The optimal strategy for seasonal influenza vaccination to prevent high-intensity level of influenza epidemics in Zhejiang, China: an integrated transmission-dynamic and health-economic modeling analysis

Abstract Background Although Seasonal Influenza Vaccination (SIV) is a crucial preventive measure, achieving sufficient coverage to completely control influenza epidemics poses a significant challenge. This study aims to evaluate optimal strategies for SIV to prevent high-intensity level of influenz...

Full description

Saved in:
Bibliographic Details
Main Authors: Mengsha Chen, Mengya Yang, Rui Yan, Zhengwei Liu, Can Chen, Rongrong Qu, Wenkai Zhou, Jiaxing Qi, Kexin Cao, Jiani Miao, Xiaoyue Wu, Jiaxin Chen, Qianqian Feng, HuiHui Zhang, Anqi Dai, Yi Yang, Jingtong Zhou, Qin Chen, Jimin Sun, Shigui Yang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-025-23648-6
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849388789947957248
author Mengsha Chen
Mengya Yang
Rui Yan
Zhengwei Liu
Can Chen
Rongrong Qu
Wenkai Zhou
Jiaxing Qi
Kexin Cao
Jiani Miao
Xiaoyue Wu
Jiaxin Chen
Qianqian Feng
HuiHui Zhang
Anqi Dai
Yi Yang
Jingtong Zhou
Qin Chen
Jimin Sun
Shigui Yang
author_facet Mengsha Chen
Mengya Yang
Rui Yan
Zhengwei Liu
Can Chen
Rongrong Qu
Wenkai Zhou
Jiaxing Qi
Kexin Cao
Jiani Miao
Xiaoyue Wu
Jiaxin Chen
Qianqian Feng
HuiHui Zhang
Anqi Dai
Yi Yang
Jingtong Zhou
Qin Chen
Jimin Sun
Shigui Yang
author_sort Mengsha Chen
collection DOAJ
description Abstract Background Although Seasonal Influenza Vaccination (SIV) is a crucial preventive measure, achieving sufficient coverage to completely control influenza epidemics poses a significant challenge. This study aims to evaluate optimal strategies for SIV to prevent high-intensity level of influenza epidemics in Zhejiang Province, China. High-intensity outbreaks were defined as weekly incidence rates above 72.2 per 100,000. Methods This study estimated the incidence of influenza from 2018 to 2023 in Zhejiang Province, China, using influenza weekly surveillance data. We developed a Susceptible-Vaccinated-Infectious-Recovered-Susceptible (SVIRS) model to simulate influenza transmission and used a decision tree to assess seven vaccination strategies aimed at preventing high-intensity influenza outbreaks. These strategies differed in vaccine coverage across the three age groups: 0–14 years, 15–59 years, and 60 + years, despite having the same overall vaccination coverage. Results Between 2018 and 2020, influenza incidence in Zhejiang Province followed typical seasonal patterns. However, during the COVID-19 pandemic, these patterns became irregular, culminating in a high-intensity influenza season in 2022–2023. Model simulations indicated that increasing population-wide vaccination coverage to 36.17% could effectively prevent outbreaks from escalating to high-intensity levels. Among various allocation strategies for additional vaccines, targeting individuals aged 0–14 years and those aged 60 years and older was found to be the most effective. This approach reduced the peak weekly incidence rate from the observed 182.83 to a predicted 42.28 per 100,000, saved 23.45 CNY per capita, and yielded a health gain of 0.0102 quality-adjusted life days (QALDs) per person. Conclusion Achieving a population-wide vaccination coverage beyond 36.17% is projected to prevent high-intensity level of influenza epidemics. Targeting the 0–14 years and 60 + years age groups proves to be the most cost-effective strategy under constrained coverage conditions. These findings highlight the importance of age-prioritized vaccination policies to optimize resource allocation and mitigate the impact of influenza outbreaks, particularly in regions with limited healthcare capacity.
format Article
id doaj-art-4e29541cda0144b08c7748eddb948557
institution Kabale University
issn 1471-2458
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj-art-4e29541cda0144b08c7748eddb9485572025-08-20T03:42:10ZengBMCBMC Public Health1471-24582025-07-0125111010.1186/s12889-025-23648-6The optimal strategy for seasonal influenza vaccination to prevent high-intensity level of influenza epidemics in Zhejiang, China: an integrated transmission-dynamic and health-economic modeling analysisMengsha Chen0Mengya Yang1Rui Yan2Zhengwei Liu3Can Chen4Rongrong Qu5Wenkai Zhou6Jiaxing Qi7Kexin Cao8Jiani Miao9Xiaoyue Wu10Jiaxin Chen11Qianqian Feng12HuiHui Zhang13Anqi Dai14Yi Yang15Jingtong Zhou16Qin Chen17Jimin Sun18Shigui Yang19Department of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineQuzhou People’s HospitalDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Public HealthDepartment of Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and PreventionDepartment of Emergency Medicine, Second Affiliated Hospital, Department of Epidemiology and Biostatistics, School of Public Health, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineAbstract Background Although Seasonal Influenza Vaccination (SIV) is a crucial preventive measure, achieving sufficient coverage to completely control influenza epidemics poses a significant challenge. This study aims to evaluate optimal strategies for SIV to prevent high-intensity level of influenza epidemics in Zhejiang Province, China. High-intensity outbreaks were defined as weekly incidence rates above 72.2 per 100,000. Methods This study estimated the incidence of influenza from 2018 to 2023 in Zhejiang Province, China, using influenza weekly surveillance data. We developed a Susceptible-Vaccinated-Infectious-Recovered-Susceptible (SVIRS) model to simulate influenza transmission and used a decision tree to assess seven vaccination strategies aimed at preventing high-intensity influenza outbreaks. These strategies differed in vaccine coverage across the three age groups: 0–14 years, 15–59 years, and 60 + years, despite having the same overall vaccination coverage. Results Between 2018 and 2020, influenza incidence in Zhejiang Province followed typical seasonal patterns. However, during the COVID-19 pandemic, these patterns became irregular, culminating in a high-intensity influenza season in 2022–2023. Model simulations indicated that increasing population-wide vaccination coverage to 36.17% could effectively prevent outbreaks from escalating to high-intensity levels. Among various allocation strategies for additional vaccines, targeting individuals aged 0–14 years and those aged 60 years and older was found to be the most effective. This approach reduced the peak weekly incidence rate from the observed 182.83 to a predicted 42.28 per 100,000, saved 23.45 CNY per capita, and yielded a health gain of 0.0102 quality-adjusted life days (QALDs) per person. Conclusion Achieving a population-wide vaccination coverage beyond 36.17% is projected to prevent high-intensity level of influenza epidemics. Targeting the 0–14 years and 60 + years age groups proves to be the most cost-effective strategy under constrained coverage conditions. These findings highlight the importance of age-prioritized vaccination policies to optimize resource allocation and mitigate the impact of influenza outbreaks, particularly in regions with limited healthcare capacity.https://doi.org/10.1186/s12889-025-23648-6Seasonal influenza vaccinationSusceptible-vaccinated-infectious-recovered-susceptible modelDecision treeOptimal vaccination strategy
spellingShingle Mengsha Chen
Mengya Yang
Rui Yan
Zhengwei Liu
Can Chen
Rongrong Qu
Wenkai Zhou
Jiaxing Qi
Kexin Cao
Jiani Miao
Xiaoyue Wu
Jiaxin Chen
Qianqian Feng
HuiHui Zhang
Anqi Dai
Yi Yang
Jingtong Zhou
Qin Chen
Jimin Sun
Shigui Yang
The optimal strategy for seasonal influenza vaccination to prevent high-intensity level of influenza epidemics in Zhejiang, China: an integrated transmission-dynamic and health-economic modeling analysis
BMC Public Health
Seasonal influenza vaccination
Susceptible-vaccinated-infectious-recovered-susceptible model
Decision tree
Optimal vaccination strategy
title The optimal strategy for seasonal influenza vaccination to prevent high-intensity level of influenza epidemics in Zhejiang, China: an integrated transmission-dynamic and health-economic modeling analysis
title_full The optimal strategy for seasonal influenza vaccination to prevent high-intensity level of influenza epidemics in Zhejiang, China: an integrated transmission-dynamic and health-economic modeling analysis
title_fullStr The optimal strategy for seasonal influenza vaccination to prevent high-intensity level of influenza epidemics in Zhejiang, China: an integrated transmission-dynamic and health-economic modeling analysis
title_full_unstemmed The optimal strategy for seasonal influenza vaccination to prevent high-intensity level of influenza epidemics in Zhejiang, China: an integrated transmission-dynamic and health-economic modeling analysis
title_short The optimal strategy for seasonal influenza vaccination to prevent high-intensity level of influenza epidemics in Zhejiang, China: an integrated transmission-dynamic and health-economic modeling analysis
title_sort optimal strategy for seasonal influenza vaccination to prevent high intensity level of influenza epidemics in zhejiang china an integrated transmission dynamic and health economic modeling analysis
topic Seasonal influenza vaccination
Susceptible-vaccinated-infectious-recovered-susceptible model
Decision tree
Optimal vaccination strategy
url https://doi.org/10.1186/s12889-025-23648-6
work_keys_str_mv AT mengshachen theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT mengyayang theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT ruiyan theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT zhengweiliu theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT canchen theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT rongrongqu theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT wenkaizhou theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jiaxingqi theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT kexincao theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jianimiao theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT xiaoyuewu theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jiaxinchen theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT qianqianfeng theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT huihuizhang theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT anqidai theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT yiyang theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jingtongzhou theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT qinchen theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jiminsun theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT shiguiyang theoptimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT mengshachen optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT mengyayang optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT ruiyan optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT zhengweiliu optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT canchen optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT rongrongqu optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT wenkaizhou optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jiaxingqi optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT kexincao optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jianimiao optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT xiaoyuewu optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jiaxinchen optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT qianqianfeng optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT huihuizhang optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT anqidai optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT yiyang optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jingtongzhou optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT qinchen optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT jiminsun optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis
AT shiguiyang optimalstrategyforseasonalinfluenzavaccinationtopreventhighintensitylevelofinfluenzaepidemicsinzhejiangchinaanintegratedtransmissiondynamicandhealtheconomicmodelinganalysis