A real-world study evaluating the relative vaccine effectiveness of a cell-based quadrivalent influenza vaccine compared to egg-based quadrivalent influenza vaccine in the US during the 2017–18 influenza season

Divino, Victoria; Krishnarajah, Girishanthy; Pelton, Stephen I.; Mould-Quevedo, J; Anupindi, Vamshi Ruthwik; DeKoven, Mitch; Postma, Maarten J.

doi:10.1016/j.vaccine.2020.07.023

Cited by 38 publications

(82 citation statements)

References 19 publications

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“…Individuals with hospitalization/ER visit, or an office visit related to influenza from the start of the influenza season leading up to 13 days post-index date, were excluded. We used the definitions for influenza-related hospitalizations/ER visits (described in more detail in subsequent sections) following similar published methods [8,9,16]. Furthermore, individuals were excluded if they received any other influenza vaccine product or multiple doses (>1 dose) of the index vaccine during the 2018-19 influenza season.…”

Section: Study Populationmentioning

confidence: 99%

“…The subgroup analyses included the following cohorts: (1) individuals aged 4-17 years at index, (2) individuals aged 18-64 years at index, (3) high-risk individuals (those at higher risk for influenza complications). Similar to our previously published study, high-risk individuals were identified based on one or more claim with a diagnosis code, procedure code, or drug code for clinical risk groups, where influenza vaccination is indicated [9]. These clinical risk groups included the asplenia or dysfunction of the spleen, diabetes, chronic kidney disease, chronic heart disease, chronic liver dysfunction, chronic neurological disorders, chronic respiratory disease, immunosuppression, morbid obesity, and pregnancy.…”

Section: Study Populationmentioning

confidence: 99%

“…Following the prior published work, the statistical approach in the current study followed similar methods [8,9,16]. The inverse probability of treatment weighting (IPTW) was used to adjust for imbalances in measured confounders between vaccine groups [24,25].…”

Section: Statistical Analysis 261 Clinical Outcomes Evaluationmentioning

confidence: 99%

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Clinical and Economic Outcomes Associated with Cell-Based Quadrivalent Influenza Vaccine vs. Standard-Dose Egg-Based Quadrivalent Influenza Vaccines during the 2018–19 Influenza Season in the United States

et al. 2021

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Non-egg-based influenza vaccines eliminate the potential for egg-adapted mutations and potentially increase vaccine effectiveness. This retrospective study compared hospitalizations/emergency room (ER) visits and all-cause annualized healthcare costs among subjects aged 4–64 years who received cell-based quadrivalent (QIVc) or standard-dose egg-based quadrivalent (QIVe-SD) influenza vaccine during the 2018–19 influenza season. Administrative claims data (IQVIA PharMetrics® Plus, IQVIA, USA) were utilized to evaluate clinical and economic outcomes. Adjusted relative vaccine effectiveness (rVE) of QIVc vs. QIVe-SD among overall cohort, as well as for three subgroups (age 4–17 years, age 18–64 years, and high-risk) was evaluated using inverse probability of treatment weighting (IPTW) and Poisson regression models. Generalized estimating equation models among the propensity score matched sample were used to estimate annualized all-cause costs. A total of 669,030 recipients of QIVc and 3,062,797 of QIVe-SD were identified after IPTW adjustments. Among the overall cohort, QIVc had higher adjusted rVEs against hospitalizations/ER visits related to influenza, all-cause hospitalizations, and hospitalizations/ER visits associated with any respiratory event compared to QIVe-SD. The adjusted annualized all-cause total costs were higher for QIVe-SD compared to QIVc ((+$461); p < 0.05).

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Section: Study Populationmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

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Clinical and Economic Outcomes Associated with Cell-Based Quadrivalent Influenza Vaccine vs. Standard-Dose Egg-Based Quadrivalent Influenza Vaccines during the 2018–19 Influenza Season in the United States

et al. 2021

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“…The relative vaccine effectiveness of aTIV compared with TIV-HD has been estimated in several observational cohort studies. [19][20][21][22][23][24][25] Coleman et al conducted a systematic literature review and meta-analysis of studies with aTIV, including those comparing aTIV with TIV-HD. 26 Using data from four studies, 19,20,24,25 they estimated that the relative vaccine effectiveness (rVE) of aTIV to TIV-HD for reducing any medical encounter due to influenza and/or pneumonia was 3.2%.…”

Section: Vaccine Effectivenessmentioning

confidence: 99%

The cost-effectiveness of an adjuvanted quadrivalent influenza vaccine in the United Kingdom

Kohli¹,

Maschio²,

Mould-Quevedo

et al. 2021

Human Vaccines & Immunotherapeutics

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In the United Kingdom (UK), both the MF59-adjuvanted quadrivalent influenza vaccine (aQIV) and the high-dose QIV (QIV-HD) are preferred for persons aged 65 years and older but only aQIV is reimbursed by the National Health Service (NHS). The objective was to determine the potential cost-effectiveness of vaccinating adults aged 65 years and above with aQIV compared with QIV-HD in the UK. A dynamic transmission model, calibrated to match infection data from the UK, was used to estimate the impact of vaccination in 10 influenza seasons. Vaccine effectiveness was based on a meta-analysis that concluded the vaccines were not significantly different. Vaccine coverage, physician visits, hospitalizations, deaths, utility losses and NHS costs were estimated using published UK sources. The list price of aQIV was £11.88 while a range of prices were tested for QIV-HD. The price of the trivalent high-dose vaccine (TIV-HD) is £20.00 but a list price for QIV-HD is not yet available. The projected differences between the vaccines in terms of clinical cases and influenza treatment costs are minimal. Our analysis demonstrates that in order to be cost-effective, the price of QIV-HD must be similar to that of aQIV and may range from £7.57 to £12.94 depending on the relative effectiveness of the vaccines. The results of the analysis were most sensitive to variation in vaccine effectiveness and the rate of hospitalization due to influenza. Given the evidence, aQIV is cost-saving unless QIV-HD is priced lower than the existing list price of TIV-HD.

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“…Several VE studies have been conducted using real-world data from the United States, but the evidence is mixed. Two large retrospective cohort studies reported that the cell culture-based influenza vaccine (QIVc) was more effective in preventing hospital encounters related to influenza and certain respiratory events [ 5 , 6 ]. One study found QIVc provided better protection against only influenza B than egg-based influenza vaccines [7] , while another found the egg-based quadrivalent influenza vaccine (QIVe) provided better protection against only A(H1N1)pdm09 than QIVc [8] .…”

Section: Introductionmentioning

confidence: 99%

Adverse events of interest following influenza vaccination, a comparison of cell culture-based with egg-based alternatives: English sentinel network annual report paper 2019/20

Lusignan

Tsang

Amirthalingam

et al. 2021

The Lancet Regional Health - Europe

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Background The cell-based quadrivalent influenza vaccine (QIVc) is now offered as an alternative to egg-based quadrivalent (QIVe) and adjuvanted trivalent (aTIV) influenza vaccines in the UK. While post-licensure studies show non-inferiority of cell-based vaccines, it is not known how its safety profile compares to other types of vaccines in real-world use. Methods We conducted a retrospective cohort study using computerised medical records from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network database. We used a self-controlled case series design and calculated the relative incidence (RI) of adverse events of interest (AEIs) over different risk periods. We then compared the RIs of AEIs within seven days of vaccination overall and between QIVc and QIVe in the 18–64 years age group, and between QIVc and aTIV in the ≥65 years age group. Findings The majority of AEIs occurred within seven days of vaccination, and a seasonal effect was observed. Using QIVc as the reference group, QIVe showed similar incidence of AEIs whereas live attenuated influenza vaccine (LAIV) and aTIV had lower incidence of AEIs. In the stratified analyses, QIVe and aTIV were associated with a 16% lower incidence of AEIs in the seven days post-vaccination in both the 18–64 years and ≥65 years age groups. Interpretation Routine sentinel network data allow comparisons of safety profiles of equally suitable seasonal influenza vaccines. The higher incidence of AEIs associated with QIVc suggest monitoring of several seasons would allow robust comparisons to be made. Funding Public Health England.

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A real-world study evaluating the relative vaccine effectiveness of a cell-based quadrivalent influenza vaccine compared to egg-based quadrivalent influenza vaccine in the US during the 2017–18 influenza season

Cited by 38 publications

References 19 publications

Clinical and Economic Outcomes Associated with Cell-Based Quadrivalent Influenza Vaccine vs. Standard-Dose Egg-Based Quadrivalent Influenza Vaccines during the 2018–19 Influenza Season in the United States

Clinical and Economic Outcomes Associated with Cell-Based Quadrivalent Influenza Vaccine vs. Standard-Dose Egg-Based Quadrivalent Influenza Vaccines during the 2018–19 Influenza Season in the United States

The cost-effectiveness of an adjuvanted quadrivalent influenza vaccine in the United Kingdom

Adverse events of interest following influenza vaccination, a comparison of cell culture-based with egg-based alternatives: English sentinel network annual report paper 2019/20

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