Vaccination strategies for future influenza pandemics: a severity-based cost effectiveness analysis

Table 1 Effectiveness, cost and cost effectiveness of interventions for mild, moderate and extreme pandemics

Mitigation strategies	Attack rate (%)	Life years saved per 10000	Total cost ($) per person	Cost ($) per LYS
Mild Pandemics (R=1.5 and CFR=0.03%)
No intervention	14	-	$170	$0
Strategy A1: Vaccination-only	13.5	1*	$210	-
Strategy A2^′: 2 weeks of SD + AV	5	17	$141	$83686
Strategy A2: 2 weeks of SD + AV + Vaccination	4	19	$178	$93202
Strategy A3^′: 8 weeks of SD + AV	5	18	$143	$81500
Strategy A3: 8 weeks of SD + AV + Vaccination	3	20	$179	$89574
Moderate Pandemics (R=1.9 and CFR=0.25%)
No intervention	33	-	$1,031	$0
Strategy B1: Vaccination-only	32.5	4*	$1,108	-
Strategy B2^′: 8 weeks of SD + AV	16	235	$719	$30527
Strategy B2: 8 weeks of SD + AV + Vaccination	15	253	$770	$30417
Strategy B3^′: Sustained SD + AV	9	342	$858	$25085
Strategy B3: Sustained SD + AV + Vaccination	4	421	$786	$18659
Extreme Pandemics (R=2.7 and CFR=1.5%)
No intervention	44	-	$6,953	$0
Strategy C1: Vaccination-only	43.8	9*	$7,021	-
Strategy C2^′: 8 weeks of SC+CCR + AV	29	1176	$4,794	$40757
Strategy C2: 8 weeks of SC+CCR + AV + Vaccination	28	1219	$4,797	$39340
Strategy C3^′: Sustained SC+CCR + AV	22	1686	$4,169	$24731
Strategy C3: Sustained SC+CCR + AV +Vaccination	11	2720	$2,332	$8571
Strategy C4^′: Sustained SC+CCR+WR + AV	22	1625	$5,310	$32671
Strategy C4: Sustained SC+CCR+WR + AV +Vaccination	7	3006	$2,812	$9355

For each pandemic severity and intervention strategy Table 1 gives the symptomatic attack rate as a percentage of the population, the number of life years saved (LYS) compared to no intervention (expressed as LYS per 10,000 population), the total cost of the pandemic per person in the community, and the cost per LYS per person. Interventions are abbreviated as follows: SD – social distancing (a combination of school closure and community contact reduction), AV – antiviral treatment and household prophylaxis, SC – school closure, CCR – community contact reduction, WR – workforce reduction.
* indicates LYS value not statistically significantly different from zero due to stochastic simulation variation – cost per LYS values with insignificant denominator have been omitted.