Abstract
Mutations of the H3N2 vaccine strain during the egg-based vaccine manufacturing process partly explain the suboptimal effectiveness of traditional seasonal influenza vaccines. Cell-based influenza vaccines improve antigenic match and vaccine effectiveness by avoiding such egg-adaptation. This study evaluated the public health and economic impact of a cell-based quadrivalent influenza vaccine (QIVc) in adults (18–64 years) compared to the standard egg-based quadrivalent influenza vaccine (QIVe) in the US. The impact of QIVc over QIVe in public health and cost outcomes was estimated using a dynamic age-structured SEIR transmission model, which accounted for four circulating influenza strains [A/H1N1pdm9, A/H3N2, B(Victoria), and B(Yamagata)] and was calibrated on the 2013–2018 influenza seasons. The robustness of the results was assessed in univariate and probabilistic sensitivity analyses. Switching from QIVe to QIVc in 18- to 64-year-olds may prevent 5.7 million symptomatic cases, 1.8 million outpatient visits, 50,000 hospitalizations, and 5453 deaths annually. The switch could save 128,000 Quality-Adjusted Life Years (QALYs) and US $ 845 M in direct costs, resulting in cost-savings in a three-year time horizon analysis. Probabilistic sensitivity analyses confirmed the robustness of the cost-saving result. The analysis shows that QIVc is expected to prevent hospitalizations and deaths, and result in substantial savings in healthcare costs.
Highlights
The purpose of the present analysis is to evaluate the cost-effectiveness of QIVc in adults (18 to 64 years) compared to conventional egg-based quadrivalent influenza vaccines (QIVe) using a dynamic influenza transmission model able to account for the indirect effect of vaccination
This study estimated an overall relative VE (rVE) of 19.3% for QIVc compared to QIVe, and age-adjusted rVE for the adult population (Table 1)
This study demonstrates the potential public health benefits of QIVc in the adult population in the US
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Mutations of influenza virus strains during the isolation and propagation steps of egg-based vaccine production may lead to an antigenic mismatch between the influenza candidate vaccine and the circulating strain [4,5]. This issue might be solved by propagating vaccine viruses in mammalian cell lines rather than fertilized chicken eggs. In years with a good match between the vaccine and circulating influenza virus strains, the lack of egg adaptation may translate into an increased VE for new cell-based quadrivalent influenza vaccines (QIVc) [6,7]. The purpose of the present analysis is to evaluate the cost-effectiveness of QIVc in adults (18 to 64 years) compared to conventional egg-based quadrivalent influenza vaccines (QIVe) using a dynamic influenza transmission model able to account for the indirect effect of vaccination
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