, Bresee JS, Shay DK, Uyeki TM, Cox NJ, Strikas RA. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2006;55(RR10):1–42. - PubMed
    1. Fiore AE, Shay DK, Haber P, et al. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007. MMWR Recomm Rep. 2007;56(RR06):1–54. - PubMed
    1. Fiore AE, Uyeki TM, Broder K, et al. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep. 2010;59(RR-8):1–62. - PubMed
    1. Ferdinands JM, Fry AM, Reynolds S, et al. Intraseason waning of influenza vaccine protection: evidence from the U.S. influenza vaccine effectiveness network, 2011–2012 through 2014–2015. Clin Infect Dis. 2017;64(5):544–550. 10.1093/cid/ciw816. - DOI - PubMed
    1. CDC. 2016–17. Influenza Season Vaccination Coverage Report. www.cdc.gov/flu/fluvaxview/reportshtml/reporti1617/reporti/index.html. Accessed November 21, 2018.

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