The Efficacy of Influenza Vaccination of Elderly: Population-Based Influenza Vaccination Program in Taiwan during 1998–2006

Background and objectives: Haemophilus influenzae type b (Hib) vaccination is not a routine immunization service in Korea yet. This study was performed to estimate the disease burden of Hib and the cost-benefit of providing Hib vaccine to children in Korea. Method: We used the Rapid Assessment Tools (RATs) of WHO to estimate the pre-vaccination Hib incidence andmortality; one based on meningitis incidence in community and the other based on under 5 year mortality statistics in 2004. The fatality and sequelaes of Hib diseases were obtained from multi-center based registry data. The direct and indirect cost of Hib were calculated from the National Health Insurance data (hospitalization and outpatient cost) in 2004, National Health and Nutrition Survey(transport cost to hospitals), Report of Ministry of Labor (indirect cost of work loss and death) in 2004. Sensitivity analysis was done. Results: The annual incidence of Hib meningitis was 10.8(95% CI: 3.8—15.0) per 100,000 children <5 years and the case fatality rate was 6%. The average treatment cost for an Hib meningitis case was about US $ 2,157. For a fatal case, the average life time discounted economic loss was about US $ 849,085. The Total annual cost of Hib diseases was about US $ 42.5million. The break-even vaccine price, where the annual vaccination costs equal annual Hib disease burden averted was US $ 23.3 per dose in base case scenario with 3% discount rate. In sensitivity analysis, due to the wide confidence interval of meningitis incidence rate, the burden of Hib was from 15.9million to 58.6million. Conclusion: In base case scenario, the routine Hib vaccination to children would be cost-benefit in Korea.