{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T21:58:40Z","timestamp":1767909520874,"version":"3.49.0"},"reference-count":108,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>(1) Background: Vaccines for seasonal influenza are a good preventive and cost-effective strategy. However, it is unknown if and how these economic evaluations include the adverse events following immunization (AEFI), and what the impact of such inclusion is on the health economic outcomes. (2) Methods: We searched the literature, up to January 2020, to identify economic evaluations of seasonal influenza vaccines that considered AEFIs. The review protocol was published in PROSPERO (CDR42017058523). (3) Results: A total of 52 economic evaluations considered AEFI-related parameters in their analyses, reflecting 16% of the economic evaluations on seasonal influenza vaccines in the initial study selection. Most studies used the societal perspective (64%) and evaluated vaccination of children (37%). Where considered, studies included direct medical costs of AEFIs (90%), indirect costs (27%), and disutilities\/quality-adjusted life years loss due to AEFIs (37%). The majority of these studies accounted for the effects of the costs of AEFI on cost-effectiveness for Guillain\u2013Barr\u00e9 syndrome. In those papers allowing cost share estimation, direct medical cost of AFEIs was less than 2% of total direct costs. (4) Conclusions: Although the overall impact of AEFIs on the cost-effectiveness outcomes was found to be low, we urge their inclusion in economic evaluations of seasonal influenza vaccines to reflect comprehensive reports for the decision makers and end-users of the vaccination strategies.<\/jats:p>","DOI":"10.3390\/vaccines9020111","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T13:01:12Z","timestamp":1612270872000},"page":"111","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Inclusion of Safety-Related Issues in Economic Evaluations for Seasonal Influenza Vaccines: A Systematic Review"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3995-447X","authenticated-orcid":false,"given":"Tanja","family":"Fens","sequence":"first","affiliation":[{"name":"Department of PharmacoTherapy, Epidemiology &amp; -Economics (PTE2), Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands"},{"name":"Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pieter T.","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of PharmacoTherapy, Epidemiology &amp; -Economics (PTE2), Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eug\u00e8ne P.","family":"van Puijenbroek","sequence":"additional","affiliation":[{"name":"Department of PharmacoTherapy, Epidemiology &amp; -Economics (PTE2), Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands"},{"name":"Netherlands Pharmacovigilance Centre Lareb, 5237 MH \u2019s-Hertogenbosch, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten J.","family":"Postma","sequence":"additional","affiliation":[{"name":"Department of PharmacoTherapy, Epidemiology &amp; -Economics (PTE2), Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands"},{"name":"Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands"},{"name":"Department of Economics, Econometrics &amp; Finance, Faculty of Economics &amp; Business, University of Groningen, 9747 AE Groningen, The Netherlands"},{"name":"Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia"},{"name":"Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung 45363, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"key":"ref_1","unstructured":"WHO (2019, January 16). 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