Effectiveness and costs associated with pH1N1 vaccination by age and risk status (inactivated vaccine).

LR  =  lower-risk; HR  =  higher-risk.1
1Individuals were defined to be at higher risk for influenza-related complications due to underlying medical conditions, which include chronic pulmonary and significant cardiac conditions and other recognized high-risk conditions.[6]
2Total vaccination costs include the cost for the vaccine (1 dose for persons aged 10 years or older and 2 doses for children aged 6 months to 9 years), administration costs, and time costs as appropriate. Cost of the vaccine dose was based on the contracts negotiated by the Biomedical Advanced Research and Development Authority for pH1N1 vaccine in 2009 (average cost: $8.60 per dose). Administration costs are assumed to be $11.30 per dose in a mass vaccination and either $13.71 for administration during an existing visit to a clinician in a physician office setting or $20.92 for administration during an extra physician office setting visit based on Medicare payment rates.[33] For vaccination cost estimates in the mass vaccination setting, (travel and vaccination) time costs included 12 minutes for waiting and vaccination time[13] at the clinic and 30 minutes of travel time for all adult age groups and for age groups less than 5 years to account for parent time costs. Children 5–17 years in the mass vaccination setting are assumed to be vaccinated in a school setting and therefore no parent time costs were included.
3Assumes a mix of mass vaccination and physician office. For the mixed setting, the proportion of persons vaccinated in a mass vaccination setting vs. a physician's office was varied by age. Time costs are always included for parents of children younger than 5 years of age assuming that a parent will need to be present for vaccination of young children in any setting. See supporting information for additional details.
4For the physician office setting, the proportion of persons needing one vs. two extra physician visits to accommodate vaccination was varied by age. Time costs were included for parents of children <18 and for adults for each extra visit required for vaccination. For the physician office setting, we include 60 minutes of time for travel, waiting, and vaccination time for either the vaccinee or the parent, which assumes a streamlined setting is used for vaccination.