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The Comparative Value of Various Employer-Sponsored Influenza Vaccination Clinics

Zimmerman, Richard K. MD, MPH; Wiringa, Ann E. MPH; Nowalk, Mary Patricia PhD; Lin, Chyongchiou J. PhD; Rousculp, Matthew D. PhD, MPH; Mitgang, Elizabeth A.; Lee, Bruce Y. MD, MBA

Journal of Occupational and Environmental Medicine: September 2012 - Volume 54 - Issue 9 - p 1107–1117
doi: 10.1097/JOM.0b013e3182677d34
Original Articles

Objective: Many US firms offer influenza vaccination clinics to prevent lost productivity due to influenza. Strategies to promote and offer vaccination differ, and the economic value of the strategies is unknown.

Methods: Decision analytic modeling and Monte Carlo probabilistic sensitivity analyses estimated the one-season cost-consequences of three types of influenza clinics (trivalent inactivated influenza vaccine only, vaccine choice [trivalent inactivated influenza or intranasal {live attenuated influenza} vaccine], or vaccine choice plus incentive) in firms of 50 and 250 employees, from the employer's perspective.

Results: On-site influenza vaccination was generally cost-saving over no vaccination. For the scenario of vaccine effectiveness of 70% and intermediate transmissibility, the incremental costs per employee for a firm of 50 employees were −$6.41 (ie, cost savings) for inactivated vaccine only versus no vaccination, −$1.48 for vaccine choice versus inactivated vaccine, and $1.84 for vaccine choice plus incentive versus vaccine choice. Clinics offering a choice of vaccines were slightly less costly under many scenarios. Generally, incremental costs were lower (1) in larger firms; (2) when influenza was assumed to be more contagious; and (3) when vaccine effectiveness was assumed to be higher.

Conclusion: Employer-sponsored influenza vaccination clinics are generally cost-saving.

From the Department of Family Medicine (Drs Zimmerman, Nowalk, and Lin), University of Pittsburgh, Pittsburgh, PA; Public Health Computational and Operations Research (PHICOR) (Ms Wiringa, Ms Mitgang, and Dr Lee), University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, PA; and MedImmune, LLC (Dr Rousculp), Gaithersburg, MD.

Address correspondence to: Mary Patricia Nowalk, PhD, RD, 3518 Fifth Ave, Pittsburgh, PA 15213 (

This study was sponsored by MedImmune, LLC.

Conflicts of Interest: University of Pittsburgh Department of Family Medicine (RKZ, MPN, and CJL): MedImmune, LLC (RKZ, MPN, CJL); Sanofi (RKZ, CJL), Investigator Initiated Research grant; and Merck (RKZ, MPN, CJL) Investigator Initiated Research grant. University of Pittsburgh Public Health Computational and Operations Research (AEW, EAM, and BYL): MedImmune, LLC. Dr Rousculp was a MedImmune employee at the time of this study.

Copyright © 2012 by the American College of Occupational and Environmental Medicine