A systematic review and meta-analysis of the direct epidemiological and economic effects of seasonal influenza vaccination on healthcare workers

Chisato Imai, Michiko Toizumi, Lisa Hall, Stephen Lambert, Kate Halton, Katharina Merollini

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Background: Influenza vaccination is a commonly used intervention to prevent influenza infection in healthcare workers (HCWs) and onward transmission to other staff and patients. We undertook a systematic review to synthesize the latest evidence of the direct epidemiological and economic effectiveness of seasonal influenza vaccination among HCW. Methods: We conducted a systematic search of MEDLINE/PubMed, Scopus, and Cochrane Central Register of Controlled Trials from 1980 through January 2018. All studies comparing vaccinated and non-vaccinated (i.e. placebo or non-intervention) groups of HCWs were included. Research articles that focused on only patient-related outcomes or monovalent A(H1N1) pdm09 vaccines were excluded. Two reviewers independently selected articles and extracted data. Pooled-analyses were conducted on morbidity outcomes including laboratory-confirmed influenza, influenza-like illnesses (ILI), and absenteeism. Economic studies were summarized for the characteristics of methods and findings. Results: Thirteen articles met eligibility criteria: three articles were randomized controlled studies and ten were cohort studies. Pooled results showed a significant effect on laboratory-confirmed influenza incidence but not ILI. While the overall incidence of absenteeism was not changed by vaccine, ILI absenteeism was significantly reduced. The duration of absenteeism was also shortened by vaccination. All published economic evaluations consistently found that the immunization of HCW was cost saving based on crude estimates of avoided absenteeism by vaccination. No studies, however, comprehensively evaluated both health outcomes and costs of vaccination programs to examine cost-effectiveness. Discussion: Our findings reinforced the influenza vaccine effects in reducing infection incidence and length of absenteeism. A better understanding of the incidence of absenteeism and comprehensive economic program evaluations are required to ensure the best possible management of ill HCWs and the investment in HCW immunization in increasingly constrained financial environments. These steps are fundamental to establish sustainability and cost-effectiveness of vaccination programs and underpin HCW immunization policy.

LanguageEnglish
Article numbere0198685
Pages1-16
Number of pages16
JournalPLoS ONE
Volume13
Issue number6
DOIs
Publication statusPublished - 7 Jun 2018

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Economic and social effects
Absenteeism
systematic review
health care workers
economic impact
Immunization
meta-analysis
influenza
Human Influenza
Meta-Analysis
Vaccination
vaccination
Economics
Delivery of Health Care
Influenza Vaccines
Cost effectiveness
Cost-Benefit Analysis
cost effectiveness
Incidence
incidence

Bibliographical note

Copyright the Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Cite this

Imai, Chisato ; Toizumi, Michiko ; Hall, Lisa ; Lambert, Stephen ; Halton, Kate ; Merollini, Katharina. / A systematic review and meta-analysis of the direct epidemiological and economic effects of seasonal influenza vaccination on healthcare workers. In: PLoS ONE. 2018 ; Vol. 13, No. 6. pp. 1-16.
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A systematic review and meta-analysis of the direct epidemiological and economic effects of seasonal influenza vaccination on healthcare workers. / Imai, Chisato; Toizumi, Michiko; Hall, Lisa; Lambert, Stephen; Halton, Kate; Merollini, Katharina.

In: PLoS ONE, Vol. 13, No. 6, e0198685, 07.06.2018, p. 1-16.

Research output: Contribution to journalReview articleResearchpeer-review

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AU - Toizumi, Michiko

AU - Hall, Lisa

AU - Lambert, Stephen

AU - Halton, Kate

AU - Merollini, Katharina

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PY - 2018/6/7

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