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. 2019 Oct 8;116(41):20786-20792.
doi: 10.1073/pnas.1909613116. Epub 2019 Sep 23.

Future epidemiological and economic impacts of universal influenza vaccines

Pratha Sah  1 , Jorge A Alfaro-Murillo  1 , Meagan C Fitzpatrick  1   2 , Kathleen M Neuzil  2 , Lauren A Meyers  3 , Burton H Singer  4 , Alison P Galvani  1
Affiliations

Future epidemiological and economic impacts of universal influenza vaccines

Pratha Sah et al. Proc Natl Acad Sci U S A. .

Erratum in

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.

Keywords: mathematical model; medical cost; seasonal vaccine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
(A) Incidence, (B) hospitalizations, (C) deaths, and (D) direct medical costs expected based on both the proportion of seasonal vaccines replaced with universal vaccines (UV) and the seasonal vaccine efficacy (VE).
Fig. 2.
Fig. 2.
State-level impact per 100,000 capita on (A) incidence, (B) hospitalizations, (C) deaths, and (D) direct medical costs averted after replacing 169 million doses of typical 44% efficacious seasonal vaccines with universal vaccines.
Fig. 3.
Fig. 3.
Age-stratified outcomes of (A) incidence, (B) hospitalizations, (C) deaths, and (D) direct medical costs expected after replacing (partially or completely) the current seasonal influenza vaccine with a universal influenza vaccine (UV). We present 3 influenza season scenarios with seasonal vaccine efficacies (VE) of 19, 44, and 60%.
Fig. 4.
Fig. 4.
Epidemiological impact of partially or completely replacing seasonal influenza vaccines with universal vaccines (UV) in terms of (A) incidence, (B) hospitalizations, (C) deaths, and (D) direct medical costs. We present 3 influenza season scenarios with seasonal vaccine efficacies (VE) of 19, 44, and 60%.
Fig. 5.
Fig. 5.
Age- and subtype/type-stratified outcomes of incidence, hospitalizations, deaths, and direct medical costs expected after replacing (partially or completely) the current seasonal influenza vaccine with a universal influenza vaccine. The seasonal vaccine is assumed to be 44% efficacious.
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References

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