Optimising age coverage of seasonal influenza vaccination in England: A mathematical and health economic evaluation
Fig 7
Age coverage for each arm of the low-risk vaccination programme that returned the greatest monetary gains, given a specified cost of influenza vaccine.
Optimal age ranges were calculated at £1 increments for influenza vaccination, in each case under an assumption of 10% vaccine wastage and a £10 administration charge. Upper age bound quantities for the young-age centric programme and elder-age centric programme (per cost of influenza vaccine values) are indicated by the filled red circles and grey circles, respectively. Columns correspond to optimal age coverage assuming: (a,c) a £20,000 cost-effectiveness threshold per QALY, successfully attained by the most likely set of model parameters; (b,d) £30,000 cost-effectiveness threshold per QALY, with 90% of all parameter sets generating cost-effective results. The outcomes displayed in panels (a,b) had no mandated age coverage conditions; we found the upper age bound of the young-age centric programme to not exceed 65 years of age under any circumstance, whilst age coverage stemming from the elder-age centric aspect of the programme was usually limited or not required. In panels (c,d), the elder-age arm of the low-risk vaccination programme had to include, at the very least, all those aged 65 and above. Amongst the programmes discerned as optimal (at each fixed vaccine dose price), none extended the lower age bound for the elder-age centric component below the age of 64. The mandated age coverage condition also narrowed the range of influenza vaccine dose prices for which the addition of a low-risk vaccination programme would be viable.