Vaccinate under-65s to save lives and money

The NSW Productivity Commission says an additional two million vaccines would save 500 lives and $1.3 billion.

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Vaccinating just over half of NSW residents aged under 65 years against influenza would achieve herd immunity across the state and could save around 500 lives, according to the NSW Productivity Commission. 

The Commission’s latest report into boosting flu vaccine uptake in NSW, released today, found that increasing vaccination rates among under 65s from 25% to 55% would also provide between $500 million and $1.3 billion every year in gross economic benefits.  

If herd immunity were to be reached, every additional person under 65 who got vaccinated could deliver between $210 to $600 worth of economic benefits, according to the report.  

Robert Booy, professor of paediatrics and child health at the University of Sydney, welcomed the findings, saying that the target of 55% coverage among those under 65 was a “realistic goal”. 

“If they were wanting to get to 80% or 90%, that wouldn’t be feasible,” Professor Booy told Health Services Daily. 

“If you can increase the proportion of people vaccinated to over 50%, you may well have a major impact on transmission of flu viral infections in the community.” 

According to Professor Booy, introducing public health campaigns offering free flu vaccination in April or May rather than June or July would help boost vaccination rates and prevent widespread outbreaks. 

Offering free vaccination in schools and rolling out needle-free vaccine patches, such as those currently being developed by biotech company Vaxxas, were other strategies NSW government could consider, Professor Booy said. 

“We already give free vaccination to children in high school against meningococcal, HPV and DCP, so extending it to children in primary school and the start of winter in secondary school could be a cost-effective way of getting more people vaccinated at a reasonable price,” he said. 

“We’ve [also] had a number of occasions in the last few years when flu vaccination has suddenly been made free in June or July, after being available for the previous three or four months.  

“The government would do well to take up routine vaccination for more people and provide it at an earlier stage because then it would have a stronger impact on preventing outbreaks and transmission.” 

Expanding the number of health professionals eligible to give the vaccine would substantially reduce the cost of delivering the additional two million vaccines needed to achieve herd immunity, the report’s authors said. 

In mass vaccination settings, an additional two million vaccines would cost around $81 million or $40 per person, compared to the $156 million needed to deliver the same number of vaccines in GP settings. 

According to AMA NSW President Dr Michael Bonning, the NSW government needed to consider increasing funding for primary care nurses to offer incidental vaccination and adopting strategies such as pop-up clinics to increase vaccine coverage. 

“Providing co-ordinated care benefits everyone. It’s more convenient for patients and ensures they get the care they need,” he said. 

“We also call for greater steps to improve the delivery of vaccination to vulnerable residents as well as those with a disability. Vaccination rates for people with a disability are critically low. 

“While the current NSW Health strategy acknowledges issues with delivery to these groups, further funding and support is urgently required to ensure equal access.”   

Commonwealth and state governments also needed to collaborate more closely to address influenza and vaccination rates at a national level, given that the flu presented a “national health challenge”, the report authors said.    

Recommended strategies for managing influenza at a national level included developing a more precise national target for vaccine coverage, using local infectious disease modelling to construct a national economic model for vaccination costs, and undertaking more detailed analysis on potential policy options to increase vaccine uptake. 

NSW residents lose up to 4000 healthy life years each year from influenza, with more than 100,000 GP consultations and 7000 hospitalisations reported on average during each flu season, according to the report. 

Researchers primarily used overseas data as the basis for the report’s cost estimations, particularly from jurisdictions such as Ontario in Canada where flu vaccination has been free for all residents since 2000.    

Around 88,000 influenza cases confirmed via PCR have been reported in NSW this year, with more than 116,000 recorded in 2022, according to NSW Health.  

The Commission’s report, Boosting the NSW influenza vaccination rate, can be viewed in full here.