Vaccination is the best intervention to prevent influenza and its complications. Effective influenza immunization strategy facilitates influenza vaccine coverage to protect the population and reduce disease burden. This paper analyzes related influenza policies from six countries with high vaccination rates and summarizes five common key elements of them. Additionally, we propose the proper immunization strategy of influenza vaccine in China.

Vaccination is the best intervention to prevent influenza and its complications. Effective influenza immunization strategy facilitates influenza vaccine coverage to protect the population and reduce disease burden. This paper analyzes related influenza policies from six countries with high vaccination rates and summarizes five common key elements of them. Additionally, we propose the proper immunization strategy of influenza vaccine in China.

Vaccination is the best intervention to prevent influenza and its complications. Effective influenza immunization strategy facilitates influenza vaccine coverage to protect the population and reduce disease burden. This paper analyzes related influenza policies from six countries with high vaccination rates and summarizes five common key elements of them. Additionally, we propose the proper immunization strategy of influenza vaccine in China.

Objective To evaluate the cost?effectiveness of seasonal influenza vaccination, compared to no vaccination, for the elderly aged ≥60 years old in China. Methods A static life?time Markov model is conducted to simulate the Chinese elderly population aged≥60 years old. Taking the health care system perspective, one?year analytic cycle length is used for each influenza season. The model was assumed to be repeated until the individual reaches 100 years old. Three interventions were evaluated, including no vaccination, annual trivalent influenza vaccination, and annual quadrivalent influenza vaccination. Using the threshold of 3 times GDP per capita per Quality?adjusted life year (QALY) (193 932/QALY), the incremental cost?effectiveness ratio (ICER) was calculated to compare the cost?effectiveness of every two interventions.Model inputs like data for costs and utilities were from studies on Chinese population if they were available. QALY was used to measure health utility. One?way sensitivity analysis and probabilistic sensitivity analysis were adopted to quantify the level of confidence of the model output. Results The total influenza associated costs of no vaccination would be 603 CNY per person, while the total costs of annual trivalent vaccination would be 1 027 CNY. Using trivalent vaccine would result in 0.007 QALY gained per person compared to no vaccination, with an increased cost of 424 CNY per person. The ICER of trivalent vaccination over no vaccination for all the elderly population in China would be 64 026 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. The total costs of annual quadrivalent vaccination would be 1 988 CNY. Using quadrivalent vaccine would result in 0.008 additional QALY gained per person compared to no vaccination, with an increased cost of 1 385 CNY per person. The ICER of quadrivalent vaccination over no vaccination would be 174 081 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. Conclusion Vaccinating elderly population would improve health utilities at higher health care costs for the elderly. Using the threshold of 3 times GDP per capita per QALY (193 932/QALY), both trivalent and quadrivalent vaccination would be cost?effective compared to no vaccination in elderly Chinese population.

Objective To evaluate the cost?effectiveness of seasonal influenza vaccination, compared to no vaccination, for the elderly aged ≥60 years old in China. Methods A static life?time Markov model is conducted to simulate the Chinese elderly population aged≥60 years old. Taking the health care system perspective, one?year analytic cycle length is used for each influenza season. The model was assumed to be repeated until the individual reaches 100 years old. Three interventions were evaluated, including no vaccination, annual trivalent influenza vaccination, and annual quadrivalent influenza vaccination. Using the threshold of 3 times GDP per capita per Quality?adjusted life year (QALY) (193 932/QALY), the incremental cost?effectiveness ratio (ICER) was calculated to compare the cost?effectiveness of every two interventions.Model inputs like data for costs and utilities were from studies on Chinese population if they were available. QALY was used to measure health utility. One?way sensitivity analysis and probabilistic sensitivity analysis were adopted to quantify the level of confidence of the model output. Results The total influenza associated costs of no vaccination would be 603 CNY per person, while the total costs of annual trivalent vaccination would be 1 027 CNY. Using trivalent vaccine would result in 0.007 QALY gained per person compared to no vaccination, with an increased cost of 424 CNY per person. The ICER of trivalent vaccination over no vaccination for all the elderly population in China would be 64 026 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. The total costs of annual quadrivalent vaccination would be 1 988 CNY. Using quadrivalent vaccine would result in 0.008 additional QALY gained per person compared to no vaccination, with an increased cost of 1 385 CNY per person. The ICER of quadrivalent vaccination over no vaccination would be 174 081 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. Conclusion Vaccinating elderly population would improve health utilities at higher health care costs for the elderly. Using the threshold of 3 times GDP per capita per QALY (193 932/QALY), both trivalent and quadrivalent vaccination would be cost?effective compared to no vaccination in elderly Chinese population.

Objective To estimate the indirect economic burden of disease-related premature deaths in China,2012.Methods Both human capital approach and friction cost methods were used to compute the indirect economic burden of premature deaths from the following sources:mortality from the national disease surveillance system in 2012,average annual income per capita from the China Statistic Yearbook in 2012,population size from the 2010 China census,and life expectancy in China from the World Health Organization life table.Results Data from the Human Capital Approach Estimates showed that the indirect economic burden of premature deaths in China was 425.1 billion in 2012,accounting for 8‰ of the GDP.The indirect economic burden of chronic non-communicable diseases associated premature deaths was accounted for the highest proportion (67.1％,295.4 billion),followed by those of injuries related premature deaths (25.6％,108.9 billion),infectious diseases,maternal and infants diseases,and malnutrition related deaths (6.4％,26.9 billion).The top five premature deaths that cause the indirect economic burden were malignancy,cardiovascular diseases,unintentional injuries,intentional injuries,and diseases of the respiratory system.The indirect economic burden of premature deaths mainly occurred in the population of 20-59 year-olds.Under the Friction Cost method,the estimates appeared to be 0.11％-3.49％ of the total human capital approach estimates.Conclusion Premature death caused heavy indirect economic burden in China.Chronic non-communicable diseases and injuries seemed to incur the major disease burden.The indirect economic burden of premature deaths mainly occurred in the working age group.

The annual deaths associated with influenza is estimated to be between 290 000 and 650 000,which caused substantial burden to the society.Children have the highest incidence of influenza among all age groups,which can cause overloaded medical visits and a significant increase of hospitalization risk.The severe economic burden includes not only the direct medical costs due to outpatients and hospitalization,but also the indirect burden of school absence of children and work absence of their family members.Annual vaccination is the best measure to prevent influenza,however,influenza vaccination coverage among children in China is very low,and influenza vaccination has not yet been included in the National Immunization Program.Now,the disease burden of influenza and the vaccine usage in children in China were reviewed,and in order to provide evidence for influenza control and prevention.

Objective: To understand characteristics of demographic, seasonal and spatial distribution of H5N1 cases in major countries of Asia (Indonesia, Cambodia, Vietnam, China) and Africa (Egypt). Methods: Through searching public data resource and published papers, we collected cases information in five countries from May 1st, 1997 to November 6th, 2017, including general characteristics, diagnosis, onset and exposure history, etc. Different characteristics of survived and death cases in different countries were described and χ² test was used to compare the differences among death cases and odds ratio (OR) and 95%CI value was used to compare death risk in different countries. Results: A total of 856 cases were reported in five countries with Egypt had the most cases (44.3%). The highest number of cases were reported in 2015 (18.3%). 53% cases were reported from January to March, and 96.1% of cases had the history of poultry exposure. 64.2% (43 cases) cases in China had live poultry market exposure, but the sick/dead poultry exposure was the major exposure for cases in other four countries. 452 death cases were reported in five countries, and the fatality rate was 52.8%. With Egypt as the reference group, the highest death risk was seen in Indonesia (OR (95%CI): 11.52 (7.46-17.77)), followed by Cambodia (OR (95%CI): 4.27(2.37-7.69)) and China (OR (95%CI): 2.87 (1.73-4.74)). The age distribution of death cases among 5 countries was statistically significant, and the highest fatality rate was in 15-54 years group in Egypt (83.6%, 102 cases), while in Cambodia the highest fatality rate was in 0-14 years group (76.9%, 30 cases). The highest number of deaths were reported in 2006, and 48.3% were reported from January to March. There was difference in exposure routes among 5 countries (χ²=43.85, P=0.001), 63.2% (24 cases) of the death cases in China had live poultry market exposure. 92.9% (79 cases), 83.3% (40 cases) and 100.0% (38 cases) death cases in Indonesia, Vietnam and Camodia had sick/dead poultry exposure, respectively;and 81.6% (31 cases) of the death cases in Egypt had backyard poultry exposure. Conclusion The geographical distribution, seasonal age, gender, exposure matter and outcome of H5N1 cases in five countries were different.

Health care workers have higher risk of influenza infection because of their occupational exposure to infected patients. Infection of the health care workers may not only result in the increasing risk of the nosocomial infection and family transmission, but also disrupt the health services due to absence from work. Health care workers were recommended as a priority group of influenza vaccinationin more than 40 countries and regions in the world. In recent years, domestic surveys show that the influenza vaccine coverage among health care workers was low. This paper outlines the current status and related policies of influenza vaccination among health care workers in China and global. Additionally, we analyzed and discussed the proper immunization strategy of influenza vaccine for medical staff in China.