The current national influenza vaccination schedule in Mexico does not recommend vaccination in the school-aged population (5–11 years). Currently, there are limited data from middle-income countries analysing the cost-effectiveness of influenza vaccination in this population. We explored the clinical effects and economic benefits of expanding the current national influenza vaccination schedule in Mexico to include the school-aged population. A static 1-year model incorporating herd effect was used to assess the cost-effectiveness of expanding the current national influenza vaccination schedule of Mexico to include the school-aged population. We performed a cross-sectional epidemiological study using influenza records (2009–2018), death records (2010–2015), and discharge and hospitalisation records (2010–2016), from the databases of Mexico’s Influenza Surveillance System (SISVEFLU), the National Mortality Epidemiological and Statistical System (SEED), and the Automated Hospital Discharge System (SAEH), respectively. Cost estimates for influenza cases were based on 7 scenarios using data analysed from SISVEFLU; assumptions for clinical management of cases were defined according to Mexico’s national clinical guidelines. The primary health outcome for this study was the number of influenza cases avoided. A sensitivity analysis was performed using conservative and optimistic parameters (vaccination coverage: 30% / 70%, Vaccine effectiveness: 19% / 68%). It was estimated that expanding the influenza immunisation programme to cover school-aged population in Mexico over the 2018–2019 influenza season would result in 671,461 cases of influenza avoided (50% coverage and 50% effectiveness assumed). Associated with this were 262,800 fewer outpatient consultations; 154,100 fewer emergency room consultations; 97,600 fewer hospitalisations, and 15 fewer deaths. Analysis of cases avoided by age-group showed that 55.4% of them were in the school-aged population, and the decrease in outpatient consultations was largest in this population. There was an overall decrease in the economic burden for the Mexican health care system of 111.9 million US dollars; the immunization programme was determined to be cost-saving in the base, conservative and optimistic scenarios. Vaccinating school-aged population in Mexico would be cost-effective; expansion of the current national vaccination schedule to this age group is supported.

中文翻译：

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墨西哥学龄人口中的流感：疾病负担和儿童疫苗接种的成本效益。

墨西哥目前的国家流感疫苗接种计划不建议学龄人群（5-11 岁）接种疫苗。目前，中等收入国家分析该人群流感疫苗接种成本效益的数据有限。我们探讨了将墨西哥当前的全国流感疫苗接种计划扩大到包括学龄人口的临床效果和经济效益。使用包含群体效应的静态一年模型来评估将墨西哥当前的全国流感疫苗接种计划扩大到包括学龄人口的成本效益。我们使用墨西哥流感监测系统 (SISVEFLU)、国家流感监测中心数据库中的流感记录（2009-2018 年）、死亡记录（2010-2015 年）以及出院和住院记录（2010-2016 年）进行了一项横断面流行病学研究。分别是死亡率流行病学和统计系统 (SEED) 和自动出院系统 (SAEH)。流感病例的成本估算是基于使用 SISVEFLU 分析数据的 7 种情景；病例临床管理的假设是根据墨西哥国家临床指南定义的。本研究的主要健康结果是避免的流感病例数。使用保守和乐观参数进行敏感性分析（疫苗覆盖率：30%/70%，疫苗有效性：19%/68%）。据估计，在 2018-2019 年流感季节，将流感免疫计划扩大到覆盖墨西哥学龄人口，将避免 671,461 例流感病例（假设覆盖率 50%，有效性 50%）。与此相关的是门诊量减少了 262,800 人次；急诊室就诊次数减少 154,100 次；住院人数减少 97,600 人，死亡人数减少 15 人。按年龄组避免的病例分析显示，其中55.4%为学龄人群，该人群门诊量下降幅度最大。墨西哥医疗保健系统经济负担总体减少1.119亿美元；免疫接种计划在基本、保守和乐观情景下被确定为节省成本。在墨西哥为学龄人口接种疫苗具有成本效益；支持将当前的国家疫苗接种计划扩大到该年龄组。