Seasonal Flu Costs How Much?!

Developed by

Virginia R. Chapman, MAT

Tampa Preparatory School

Acknowledgements

This lesson plan was developed by teachers in consultation with subject matter experts from the

National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and

Prevention:

Health Economist

Scientific and editorial review was provided by Ralph Cordell, PhD and Kelly Cordeira, MPH from

Career Paths to Public Health, Division of Scientific Education and Professional Development, Center

for Surveillance, Epidemiology, and Laboratory Services, Office of Public Health Scientific Services,

Centers for Disease Control and Prevention.

Suggested citation

Centers for Disease Control and Prevention (CDC). Science Ambassador Workshop— Seasonal Flu

Costs How Much?!. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2015.

Available at: http://www.cdc.gov/scienceambassador/lesson-plans/.

Citation as to source, however, is appreciated.

Links to nonfederal organizations are provided solely as a service to our users. These links do

not constitute an endorsement of these organizations nor their programs by the Centers for

Disease Control and Prevention (CDC) or the federal government, and none should be

inferred. CDC is not responsible for the content contained at these sites. URL addresses listed

were current as of the date of publication.

Use of trade names and commercial sources is for identification only and does not imply

Contents

Summary ................................................................................................................................................. 1

Learning Outcomes ................................................................................................................................. 2

Duration .................................................................................................................................................. 3

Procedures ............................................................................................................................................... 3

Conclusions ............................................................................................................................................. 7

Educational Standards ............................................................................................................................. 9

Appendices: Supplementary Documents .............................................................................................. 11

illness are more likely than others to have severe

consequences of flu, even otherwise healthy persons can get

sick and spread it to others. During 31 flu seasons (1976–

2007) estimates of flu-associated annual deaths in the United

States range from a low of approximately 3,000 to a high of

approximately 49,000 persons dying from a condition

associated with flu each year.

Everyone aged 6 months and older should get a seasonal flu vaccination every year. This

recommendation has been in place since February 24, 2010, when CDC’s Advisory Committee on

Attenuation takes an infectious agent and alters it so it is viable (or live), but harmless or less virulent.

This lesson examines the economic effects associated with seasonal flu and vaccination decisions. It is

based on a study by the Centers for Disease Control and Prevention

, published in the journal Vaccine

,

that estimated an average dollar figure for visits to doctor’s offices and emergency departments (EDs)

to care for children while they recover. The study examined the experience of 282 children under the age

of 5 in 3 U.S. cities, and reported that parents had medical expenses ranging from approximately $300 to

The target grade level for this lesson is high school grades 9 or 10. Students need only basic prior

knowledge of influenza and vaccines, although the teacher can choose to provide prior instruction about

viruses and vaccinations.

CDC. Seasonal Flu. CDC. CDC. http://www.cdc.gov/flu/index.htm. Updated October 2, 2015. Accessed April 14, 2016.

Learning Outcomes

After completing this lesson, students should be able to

• Describe scientific, social, and economic considerations that affect the choice of intervention

• Mathematically analyze data to determine cost effectiveness of vaccination program options; and

• Construct an argument to make a decision about implementing a vaccination strategy by using

Procedures

Before Day 1,

• Print copies of Worksheet 1A: Seasonal Flu Costs How Much?! (Appendix 1A), one copy per

• Review Worksheet 1B: Seasonal Flu Costs How Much?! Guide (Appendix 1B).

• Review cdc.gov/flu/ about the flu for the first part of day one.

• Worksheet 1A: Seasonal Flu Costs How Much?! (Appendix 1A)

• Worksheet 1B: Seasonal Flu Costs How Much?! Guide (Appendix 1B)

Online Resources

Name: ___________________________________ Date: ________________

Directions: Read the information below about the flu and answer the questions when prompted.

Seasonal influenza is estimated to result in approximately 200,000 hospitalizations and 31 million

outpatient visits annually in the United States. Direct medical costs of influenza illness among U.S.

looked at medical costs, which can include the costs of diagnostic testing, medications, room fees and

supplies, and physician services. More recently, researchers have also considered influenza-related

indirect costs (e.g., time lost from work to care for children and take them to medical visits, time spent

in hospitals for parents of hospitalized children) and out-of-pocket expenses (e.g., copayments, over-the-

counter medication, and travel costs).

Question 2: How does your list in Question 1 compare with the items listed above? What other factors

might you consider when estimating these costs?

Let us pretend that you have flu-like symptoms. The flu virus can cause mild to severe illness and often

comes on suddenly. Symptoms include fever or feeling feverish, chills, cough, sore throat, runny or

stuffy nose, muscle or body aches, headaches, fatigue, and sometimes vomiting or diarrhea. The

majority of persons with the flu have mild illness. The majority of persons who get influenza will

symptoms are moderate or severe, or if you are at high risk for flu complications, you might need

professional medical care.

that medical care is necessary, consider what kind of medical care you would need.

Consider how much it might cost to have the flu depending on what type of medical care is sought out

by you and your parents and needed. Table 1 presents information on estimated costs associated with

influenza to parents of the patient (aged <18 years) with medical insurance. Costs are identified as

medical facility cost, parent time-cost (the value of time lost from work), and out-of-pocket expenses.

Doctor’s Visit

department visit

doctor visit

CDC recommends that everyone take time to get the flu vaccine, take everyday preventive actions to

stop the spread of germs, and take antiviral flu drugs, if the doctor prescribes them. CDC also

recommends that patients suspected of having influenza who are at high risk of flu complications or who

are very sick with flu-like illness should receive prompt treatment with influenza antiviral drugs without

waiting for confirmatory testing. (http://www.cdc.gov/flu/). Let’s focus on the prevention effectiveness

Prevention effectiveness, or public health economics, is based on the science of decision making.

Researchers can assess the influence of public health interventions (e.g., flu vaccine programs) on health

ability to produce a desired result in an ideal setting), effectiveness (i.e., the ability to produce a desired

result in a real-world setting), and cost (e.g., direct and indirect). It can also account for scientific,

economic, environmental, cultural, and political factors that influence the intervention.

By weighing these findings and considering trade-offs, informed decisions about the intervention can be

How well the flu vaccine works (or its ability to prevent flu illness) varies substantially from season to

season. The vaccine’s effectiveness also can be different depending on who is being vaccinated. At least

two factors play an important role in determining the likelihood that flu vaccine will protect a person

from flu illness, including (1) characteristics of the person being vaccinated (e.g., age and health), and

(2) the similarity or match between the predetermined flu viruses the flu vaccine is designed to protect

Two general types of studies are used to determine how well influenza vaccines work: randomized

decisions about whether or not to be vaccinated. In this type of study, vaccine effectiveness is measured

by comparing the frequency of influenza illness between the vaccinated and unvaccinated groups.

Researchers usually perform mathematical calculations to adjust for factors to make sure the groups with

and without the vaccine are as similar as possible with regards to other things that might affect if they

have flu or its severity. (http://www.cdc.gov/flu/professionals/vaccination/effectivenessqa.htm)

Question 8. In your own words, explain the difference between vaccine efficacy and vaccine

looked at medical costs, which can include the costs of diagnostic testing, medications, room fees and

supplies, and physician services. More recently, researchers have also considered influenza-related

indirect costs (e.g., time lost from work to care for children and take them to medical visits, time spent

in hospitals for parents of hospitalized children) and out-of-pocket expenses (e.g., copayments, over-the-

counter medication, and travel costs).

Question 2: How does your list in Question 1 compare with the items listed above? What other factors

might you consider when estimating these costs?

Note: As a class, ask students to consider what they came up with, compared with what studies have

used to estimate costs. Ask student volunteers what other factors they might consider when estimating

costs. Use this as an opportunity to indicate that the symptoms’ severity might influence cost indirectly.

Answer: Answers will vary. Students will want to consider symptoms’ severity.

Let us pretend that you have flu-like symptoms. The flu virus can cause mild to severe illness and often

comes on suddenly. Symptoms include fever or feeling feverish, chills, cough, sore throat, runny or

stuffy nose, muscle or body aches, headaches, fatigue, and sometimes vomiting or diarrhea. The

the duration of the flu, and those who take them usually do not need further medical care. However, if

symptoms are moderate or severe, or if you are at high risk for flu complications, you might need

professional medical care.

Directions: Read the information below about the flu and answer the questions when prompted.

Consider how much it might cost to have the flu depending on what type of medical care is sought out

by you and your parents and needed. Table 1 presents information on estimated costs associated with

influenza to parents of the patient (aged <18 years) with medical insurance. Costs are identified as

Table 1: Economic costs of influenza per family of sick student