Move to adjuvanted flu vaccine could help over-65s
Over 1,700 flu deaths a year in the UK could be avoided by switching to a new flu vaccine, according to newÂ health economic modelling presented at the European Scientific Working group on Influenza (ESWI) meeting in Riga [i].
The findingsÂ followÂ Public Health England's recent announcement that last year's flu vaccine, while working well in children, was not as effective in those aged 65+.
The new influenza vaccine, Fluad, which is now available in the UK for pre-ordering for use in the 2018/19 season, uses an adjuvant which helps the bodyâ€™s immune system develop a strong response to flu, particularly in people 65 years and over whose immune systems are weakening with age, a natural process called â€œimmunosenescenceâ€.Â
Adjuvanted flu vaccines have already been available for many years in numerous European countries, the US, and Canada, and furthermore, large real-world studies conducted in Italy and Canada founded the basis for the vaccine effectiveness estimates used in this health economic model. Data from these real-world studies demonstrate that Fluad is significantly more effective than comparator non-adjuvanted vaccines in the elderly.[ii],[iii]
Fluadâ€™s favourable significant difference in vaccine effectiveness was recognised by the Joint Committee on Vaccination and Immunisation, the UK government advisory body, in its recent review of its data. The Committee stated that there is â€œhigher vaccine immunogenicity and effectiveness for the adjuvanted [influenza] vaccine in comparison with non-adjuvanted [influenza] vaccines.â€[iv] Currently, only non-adjuvanted influenza vaccines are used amongst the overÂ 65s in the UK.
Fluad also delivers extra quality adjusted life years at a cost that is well within the guidelines used by the NHS, says Dr Van Hung Nguyen, the lead author of the study.
â€œThe model demonstrated that the adjuvanted vaccine had an incremental cost-effectiveness ratio of Â£3,540 per quality-adjusted life year if used preferentially in those aged 65 years of age and over in the UK. This is well within, and actually considerably below, the National Institute of Health and Clinical Excellenceâ€™s guideline threshold of Â£20,000 per quality-adjusted life year for medicines.â€[i]
â€œHealth economic analyses consistently show that more effective flu vaccines are very good value in older patients,â€ said Dr Marco Barbieri of the Centre for Health Economics at the University of York. â€œThey reduce the number of GP consultations, A&E visits and episodes of serious illness and, of course, they help older people to remain healthy and independent,â€ he added.Â â€œThese data suggest that use of an adjuvanted influenza vaccine is a cost-effective option for the NHS immunisation programme.â€
[i] Nguyen VH, Kelly C, Mansi JA. UK Health Economic Model Demonstrates Use of Adjuvanted Trivalent Seasonal Influenza Vaccine in Older Adults to be Highly Cost-Effective [abstract]. Presented at the Sixth ESWI Influenza Conference, Riga, Latvia, 2017 September 10-13
[ii] Mannino S, Villa M, Apolone G, Weiss NS, Groth N, Aquino I, et al. Effectiveness of adjuvanted influenza vaccination in elderly subjects in northern Italy. Am J Epidemiol. 2012 Sep 15;176(6):527â€“33
[iii]Â Van Buynder PG, Konrad S, Van Buynder JL, Brodkin E, Krajden M, Ramler G, et al. The comparative effectiveness of adjuvanted and unadjuvanted trivalent inactivated influenza vaccine (TIV) in the elderly. Vaccine. 2013 Dec 9;31(51):6122â€“8
[iv] JCVI minutes for meeting held on 07 June 2017. Available at: https://app.box.com/s/iddfb4ppwkmtjusir2tc/file/198733240440 [accessed 09 September 2017]