A Systematic Review and Meta-Analysis of Health-State Utility Values for Infectious Diseases With Pandemic Potential and Associated Vaccine Adverse Reactions.

Abstract

Objectives: The COVID-19 pandemic and its vaccine deployment have illustrated the importance of estimating the disease burden of the pandemic and vaccine adverse reactions in a comparable fashion. The objective was to evaluate health-state utility value (HSUV) scores for infectious diseases with pandemic potential and associated vaccine adverse reactions.

Methods: We included studies from which we could extract a single HSUV associated with priority infectious diseases with pandemic potential or associated vaccine adverse reactions. We assessed risk of bias using the criteria recommended by National Institute for Health and Care Excellence. We conducted random-effects meta-analyses.

Results: We included 39 studies, and data synthesis was conducted for COVID-19, influenza, and dengue for infectious diseases and myocarditis and narcolepsy for vaccine adverse reactions. Response rates varied (2%-98%), whereas follow-up rates ranged from 68% to 100%. Twenty-four studies did not report how they handled missing data. Compared with control groups, COVID-19 (acute phase) and influenza (acute phase) had reduced EQ-5D scores: -0.11 (95% CI -0.14, -0.07) in COVID-19 and -0.50 (95% CI -0.60, -0.41) in influenza. For associated vaccine adverse reactions, the mean EQ-5D score for myocarditis and PedsQL score for narcolepsy were 0.88 (95% CI 0.76, 1.00) and 64.0 (95% CI 59.4, 68.7), respectively. No apparent asymmetry was observed in funnel plots.

Conclusions: This study provided HSUV scores for some infectious diseases with pandemic potential and associated vaccine adverse reactions. These results can be used as HSUV indicators for future health technology and cost-effectiveness assessments.