中小学校学生流感疫苗接种效果评估和卫生经济学评价

目的评估中小学校学生流感疫苗接种效果,开展疫苗接种的卫生经济学评价,为制定流感疫苗接种策略提供依据。方法采用易感者-潜伏者-显性感染者/隐性感染者-移出者/恢复者(susceptible-exposed-infectious/asymptomatic-removed/recovered,SEIARR)动力学模型对既往疫情数据进行模拟,计算累计罹患率评估疫苗接种效果,计算成本-效果和成本-效益进行卫生经济学评价。结果当流感疫苗接种率为0%、50%、70%和90%时,疫情平均累积罹患率为99.79%(99.75%,99.82%)、70.84%(70.58%,71.09%)、56.81%(56.17%,57.45%)和34.29%(32.46%,36.20%),流感疫苗接种率越高,累计罹患率越低;当疫苗接种率为50%、70%和90%时,疫苗的成本-效果比为:141.03(139.86,142.19)元、133.16(131.34,135.08)元和112.90(110.03,116.11)元,疫苗的成本-效益比为:6.27(6.22,6.32)元、6.65(6.56,6.74)元和7.88(7.66,8.09)元;流感疫苗接种率越高,疫苗的成本-效果越好,成本-效益越高。结论接种流感疫苗能有效降低疫情的累计罹患率,提高接种率能有效增加疫苗接种的卫生经济学效应。

Assessment on effect of influenza vaccination and its health economics in primary and middle school students

Objective To evaluate the effect of influenza vaccination among primary and secondary school students, to conduct an evaluation on health economics of vaccination, and to provide a basis for formulating influenza vaccination strategies. Methods The susceptible-exposed-infectious/asymptomatic-removed/recovered (SEIARR) dynamic model was used to simulate past epidemic data. The cumulative attack rate was calculated to evaluate the effect of vaccination, and the cost-effectiveness and cost-benefit were calculated for appraising health economics. Results When the influenza vaccination rates were 0%, 50%, 70% and 90%, respectively, the average cumulative attack rates of the epidemic were 99.79% (99.75, 99.82), 70.84% (70.58, 71.09), 56.81% (56.17, 57.45) and 34.29% (32.46, 36.20), respectively. The higher the influenza vaccination rate, the lower the cumulative attack rate. When the vaccination rates were 50%, 70% and 90%, respectively, the cost-effectiveness ratios of the vaccine were 141.03 (139.86, 142.19) yuan, 133.16 (131.34, 135.08) yuan and 112.90 (110.03, 116.11) yuan, respectively, and the cost-benefit ratios of the vaccine were 6.27 (6.22, 6.32) yuan, 6.65 (6.56, 6.74) yuan and 7.88 (7.66, 8.09) yuan, respectively. The higher the influenza vaccination rate, the better the cost-effectiveness and cost-benefit of the vaccine. Conclusion Influenza vaccination can effectively reduce the cumulative attack rate of the epidemic, and increasing the vaccination rate can effectively improve the health economic effect of vaccination.