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The following is a summary of “Critical assessment of uncertainty in economic evaluations on influenza vaccines for the elderly population in Spain,” published in the February 2025 issue of Infectious Disease by Leonardo et al.
Influenza mainly impacts older adults (OAs) morbidity and mortality, making vaccination crucial. The recent introduction of new influenza vaccines in Spain has prompted several cost-effectiveness analyses (CEA) to notify healthcare decisions.
Researchers conducted a retrospective study to evaluate potential sources of uncertainty in the CEAs for OAs, of the influenza vaccines in Spain.
They reviewed Spanish CEAs published in 2016. The TRansparent Uncertainty ASsessmenT (TRUST) Tool, quality assessment checklists, and WHO guidance on economic evaluations of influenza vaccine strategies were used to analyze potential sources of structural, methodological, and parametric uncertainty. The primary efficacy/effectiveness sources were examined to determine if they supported the conclusions of the CEAs.
The results showed 7 CEAs were included, and mostly followed the applicable guidelines, several critical sources of uncertainty were identified, including the selection of efficacy/effectiveness data from real-world single-season studies, meta-analyses with high bias risk and/or heterogeneity, and biased interpretation; the use of fewer than 5 seasons to estimate influenza burden; and the generalized use of influenza-like illness data to estimate effectiveness and burden.
Investigators concluded that even well-designed studies could conceal critical uncertainties that impact the results, which must be considered when interpreting findings for decision-making.
Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-10442-3
