Giuseppe
Emeritus
[Source: PLoS ONE, full text: (LINK). Abstract, edited.]
Community-Based Values for 2009 Pandemic Influenza A H1N1 Illnesses and Vaccination-Related Adverse Events
Tara A. Lavelle<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>*</SUP>, Martin I. Meltzer<SUP>3</SUP>, Achamyeleh Gebremariam<SUP>4</SUP>, Kara Lamarand<SUP>4</SUP>, Anthony E. Fiore<SUP>3</SUP>, Lisa A. Prosser<SUP>4</SUP>
1 Ph.D. Program in Health Policy, Harvard University, Cambridge, Massachusetts, United States of America, 2 The Center for Health Decision Science, Harvard School of Public Health, Boston, Massachusetts, United States of America, 3 Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America, 4 Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan Health System, Ann Arbor, Michigan, United States of America
Abstract
Objective
To evaluate community-based values for avoiding pandemic influenza (A) H1N1 (pH1N1) illness and vaccination-related adverse events in adults and children.
Methods
Adult community members were randomly selected from a nationally representative research panel to complete an internet survey (response rate = 65%; n = 718). Respondents answered a series of time trade-off questions to value four hypothetical health state scenarios for varying ages (1, 8, 35, or 70 years): uncomplicated pH1N1 illness, pH1N1 illness-related hospitalization, severe allergic reaction to the pH1N1 vaccine, and Guillain-Barr? syndrome. We calculated descriptive statistics for time trade-off amounts and derived quality adjusted life year losses for these events. Multivariate regression analyses evaluated the effect of scenario age, as well as respondent socio-demographic and health characteristics on time trade-off amounts.
Results
Respondents were willing to trade more time to avoid the more severe outcomes, hospitalization and Guillain-Barr? syndrome. In our adjusted and unadjusted analyses, age of the patient in the scenario was significantly associated with time trade-off amounts (p-value<0.05), with respondents willing to trade more time to prevent outcomes in children versus adults. Persons who had received the pH1N1 vaccination were willing to trade significantly more time to avoid hospitalization, severe allergic reaction, and Guillain-Barr? syndrome, controlling for other variables in adjusted analyses.(p-value<0.05)
Conclusions
Community members placed the highest value on preventing outcomes in children, compared with adults, and the time trade-off values reported were consistent with the severity of the outcomes presented. Considering these public values along with other decision-making factors may help policy makers improve the allocation of pandemic vaccine resources.
Citation: Lavelle TA, Meltzer MI, Gebremariam A, Lamarand K, Fiore AE, et al. (2011) Community-Based Values for 2009 Pandemic Influenza A H1N1 Illnesses and Vaccination-Related Adverse Events. PLoS ONE 6(12): e27777. doi:10.1371/journal.pone.0027777
Editor: Vittoria Colizza, INSERM and Universit? Pierre et Marie Curie, France
Received: July 15, 2011; Accepted: October 25, 2011; Published: December 19, 2011
This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Funding: This study was funded by the Centers for Disease Control and Prevention. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: tlavelle@fas.harvard.edu
- ------Tara A. Lavelle<SUP>1</SUP><SUP>,</SUP><SUP>2</SUP><SUP>*</SUP>, Martin I. Meltzer<SUP>3</SUP>, Achamyeleh Gebremariam<SUP>4</SUP>, Kara Lamarand<SUP>4</SUP>, Anthony E. Fiore<SUP>3</SUP>, Lisa A. Prosser<SUP>4</SUP>
1 Ph.D. Program in Health Policy, Harvard University, Cambridge, Massachusetts, United States of America, 2 The Center for Health Decision Science, Harvard School of Public Health, Boston, Massachusetts, United States of America, 3 Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America, 4 Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan Health System, Ann Arbor, Michigan, United States of America
Abstract
Objective
To evaluate community-based values for avoiding pandemic influenza (A) H1N1 (pH1N1) illness and vaccination-related adverse events in adults and children.
Methods
Adult community members were randomly selected from a nationally representative research panel to complete an internet survey (response rate = 65%; n = 718). Respondents answered a series of time trade-off questions to value four hypothetical health state scenarios for varying ages (1, 8, 35, or 70 years): uncomplicated pH1N1 illness, pH1N1 illness-related hospitalization, severe allergic reaction to the pH1N1 vaccine, and Guillain-Barr? syndrome. We calculated descriptive statistics for time trade-off amounts and derived quality adjusted life year losses for these events. Multivariate regression analyses evaluated the effect of scenario age, as well as respondent socio-demographic and health characteristics on time trade-off amounts.
Results
Respondents were willing to trade more time to avoid the more severe outcomes, hospitalization and Guillain-Barr? syndrome. In our adjusted and unadjusted analyses, age of the patient in the scenario was significantly associated with time trade-off amounts (p-value<0.05), with respondents willing to trade more time to prevent outcomes in children versus adults. Persons who had received the pH1N1 vaccination were willing to trade significantly more time to avoid hospitalization, severe allergic reaction, and Guillain-Barr? syndrome, controlling for other variables in adjusted analyses.(p-value<0.05)
Conclusions
Community members placed the highest value on preventing outcomes in children, compared with adults, and the time trade-off values reported were consistent with the severity of the outcomes presented. Considering these public values along with other decision-making factors may help policy makers improve the allocation of pandemic vaccine resources.
Citation: Lavelle TA, Meltzer MI, Gebremariam A, Lamarand K, Fiore AE, et al. (2011) Community-Based Values for 2009 Pandemic Influenza A H1N1 Illnesses and Vaccination-Related Adverse Events. PLoS ONE 6(12): e27777. doi:10.1371/journal.pone.0027777
Editor: Vittoria Colizza, INSERM and Universit? Pierre et Marie Curie, France
Received: July 15, 2011; Accepted: October 25, 2011; Published: December 19, 2011
This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Funding: This study was funded by the Centers for Disease Control and Prevention. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
* E-mail: tlavelle@fas.harvard.edu