title: Economic evaluation of the vaccination program against seasonal and pandemic A/H1N1 influenza among customs officers in Greece.
abstract: BACKGROUND
  Health policies from many countries recommend influenza vaccination of "high-priority" professional groups, including customs officers. Our aim was to estimate the economic impact of the vaccination program against influenza among customs officers in Greece during the 2009/2010 period.
  
  
  METHODS
  We developed a decision analytical computational simulation model including dynamic transmission elements that estimated the economic impact of various scenarios with different attack rates, symptomatic percentages and vaccination participation among customs officers. We also assessed in real-time the economic impact of the national 2009/2010 campaign against seasonal and pandemic A/H1N1 influenza.
  
  
  RESULTS
  Implementing a seasonal and pandemic A/H1N1 influenza vaccination program among customs officers in Greece with a participation rate of 30%, influenza vaccination was not cost-saving in any of the studied influenza scenarios. When the participation rate reached 100%, the program was cost-saving, when the influenza attack rate was 30% and the symptomatic rate 65%. The real-time estimated mean net cost-benefit value in 2009/2010 period was -7.3 euros/custom officer.
  
  
  CONCLUSIONS
  With different clinical scenarios, providing a vaccination program against seasonal and pandemic A/H1N1 influenza can incur a substantial net benefit for customs offices. However, the size of the benefit strongly depends upon the attack rate of influenza, the symptomatic rate as well as the participation rate of the customs officers in the program.
authors.affiliation: Department of Virology, University of Crete School of Medicine, Heraklion, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Mamma
authors.forename: Demetrios A
authors.initials: DA
authors.lastname: Spandidos
mesh_terms: D000328:Adult; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006077:Government Agencies / Q000706:statistics & numerical data; D006115:Greece / Q000453:epidemiology; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D017589:Immunization Programs / Q000191:economics* / Q000706:statistics & numerical data; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000191:economics / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D009790:Occupations / Q000706:statistics & numerical data; D058873:Pandemics / Q000191:economics / Q000517:prevention & control*; D012621:Seasons