Future epidemiological and economic impacts of universal influenza vaccines

Abstract

The efficacy of influenza vaccines, currently at 44%, is limited by the rapid antigenic evolution of the virus and a manufacturing process that can lead to vaccine mismatch. The National Institute of Allergy and Infectious Diseases (NIAID) recently identified the development of a universal influenza vaccine with an efficacy of at least 75% as a high scientific priority. The US Congress approved $130 million funding for the 2019 fiscal year to support the development of a universal vaccine, and another $1 billion over 5 y has been proposed in the Flu Vaccine Act. Using a model of influenza transmission, we evaluated the population-level impacts of universal influenza vaccines distributed according to empirical age-specific coverage at multiple scales in the United States. We estimate that replacing just 10% of typical seasonal vaccines with 75% efficacious universal vaccines would avert ∼5.3 million cases, 81,000 hospitalizations, and 6,300 influenza-related deaths per year. This would prevent over $1.1 billion in direct health care costs compared to a typical season, based on average data from the 2010–11 to 2018–19 seasons. A complete replacement of seasonal vaccines with universal vaccines is projected to prevent 17 million cases, 251,000 hospitalizations, 19,500 deaths, and $3.5 billion in direct health care costs. States with high per-hospitalization medical expenses along with a large proportion of elderly residents are expected to receive the maximum economic benefit. Replacing even a fraction of seasonal vaccines with universal vaccines justifies the substantial cost of vaccine development.

Epidemiological impact of SARS-CoV-2 vaccination: mathematical modeling analyses

“…Assessment of the population-level impact of vaccine candidates through mathematical modeling is a critical component of the process of vaccine development, value proposition, licensure, decision-making, and pathways and costs of vaccine administration, and has been utilized for a wide range of infectious diseases [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. In early stages of development, modeling is used to define the vaccine's key preferred product characteristics, by estimating levels of efficacy necessary to observe significant population-level impact, determining necessary duration of protection/immunity incurred by the vaccine, and identifying priority populations for optimal effectiveness [21,29,30]. These parameters provide early guidance to developers, manufacturers, regulators, and decision makers about candidates that are likely to be optimal through specifying vaccine characteristics that will maximize public health impact and cost-All rights reserved.…”

“…(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. effectiveness [21,28,29,31,32]. Once key attributes are established, modeling plays an integral role in building the case for investment in vaccine development, and in ensuring rapid roll-out post-licensing, through assessment of risks, costs, and predicted returns associated with different immunization strategies [29,33].…”

“…effectiveness [21,28,29,31,32]. Once key attributes are established, modeling plays an integral role in building the case for investment in vaccine development, and in ensuring rapid roll-out post-licensing, through assessment of risks, costs, and predicted returns associated with different immunization strategies [29,33]. Post-vaccination, modeling is used to inform design and interpretation of surveillance studies [25][26][27].…”

Better influenza vaccines: an industry perspective

“…From a public health perspective influenza continues to be the only human disease that requires annual vaccination. It is estimated that replacing just 10% of seasonal vaccines with a universal vaccine would avert 6300 influenza-related deaths and save 1.1 billion US dollars in direct healthcare costs per year in the United States alone [44]. In 2017, the National Institute of Allergy and Infectious Diseases (NIAID) in the US laid out a detailed strategic plan for the development of a universal influenza vaccine, highlighting knowledge gaps and research areas in pursuit of this common goal [43].…”

Spatial Transmission Network Construction of Influenza-Like Illness Using Dynamic Bayesian Network and Vector-Autoregressive Moving Average Model

“…As for influenza, also a representative infectious disease, the primary intervention strategy is seasonal vaccine 3,4 . However, the antigenic drift often makes the vaccineinduced immunity wane over the course of a season 4 .…”