Research on the control of influenza has traditionally been conducted within the paradigm of epidemiology, with little involvement of economics. The purpose of this K25 grant proposal is to develop a didactic training and research program that will enable Dr. Byung-Kwang Yoo to become an independent investigator in economic epidemiology of vaccine-preventable diseases, particularly influenza. Economic epidemiology aims at offering unique insights to the current epidemiology-dominated paradigm through incorporating economic theory and econometric techniques. Dr. Yoo is particularly interested in two quantitative issues regarding influenza vaccination behavior: (i) how individual behavioral patterns respond to external factors such as limited vaccine supply and epidemic levels, and (ii) effects of such behavioral responses on the population-wide benefits of influenza vaccination programs. Trained as a health economist, Dr. Yoo has strong quantitative skills in addition to his background in clinical medicine and public health. The career development part of the K25 grant proposal will enable him to strengthen his quantitative skills in economics (e.g., dynamic modeling) and statistics (e.g., panel data analysis and computer simulation) as well as to gain more knowledge on child influenza vaccination and vaccine distribution/production systems.
The specific aims of this method research program are: 1) To develop a dynamic theoretical model for predicting influenza epidemics and individual influenza vaccination receipt and timing, emphasizing potential negative individual incentives incurred by the observations of (i) a lower epidemic level or (ii) a high population flu vaccination coverage level;2) To conduct empirical analyses among Medicare elderly (a) to examine the determinants of flu vaccination receipt and its timing, including vaccine supply delay/shortage, current and prior epidemic levels, mass media reports, travel time cost to a clinic, and reimbursement rates for health care providers, (b) to explore if vaccine shortage exacerbates health disparities in vaccination receipt and its timing (e.g., the later the worse), (c) to examine influenza vaccine effectiveness in reducing flu-related hospitalization and mortality, adjusting for self-selection bias, e.g., the sicker elderly are more likely to be vaccinated;3) To construct computer simulation models for predicting the population-wide benefits of influenza vaccination programs targeting all children and the non-elderly adult population.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Mentored Quantitative Research Career Development Award (K25)
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Microbiology and Infectious Diseases B Subcommittee (MID)
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Kim, Sonnie
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University of Rochester
Public Health & Prev Medicine
Schools of Dentistry
United States
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Yoo, Byung-Kwang; Humiston, Sharon G; Szilagyi, Peter G et al. (2013) Cost effectiveness analysis of elementary school-located vaccination against influenza--results from a randomized controlled trial. Vaccine 31:2156-64
Yoo, Byung-Kwang; Kasajima, Megumi; Phelps, Charles E et al. (2011) Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly. Am J Prev Med 40:1-10
Yoo, Byung Kwang (2011) How to improve influenza vaccination rates in the U.S. J Prev Med Public Health 44:141-8
Yoo, Byung-Kwang; Holland, Margaret L; Bhattacharya, Jay et al. (2010) Effects of mass media coverage on timing and annual receipt of influenza vaccination among Medicare elderly. Health Serv Res 45:1287-309
Yoo, Byung-Kwang; Berry, Andrea; Kasajima, Megumi et al. (2010) Association between Medicaid reimbursement and child influenza vaccination rates. Pediatrics 126:e998-1010
Yoo, Byung-Kwang; Kasajima, Megumi; Fiscella, Kevin et al. (2009) Effects of an ongoing epidemic on the annual influenza vaccination rate and vaccination timing among the Medicare elderly: 2000-2005. Am J Public Health 99 Suppl 2:S383-8
Yoo, Byung-Kwang; Szilagyi, Peter G; Schaffer, Stanley J et al. (2009) Cost of universal influenza vaccination of children in pediatric practices. Pediatrics 124 Suppl 5:S499-506