Influenza Vaccination in Pediatric Emergency Departments

HealthDay News — Influenza vaccination in the pediatric emergency department (PED) setting appears to be a cost-effective strategy, according to a study published in JAMA Pediatrics.

Rebecca J. Hart, MD, from the University of Louisville in Kentucky, and colleagues compared the cost-effectiveness of 4 strategies for PED-based influenza vaccine: offering vaccine to all patients, only to patients <5 years, only to high-risk patients (all ages), or to no patients. Estimates were based on visits among a hypothetical cohort of children during flu season to a tertiary, urban, freestanding PED with an estimated 60,000 visits per year.

The researchers found that offering influenza vaccine to all eligible patients had the lowest cost ($114.45 per case of influenza averted). 

This strategy saved $33.51 per case averted versus no vaccination and averaged 27 fewer cases of influenza per 1000 patients. Offering vaccine to all patients resulted in 0.72 days (95% confidence interval, 0.18 to 1.78) of quality-adjusted life-years lost, while offering vaccines to none resulted in 0.91 days (95% confidence interval, 0.25 to 2.2) of quality-adjusted life-years lost. This strategy remained robustly cost-effective across a wide range of assumptions in sensitivity analyses. Routine vaccination in the PED also results in a net societal monetary benefit under many circumstances.

“Although few PEDs routinely offer influenza vaccination, doing so appears to be cost-effective, with the potential to significantly reduce the economic (and patient) burden of pediatric influenza,” conclude the authors.

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Hart RJ, Stevenson MD, Smith MJ, et al. Cost-effectiveness of strategies for offering influenza vaccine in the pediatric emergency department [published online November 6, 2017]. JAMA Pediatr. doi: 10.1001/jamapediatrics.2017.3879