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. 2022 Mar 31;19(7):4166.
doi: 10.3390/ijerph19074166.

The New Quadrivalent Adjuvanted Influenza Vaccine for the Italian Elderly: A Health Technology Assessment

Giovanna Elisa Calabrò  1   2 , Sara Boccalini  3 , Donatella Panatto  4 , Caterina Rizzo  5 , Maria Luisa Di Pietro  1 , Fasika Molla Abreha  6 , Marco Ajelli  7 , Daniela Amicizia  4 , Angela Bechini  3 , Irene Giacchetta  8 , Piero Luigi Lai  4 , Stefano Merler  9 , Chiara Primieri  8 , Filippo Trentini  9   10 , Sara Violi  8 , Paolo Bonanni  3 , Chiara de Waure  8
Affiliations

The New Quadrivalent Adjuvanted Influenza Vaccine for the Italian Elderly: A Health Technology Assessment

Giovanna Elisa Calabrò et al. Int J Environ Res Public Health. .

Abstract

Background: The elderly, commonly defined as subjects aged ≥65 years, are among the at-risk subjects recommended for annual influenza vaccination in European countries. Currently, two new vaccines are available for this population: the MF59-adjuvanted quadrivalent influenza vaccine (aQIV) and the high-dose quadrivalent influenza vaccine (hdQIV). Their multidimensional assessment might maximize the results in terms of achievable health benefits. Therefore, we carried out a Health Technology Assessment (HTA) of the aQIV by adopting a multidisciplinary policy-oriented approach to evaluate clinical, economic, organizational, and ethical implications for the Italian elderly.

Methods: A HTA was conducted in 2020 to analyze influenza burden; characteristics, efficacy, and safety of aQIV and other available vaccines for the elderly; cost-effectiveness of aQIV; and related organizational and ethical implications. Comprehensive literature reviews/analyses were performed, and a transmission model was developed in order to address the above issues.

Results: In Italy, the influenza burden on the elderly is high and from 77.7% to 96.1% of influenza-related deaths occur in the elderly. All available vaccines are effective and safe; however, aQIV, such as the adjuvanted trivalent influenza vaccine (aTIV), has proved more immunogenic and effective in the elderly. From the third payer's perspective, but also from the societal one, the use of aQIV in comparison with egg-based standard QIV (eQIV) in the elderly population is cost-effective. The appropriateness of the use of available vaccines as well as citizens' knowledge and attitudes remain a challenge for a successful vaccination campaign.

Conclusions: The results of this project provide decision-makers with important evidence on the aQIV and support with scientific evidence on the appropriate use of vaccines in the elderly.

Keywords: HTA; Health Technology Assessment; elderly; influenza; quadrivalent adjuvanted influenza vaccine; vaccination; vaccines.

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Conflict of interest statement

The authors (G.E.C., S.B., D.P., M.L.D.P., D.A., A.B., I.G., P.L.L., C.P., S.V., P.B. and C.d.W.) worked as consultants of VIHTALI, a spin-off of the Università Cattolica del Sacro Cuore, which received funds from Seqirus srl. The authors C.R., F.M.A., M.A., S.M. and F.T. received funds from Seqirus srl. The sponsor had no role in conducting the HTA, in the design of the study, the collection, analysis and interpretation of data, or the writing of the manuscript.

Figures

Figure 1
Figure 1
Influenza burden avoided thanks to the introduction of aQIV in Italy.
Figure 2
Figure 2
Probabilistic sensitivity analysis: base scenario (QIVe) vs. alternative scenario (aQIV in subjects aged ≥65 years), by study perspective (NHS on the left, society on the right).
See this image and copyright information in PMC

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