Abstract
INTRODUCTION: The cost-effectiveness of vaccination strategies plays a crucial role in managing infectious diseases such as influenza within public health systems. This study evaluated the cost-effectiveness of vaccination compliance strategies by comparing an "adherence" strategy, which promoted continuous vaccination uptake, with a "volunteer" strategy through model-based simulations. METHODS: We developed a novel hybrid model that integrates continuous-time agent-based models (ABMs) with a Markov model to simulate vaccination behaviors and disease dynamics at the individual level. The model incorporated socioeconomic factors, vaccine efficacy, and population interactions to evaluate the long-term health outcomes and associated costs of different vaccination compliance strategies. RESULTS: Simulation results demonstrated that the "adherence" strategy significantly enhanced vaccination coverage and reduced influenza cases, yielding an incremental cost-effectiveness ratio (ICER) of 33,847 CNY per quality-adjusted life year (QALY) gained, indicating superior cost-effectiveness compared to the "volunteer" strategy. DISCUSSION: Our findings support implementing targeted influenza vaccination compliance strategies, presenting an innovative approach to strengthening public health interventions and enhancing vaccination program effectiveness. The hybrid model shows promise in informing public health policy and practice, warranting further investigation of its applications across diverse public health contexts.