Abstract
The availability of several effective and safe vaccines enables health systems to counteract annual influenza epidemics. However, the criteria of appropriateness and sustainability require that each citizen should receive the right vaccine. The value of each vaccine can be assessed within well-known frameworks, such as the Health Technology Assessment (HTA), a step that is fundamental to the process of allocating resources to vaccination strategies. The paper describes how HTA has been incorporated as an evidence-based tool to support the definition of Italian vaccination strategies, reports the results of the HTA report on the most recently available influenza vaccine in Italy (cell-based quadrivalent vaccine (QIVc)—Flucelvax® Tetra) and elaborates on current and future recommendations in the field of influenza vaccination. Recommendations issued by the Italian Ministry of Health foster the appropriate use of influenza vaccines from 2018–2019 onwards. Evidence of the value of newly available vaccines will hopefully support future decisions and promote the appropriate use of these vaccines on the basis of the characteristics of the target population. However, the success of influenza vaccination will also depend on citizens’ empowerment and engagement in the decision-making process.
Highlights
Vaccinations prevent around 2.5 million deaths every year and protect both children and adults against the threat of vaccine preventable diseases (VPDs)
With regard to new vaccines, a forecast of their health and economic impact is required, together with an evaluation of their organizational, ethical, social and legal implications. In accordance with this approach, several influenza vaccines have been assessed through the Health Technology Assessment (HTA) in Italy [14,15,16] and in 2018 a National Immunization Technical Advisory Group (NITAG)
2012–2014 National Immunization Programme (NIP) and the subsequent 2017–2019 NIP, we have summarized below the main findings of the Italian HTA report on the new cell-based quadrivalent vaccine (QIVc) [15]
Summary
Vaccinations prevent around 2.5 million deaths every year and protect both children and adults against the threat of vaccine preventable diseases (VPDs). With regard to new vaccines, a forecast of their health and economic impact is required, together with an evaluation of their organizational, ethical, social and legal implications In accordance with this approach, several influenza vaccines have been assessed through the HTA in Italy [14,15,16] and in 2018 a National Immunization Technical Advisory Group (NITAG). In accordance with the EUnetHTA core model, the first aspect addressed in the HTA report was the health problem and its current management This involved conducting a systematic review of the available literature on the burden of disease, in terms of both complications and mortality, and of current alternatives to the cell-based vaccine, namely the adjuvanted trivalent vaccine (aTIV). This analysis revealed the importance of promoting an appropriate use of vaccines, in order to achieve the goal of value-based healthcare
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