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Fasseeh AN, Korra N, Elezbawy B, Sedrak AS, Gamal M, Eldessouki R, Eldebeiky M, George M, Seyam A, Abourawash A, Khalifa AY, Shaheen M, Abaza S, Kaló Z. Framework for developing cost-effectiveness analysis threshold: the case of Egypt. J Egypt Public Health Assoc 2024; 99:12. [PMID: 38825614 PMCID: PMC11144683 DOI: 10.1186/s42506-024-00159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/01/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND Cost-effectiveness analyses rarely offer useful insights to policy decisions unless their results are compared against a benchmark threshold. The cost-effectiveness threshold (CET) represents the maximum acceptable monetary value for achieving a unit of health gain. This study aimed to identify CET values on a global scale, provide an overview of using multiple CETs, and propose a country-specific CET framework specifically tailored for Egypt. The proposed framework aims to consider the globally identified CETs, analyze global trends, and consider the local structure of Egypt's healthcare system. METHODS We conducted a literature review to identify CET values, with a particular focus on understanding the basis of differentiation when multiple thresholds are present. CETs of different countries were reviewed from secondary sources. Additionally, we assembled an expert panel to develop a national CET framework in Egypt and propose an initial design. This was followed by a multistakeholder workshop, bringing together representatives of different governmental bodies to vote on the threshold value and finalize the recommended framework. RESULTS The average CET, expressed as a percentage of the gross domestic product (GDP) per capita across all countries, was 135%, with a range of 21 to 300%. Interestingly, while the absolute value of CET increased with a country's income level, the average CET/GDP per capita showed an inverse relationship. Some countries applied multiple thresholds based on disease severity or rarity. In the case of Egypt, the consensus workshop recommended a threshold ranging from one to three times the GDP per capita, taking into account the incremental relative quality-adjusted life years (QALY) gain. For orphan medicines, a CET multiplier between 1.5 and 3.0, based on the disease rarity, was recommended. A two-times multiplier was proposed for the private reimbursement threshold compared to the public threshold. CONCLUSION The CET values in most countries appear to be closely related to the GDP per capita. Higher-income countries tend to use a lower threshold as a percentage of their GDP per capita, contrasted with lower-income countries. In Egypt, experts opted for a multiple CET framework to assess the value of health technologies in terms of reimbursement and pricing.
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Affiliation(s)
- Ahmad N Fasseeh
- Faculty of Pharmacy Alexandria University, Alexandria, Egypt
- Syreon Middle East, Alexandria, Egypt
| | | | | | - Amal S Sedrak
- Department of Public Health, Cairo University, Cairo, Egypt
- Egyptian Authority for Unified Procurement, Medical Supply and Technology Management, Cairo, Egypt
| | - Mary Gamal
- Egyptian Authority for Unified Procurement, Medical Supply and Technology Management, Cairo, Egypt
| | - Randa Eldessouki
- Department of Community Health, Fayoum University, Fayoum, Egypt
| | - Mariam Eldebeiky
- Egyptian Authority for Unified Procurement, Medical Supply and Technology Management, Cairo, Egypt
| | | | - Ahmed Seyam
- Universal Health Insurance Authority, Cairo, Egypt
| | | | - Ahmed Y Khalifa
- World Health Organization Representative Office, Cairo, Egypt
| | | | | | - Zoltán Kaló
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
- Syreon Research Institute, Budapest, Hungary
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Warmath CR, Ortega-Sanchez IR, Duca LM, Porter RM, Usher MG, Bresee JS, Lafond KE, Davis WW. Comparisons in the Health and Economic Assessments of Using Quadrivalent Versus Trivalent Influenza Vaccines: A Systematic Literature Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:768-779. [PMID: 36436790 DOI: 10.1016/j.jval.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Seasonal influenza vaccines protect against 3 (trivalent influenza vaccine [IIV3]) or 4 (quadrivalent influenza vaccine [IIV4]) viruses. IIV4 costs more than IIV3, and there is a trade-off between incremental cost and protection. This is especially the case in low- and middle-income countries (LMICs) with limited budgets; previous reviews have not identified studies of IIV4-IIV3 comparisons in LMICs. We summarized the literature that compared health and economic outcomes of IIV4 and IIV3, focused on LMICs. METHODS We systematically searched 5 databases for articles published before October 6, 2021, that modeled health or economic effects of IIV4 versus IIV3. We abstracted data and compared findings among countries and models. RESULTS Thirty-eight studies fit our selection criteria; 10 included LMICs. Most studies (N = 31) reported that IIV4 was cost-saving or cost-effective compared with IIV3; we observed no difference in health or economic outcomes between LMICs and other countries. Based on cost differences of influenza vaccines, only one study compared coverage of IIV3 with IIV4 and reported that the maximum IIV4 price that would still yield greater public health impact than IIV3 was 13% to 22% higher than IIV3. CONCLUSIONS When vaccination coverage with IIV4 and IIV3 is the same, IIV4 tends to be not only more effective but more cost-effective than IIV3, even with relatively high price differences between vaccine types. Alternatively, where funding is limited as in most LMICs, higher vaccine coverage can be achieved with IIV3 than IIV4, which could result in more favorable health and economic outcomes.
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Affiliation(s)
- Clara R Warmath
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Ismael R Ortega-Sanchez
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lindsey M Duca
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rachael M Porter
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Molly G Usher
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Joseph S Bresee
- Partnership for Influenza Vaccine Introduction, The Task Force for Global Health, Decatur, GA, USA
| | - Kathryn E Lafond
- Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Gong Y, Yao X, Peng J, Ma Y, Fang Y, Yan K, Jiang M. Cost-Effectiveness and Health Impacts of Different Influenza Vaccination Strategies for Children in China. Am J Prev Med 2023:S0749-3797(23)00035-1. [PMID: 37037733 DOI: 10.1016/j.amepre.2023.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 04/12/2023]
Abstract
INTRODUCTION We aimed to evaluate the economic and health impacts of 3 influenza vaccines available in China, including trivalent inactivated vaccine, quadrivalent inactivated vaccine, and live attenuated influenza vaccine, for children aged 6 months to 18 years. METHODS Two decision-analytic models were developed to simulate 4 vaccination strategies. Outcomes included total costs from a societal perspective in 2021, quality-adjusted life-year loss, numbers of outpatient and inpatient cases, and deaths avoided using each strategy. Deterministic and probabilistic sensitivity analyses were performed to examine the uncertainty of model inputs. RESULTS For children aged 6 months to 3 years, trivalent inactivated vaccine saved $48 million and avoided a loss of 17,637 quality-adjusted life-years compared with no vaccination. For children aged 3-18 years, quadrivalent inactivated vaccine was cost-effective compared with trivalent inactivated vaccine, with an incremental cost-effectiveness ratio of $32,948.5/quality-adjusted life-year (willingness-to-pay threshold=$37,653/quality-adjusted life-year), which was sensitive to the RR of vaccine effectiveness of quadrivalent inactivated vaccine versus of trivalent inactivated vaccine. When compared with quadrivalent inactivated vaccine, live attenuated influenza vaccine was $1.28 billion more costly but gained an additional 13,560 quality-adjusted life-years; its incremental cost-effectiveness ratio was $123,983.8/quality-adjusted life-year. Live attenuated influenza vaccine would be cost-effective if its vaccine effectiveness was >0.79. Probabilistic sensitivity analysis revealed that quadrivalent inactivated vaccine, trivalent inactivated vaccine, live attenuated influenza vaccine, and no vaccination were cost-effective in 55.94%, 33.09%, 10.97%, and 0% of 10,000 Monte Carlo simulations. CONCLUSIONS Trivalent inactivated vaccine was cost-effective compared with no vaccination in children aged 6 months to 18 years. Of the 3 vaccination strategies for children aged 3-18 months, quadrivalent inactivated vaccine appears to be the most cost-effective.
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Affiliation(s)
- Yilin Gong
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Department of Pharmacy, Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, China
| | - Xuelin Yao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Jin Peng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Yue Ma
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Kangkang Yan
- Department of Pharmacy, Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, China
| | - Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China.
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Bianculli PM, Bellier L, Mangado IO, Pérez CG, Mieres G, Lazarov L, Petitjean A, Dibarboure H, Lopez JG. Switching from trivalent to quadrivalent inactivated influenza vaccines in Uruguay: a cost-effectiveness analysis. Hum Vaccin Immunother 2022; 18:2050653. [PMID: 35344679 PMCID: PMC9225211 DOI: 10.1080/21645515.2022.2050653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We evaluated the cost-utility of replacing trivalent influenza vaccine (TIV) with quadrivalent influenza vaccine (QIV) in the current target populations in Uruguay. An existing decision-analytic static cost-effectiveness model was adapted for Uruguay. The population was stratified into age groups. Costs and outcomes were estimated for an average influenza season, based on observed rates from 2013 to 2019 inclusive. Introducing QIV instead of TIV in Uruguay would avoid around 740 additional influenza cases, 500 GP consultations, 15 hospitalizations, and three deaths, and save around 300 workdays, for the same vaccination coverage during an average influenza season. Most of the influenza-related consultations and hospitalizations would be avoided among children ≤4 and adults ≥65 years of age. Using QIV rather than TIV would cost an additional ~US$729,000, but this would be partially offset by savings in consultations and hospitalization costs. The incremental cost per quality-adjusted life-year (QALY) gained with QIV would be in the order of US$18,000 for both the payor and societal perspectives, for all age groups, and around US$12,000 for adults ≥65 years of age. The main drivers influencing the incremental cost-effectiveness ratio were the vaccine efficacy against the B strains and the percentage of match each season with the B strain included in TIV. Probabilistic sensitivity analysis showed that switching to QIV would provide a favorable cost-utility ratio for 50% of simulations at a willingness-to-pay per QALY of US$20,000. A switch to QIV is expected to be cost-effective for the current target populations in Uruguay, particularly for older adults.
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Affiliation(s)
| | | | | | - Carlos Grau Pérez
- Centro de Investigaciones Económicas (CINVE), Montevideo, Uruguay.,Faculty, Universidad de la República, Montevideo, Uruguay
| | - Gustavo Mieres
- Centro de Investigaciones Económicas (CINVE), Montevideo, Uruguay
| | - Luis Lazarov
- Centro de Investigaciones Económicas (CINVE), Montevideo, Uruguay.,Faculty, Universidad de la República, Montevideo, Uruguay
| | - Audrey Petitjean
- Health Economics & Value Assessment, Sanofi Pasteur Global, Lyon, France
| | - Hugo Dibarboure
- Public Affairs, Sanofi Pasteur South Cone, Montevideo, Uruguay
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Loong D, Pham B, Amiri M, Saunders H, Mishra S, Radhakrishnan A, Rodrigues M, Yeung MW, Muller MP, Straus SE, Tricco AC, Isaranuwatchai W. Systematic Review on the Cost-Effectiveness of Seasonal Influenza Vaccines in Older Adults. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1439-1458. [PMID: 35659487 DOI: 10.1016/j.jval.2022.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 03/03/2022] [Accepted: 03/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Older adults are at high risk of influenza-related complications or hospitalization. The purpose of this systematic review is to assess the relative cost-effectiveness of all influenza vaccine options for older adults. METHODS This systematic review identified economic evaluation studies assessing the cost-effectiveness of influenza vaccines in adults ≥65 years of age from 5 literature databases. Two reviewers independently selected, extracted, and appraised relevant studies using the JBI Critical Appraisal Checklist for Economic Evaluations and Heyland's generalizability checklist. Costs were converted to 2019 Canadian dollars and adjusted for inflation and purchasing power parity. RESULTS A total of 27 studies were included. There were 18 comparisons of quadrivalent inactivated vaccine (QIV) versus trivalent inactivated vaccine (TIV): 5 showed QIV dominated TIV (ie, lower costs and higher health benefit), and 13 showed the results depended on willingness to pay (WTP). There were 9 comparisons of high-dose TIV (TIV-HD) versus TIV: 5 showed TIV-HD dominated TIV, and 4 showed the results depended on WTP. There were 8 comparisons of adjuvanted TIV (TIV-ADJ) versus TIV: 4 showed TIV-ADJ dominated TIV, and 4 showed the results depended on WTP. There were few pairwise comparisons among QIV, TIV-HD, and TIV-ADJ. CONCLUSIONS The evidence suggests QIV, TIV-HD, and TIV-ADJ are cost-effective against TIV for a WTP threshold of $50 000 per quality-adjusted life-year. Future studies should include new and existing vaccine options for broad age ranges and use more robust methodologies-such as real-world evaluations or modeling studies accounting for methodological, structural, and parameter uncertainty.
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Affiliation(s)
- Desmond Loong
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Ba' Pham
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Mohammadreza Amiri
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Hailey Saunders
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sujata Mishra
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Amruta Radhakrishnan
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Myanca Rodrigues
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Health Research Methodology Graduate Program, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Man Wah Yeung
- National Advisory Committee on Immunization Secretariat, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Matthew P Muller
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Infection Prevention and Control, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sharon E Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Wanrudee Isaranuwatchai
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
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Does Vaccinating against Influenza in a Given Epidemic Season Have an Impact on Vaccination in the Next Season: A Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137976. [PMID: 35805631 PMCID: PMC9265947 DOI: 10.3390/ijerph19137976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022]
Abstract
To improve the uptake of influenza vaccine in the elderly, it is important to understand the factors that predict vaccination. The study objective was to explain influenza vaccination uptake in the next season (2019/2020) in a sample of primary care clinic patients from Gryfino, Poland, vaccinated in 2018/2019 with the free-of-charge quadrivalent vaccine. A baseline and a follow-up survey assessed respondent intentions to receive a vaccine (2018), then (2020) vaccine uptake and its predictors. Patients (n = 108, 54.6% males, Mage = 66.7 ± 6.7) filled in a researcher-administered questionnaire. A majority (69.3%) intended to get vaccinated in the next season, with 25.9% receipt. Of those willing to be immunized, only 31.9% were vaccinated in the next season; of those whose decision was dependent on reimbursement, none received influenza vaccine; of undecided patients, 23.1% were vaccinated. Multivariable analysis indicated that living with a partner (OR 6.22, p = 0.01), being employed (OR = 4.55, p = 0.05) and past vaccination behavior (OR 4.12; p = 0.04) were predictors of vaccine uptake. The findings show limited follow-through on initial influenza vaccination plans for the nearest season in previously vaccinated elderly patients. Future interventions should additionally focus on unanticipated barriers to vaccination, such as those revealed in this study, to increase vaccination coverage rates.
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Shin G, Kang D, Cheong HJ, Choi SE. Cost-Effectiveness of Extending the National Influenza Vaccination Program in South Korea: Does Vaccination of Older Adults Provide Health Benefits to the Entire Population? Vaccines (Basel) 2022; 10:vaccines10060932. [PMID: 35746540 PMCID: PMC9228362 DOI: 10.3390/vaccines10060932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
The South Korean government has successfully improved influenza vaccination coverage for individuals aged 65 years or older as part of its National Immunization Program (NIP). Those aged 50–64 years without funded vaccination care have significantly lower vaccination rates and face a substantial risk of influenza-related complications. We use a dynamic epidemiological and economic model to investigate the cost-effectiveness of expanding the universal vaccine fund to include those aged 50–64. The epidemiological model is estimated using the susceptibility-infection-recovery model and influenza and influenza-like illness incidence rates, which were calculated by the National Health Insurance Service–National Sample Cohort from the 2008/09 to 2012/13 influenza seasons but excluding the 2009/10 season for pandemic influenza A (H1N1). The decision tree economic model is assessed from societal and healthcare sector perspectives. The proposed policy would eliminate 340,000 annual influenza cases and prevent 119 unnecessary deaths. From a societal perspective, the proposed policy would reduce costs by USD 68 million. From a healthcare perspective, the cost is USD 4318 per quality-adjusted life years. Within the study range, sensitivity analyses found consistent cost-effectiveness results. The influenza vaccine for adults aged 50–64 appears to be cost-saving or cost-effective and, thus, should be considered for the NIP.
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Affiliation(s)
- Gyeongseon Shin
- College of Pharmacy, Korea University, Sejong City 30019, Korea; (G.S.); (D.K.)
| | - Daewon Kang
- College of Pharmacy, Korea University, Sejong City 30019, Korea; (G.S.); (D.K.)
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Gurodong-ro 148, Seoul 08308, Korea;
| | - Sang-Eun Choi
- College of Pharmacy, Korea University, Sejong City 30019, Korea; (G.S.); (D.K.)
- Correspondence: ; Tel.: +82-44-860-1617
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Choi MJ, Shin G, Kang D, Lim JO, Kim YK, Choi WS, Yun JW, Noh JY, Song JY, Kim WJ, Choi SE, Cheong HJ. Cost-Effectiveness of Influenza Vaccination Strategies in Adults: Older Adults Aged ≥65 Years, Adults Aged 50–64 Years, and At-Risk Adults Aged 19–64 Years. Vaccines (Basel) 2022; 10:vaccines10030445. [PMID: 35335077 PMCID: PMC8955502 DOI: 10.3390/vaccines10030445] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/24/2022] [Accepted: 03/04/2022] [Indexed: 01/25/2023] Open
Abstract
The high disease burden of influenza in elderly and chronically ill adults may be due to the suboptimal effectiveness and mismatch of the conventional trivalent influenza vaccine (TIV). This study evaluated the cost-effectiveness of quadrivalent (QIV), adjuvanted trivalent (ATIV), and high-dose quadrivalent (HD-QIV) vaccines versus TIV used under the current Korean National Immunization Program (NIP) in older adults aged ≥65 years. We also evaluated the cost-effectiveness of programs for at-risk adults aged 19–64 and adults aged 50–64. A one-year static population model was used to compare the costs and outcomes of alternative vaccination programs in each targeted group. Influenza-related parameters were derived from the National Health Insurance System claims database; other inputs were extracted from the published literature. Incremental cost-effectiveness ratios (ICERs) were assessed from a societal perspective. In the base case analysis (older adults aged ≥65 years), HD-QIV was superior, with the lowest cost and highest utility. Compared with TIV, ATIV was cost-effective (ICER $34,314/quality-adjusted life-year [QALY]), and QIV was not cost-effective (ICER $46,486/QALY). The cost-effectiveness of HD-QIV was robust for all parameters except for vaccine cost. The introduction of the influenza NIP was cost-effective or even cost-saving for the remaining targeted gr3oups, regardless of TIV or QIV.
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Affiliation(s)
- Min Joo Choi
- Department of Internal Medicine, International St. Mary’s Hospital, Catholic Kwandong University, Incheon 22711, Korea;
| | - Gyeongseon Shin
- College of Pharmacy, Korea University, Sejong 30019, Korea; (G.S.); (D.K.)
| | - Daewon Kang
- College of Pharmacy, Korea University, Sejong 30019, Korea; (G.S.); (D.K.)
| | - Jae-Ok Lim
- Department of Data-Centric Problem Solving Research, Korea Institute of Science and Technology Information, Daejeon 34141, Korea;
| | - Yun-Kyung Kim
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Korea;
| | - Won Suk Choi
- Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Korea;
| | - Jae-Won Yun
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (J.-W.Y.); (J.Y.N.); (J.Y.S.); (W.J.K.)
| | - Ji Yun Noh
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (J.-W.Y.); (J.Y.N.); (J.Y.S.); (W.J.K.)
| | - Joon Young Song
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (J.-W.Y.); (J.Y.N.); (J.Y.S.); (W.J.K.)
| | - Woo Joo Kim
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (J.-W.Y.); (J.Y.N.); (J.Y.S.); (W.J.K.)
| | - Sang-Eun Choi
- College of Pharmacy, Korea University, Sejong 30019, Korea; (G.S.); (D.K.)
- Correspondence: (S.-E.C.); (H.J.C.); Tel.: +82-44-860-1617 (S.-E.C.); +82-2-2626-3050 (H.J.C.)
| | - Hee Jin Cheong
- Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea; (J.-W.Y.); (J.Y.N.); (J.Y.S.); (W.J.K.)
- Correspondence: (S.-E.C.); (H.J.C.); Tel.: +82-44-860-1617 (S.-E.C.); +82-2-2626-3050 (H.J.C.)
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Influenza Vaccination for the Prevention of Cardiovascular Disease in the Americas: Consensus document of the Inter-American Society of Cardiology and the Word Heart Federation. Glob Heart 2021; 16:55. [PMID: 34381676 PMCID: PMC8344961 DOI: 10.5334/gh.1069] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 02/01/2023] Open
Abstract
Background Cardiovascular mortality is decreasing but remains the leading cause of death world-wide. Respiratory infections such as influenza significantly contribute to morbidity and mortality in patients with cardiovascular disease. Despite of proven benefits, influenza vaccination is not fully implemented, especially in Latin America. Objective The aim was to develop a regional consensus with recommendations regarding influenza vaccination and cardiovascular disease. Methods A multidisciplinary team composed by experts in the management and prevention of cardiovascular disease from the Americas, convened by the Inter-American Society of Cardiology (IASC) and the World Heart Federation (WHF), participated in the process and the formulation of statements. The modified RAND/UCLA methodology was used. This document was supported by a grant from the WHF. Results An extensive literature search was divided into seven questions, and a total of 23 conclusions and 29 recommendations were achieved. There was no disagreement among experts in the conclusions or recommendations. Conclusions There is a strong correlation between influenza and cardiovascular events. Influenza vaccination is not only safe and a proven strategy to reduce cardiovascular events, but it is also cost saving. We found several barriers for its global implementation and potential strategies to overcome them.
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Kim TH, Choi JH, Park SH, Yoo JH, Lee DG, Choi SM, Kim YR, Lee MS, Choo EJ, Choi HJ. Safety and immunogenicity of a seasonal quadrivalent influenza vaccine (GC3110A) in healthy participants aged ≥ 65 years. Vaccine 2021; 39:3621-3625. [PMID: 33992436 DOI: 10.1016/j.vaccine.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/15/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Seasonal Influenza is still considered associated with seasonal morbidity and hospitalization in the elderly population. The World Health Organization (WHO) recommended seasonal quadrivalent influenza vaccine (QIV) to reduce burden of two currently circulating influenza B lineages. Until 2019 Korean National Immunization Program (NIP) recommended trivalent influenza vaccine (TIV) after ongoing debates on cost effectiveness of QIV for elderly population. Although influenza vaccine only showed modest effect on reducing influenza in elderly, this study aimed to evaluate the immunogenicity and safety of inactivated QIV in healthy participants ≥ 65 years of age. METHODS A total of 274 healthy participants aged ≥ 65 years received a QIV. Seroconversion-based vaccine efficacy of 4 strains of seasonal influenza was assessed 21 days after vaccination and adverse events were monitored until 180 days after vaccination. RESULTS The percentages of participants seroconverted after vaccination on HI antibody against each strain were 36.5% (99/271) to A/H1N1, 47.6% (129/271) to A/H3N2, 40.6% (110/271) to B Yamagata, and 49.1% (133/271) to B Victoria. The percentages of participants seroprotected after vaccination on HI antibody against each strain were 81.2% (220/271) to A/H1N1, 98.5% (267/271) to A/H3N2, 95.2% (258/271) to B Yamagata, and 93.7% (254/271) to B Victoria. There was no serious adverse event (SAE) related with the study vaccine. CONCLUSION The quadrivalent split influenza vaccine is expected to offer seroprotection against influenza A and both influenza B lineages even in the elderly population.
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Affiliation(s)
- Tae Hyong Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea
| | - Jung-Hyun Choi
- Division of Infectious Diseases, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Sun Hee Park
- Division of Infectious Diseases, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin-Hong Yoo
- Division of Infectious Diseases, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Gun Lee
- Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Su-Mi Choi
- Division of Infectious Diseases, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yang Ree Kim
- Division of Infectious Diseases, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi Suk Lee
- Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Eun Ju Choo
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Hee Jung Choi
- Division of Infectious Diseases, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
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Tao YY, Li JX, Hu YM, Hu YS, Zeng G, Zhu FC. Quadrivalent influenza vaccine (Sinovac Biotech) for seasonal influenza prophylaxis. Expert Rev Vaccines 2021; 20:1-11. [PMID: 33434084 DOI: 10.1080/14760584.2021.1875823] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Quadrivalent Influenza Vaccine (Sinovac Biotech) is a quadrivalent split-virion-inactivated influenza vaccine approved in China in June 2020 for individuals ≥3 years of age. It contains 15 µg hemagglutinin per strain including A/H1N1, A/H3N2, B/Victoria, and B/Yamagata, which could potentially improve protection against influenza B viruses. AREAS COVERED In this review, we summarize the development of quadrivalent influenza vaccines in China and foreign countries, and assess the immunogenicity and safety from the phase I and III clinical trials of Quadrivalent Influenza Vaccine in individuals ≥3 years of age. We also discuss the potential application of Quadrivalent Influenza Vaccine in young children 6-35 months of age according to the results of the phase III trial. EXPERT COMMENTARY The immunogenicity and safety profiles of Quadrivalent Influenza Vaccine containing two A and two B strains were comparable to the trivalent vaccines for the shared strains. The addition of a second B strain to the trivalent vaccine could induce superior immune responses for the alternate B strain. Since the two B strains co-circulated worldwide, the introduction of quadrivalent influenza vaccines has been expected to be a cost-effective strategy.
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Affiliation(s)
- Yan-Yang Tao
- School of Public Health, Southeast University; Nanjing, China
| | - Jing-Xin Li
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yue-Mei Hu
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuan-Sheng Hu
- Clinical Research Department, Sinovac Biotech Co., LTD., Beijing, China
| | - Gang Zeng
- Clinical Research Department, Sinovac Biotech Co., LTD., Beijing, China
| | - Feng-Cai Zhu
- School of Public Health, Southeast University; Nanjing, China.,NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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12
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Choi EJ, Park JH, Chun BC. Cost effectiveness of trivalent and quadrivalent influenza vaccines in 50- to 64-year-old adults in Korea. Vaccine 2020; 38:5002-5008. [PMID: 32532543 DOI: 10.1016/j.vaccine.2020.05.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/04/2020] [Accepted: 05/21/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Influenza causes severe complications in at-risk populations, resulting in significant morbidity and mortality. Vaccination is the most effective measure to prevent infection and complications caused by seasonal influenza. However, no study has analyzed the cost-effectiveness of influenza vaccines in 50- to 64-year-olds in South Korea. OBJECTIVE We examined the application of the National Immunization Program (NIP) in 50- to 64-year-olds and compared the cost-effectiveness of quadrivalent influenza vaccine (QIV) with that of trivalent influenza vaccine (TIV) in South Korea. METHODS One-year static model was assumed by constructing separate decision trees for age subgroups: 50-54, 55-59, and 60-64. Each subgroup was divided into at-risk and not-at-risk groups. Using circulation data from previous studies and Korea Centers for Disease Control and Prevention, we estimated the probabilities of influenza infection, outpatient treatment, hospitalization, and deaths. Medical cost was estimated from 2015 to 2017 National Health Insurance Sharing Service claim data, while productivity losses from work absenteeism or death were estimated from labor and economic surveys of Korean government. Disutility was estimated based on previous studies. RESULTS Compared with non-vaccination, incremental cost-effectiveness ratios (ICERs) for the 50-54, 55-59, and 60-64 age groups for TIV were US$2010.90, US$2004.58, and US$1865.55, respectively, while for QIV were US$2187.17, US$2190.89, and US$2074.52, respectively. Compared with TIV, ICERs for QIV were US$4445.66, US$4578.06, and US$4751.93, respectively. All the aforementioned ICER values were lower than the 2017 Korean GDP per capita of US$29,742.839. CONCLUSION Implementing the NIP in the 50- to 64-year-old age group was found to be cost effective. Since both TIV and QIV were cost effective, we recommend QIV as the preferred option, based on its greater protection against Influenza B.
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Affiliation(s)
- Eun Joung Choi
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Joo Hee Park
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Byung Chul Chun
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea; Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, Republic of Korea.
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Leite JA, Resende P, Araya JL, Barrera GB, Baumeister E, Caicedo AB, Coppola L, de Mello WA, de Mora D, Cordeiro dos Santos M, Fasce R, Fernández J, Goñi N, Martínez IL, Mayhua JO, Motta F, Nuñez MCH, Ojeda J, Ortega MJ, Ospitia E, de Paiva TM, Pontoriero A, Porras HB, Quinonez JAD, Ramas V, Ramírez JB, Santos KCDO, Siqueira MM, Vàzquez C, Palekar R. Genetic evolution of influenza viruses among selected countries in Latin America, 2017-2018. PLoS One 2020; 15:e0227962. [PMID: 32155152 PMCID: PMC7064222 DOI: 10.1371/journal.pone.0227962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 01/03/2020] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE Since the 2009 influenza pandemic, Latin American (LA) countries have strengthened their influenza surveillance systems. We analyzed influenza genetic sequence data from the 2017 through 2018 Southern Hemisphere (SH) influenza season from selected LA countries, to map the availability of influenza genetic sequence data from, and to describe, the 2017 through 2018 SH influenza seasons in LA. METHODS We analyzed influenza A/H1pdm09, A/H3, B/Victoria and B/Yamagata hemagglutinin sequences from clinical samples from 12 National Influenza Centers (NICs) in ten countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Paraguay, Peru and Uruguay) with a collection date from epidemiologic week (EW) 18, 2017 through EW 43, 2018. These sequences were generated by the NIC or the WHO Collaborating Center (CC) at the U.S Centers for Disease Control and Prevention, uploaded to the Global Initiative on Sharing All Influenza Data (GISAID) platform, and used for phylogenetic reconstruction. FINDINGS Influenza hemagglutinin sequences from the participating countries (A/H1pdm09 n = 326, A/H3 n = 636, B n = 433) were highly concordant with the genetic groups of the influenza vaccine-recommended viruses for influenza A/H1pdm09 and influenza B. For influenza A/H3, the concordance was variable. CONCLUSIONS Considering the constant evolution of influenza viruses, high-quality surveillance data-specifically genetic sequence data, are important to allow public health decision makers to make informed decisions about prevention and control strategies, such as influenza vaccine composition. Countries that conduct influenza genetic sequencing for surveillance in LA should continue to work with the WHO CCs to produce high-quality genetic sequence data and upload those sequences to open-access databases.
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Affiliation(s)
- Juliana Almeida Leite
- Pan American Health Organization (PAHO/WHO), Washington, DC, United States of America
| | - Paola Resende
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jenny Lara Araya
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Gisela Badillo Barrera
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ciudad de México, Mexico, Mexico
| | - Elsa Baumeister
- Instituto Nacional de Enfermedades Infecciosas—Administración Nacional de Laboratorios e Institutos de Salud (INEI-ANLIS) "Dr. Carlos G. Malbran", Buenos Aires, Argentina
| | - Alfredo Bruno Caicedo
- Instituto Nacional de Investigación en Salud Pública (INSPI), Guayaquil, Guayas, Ecuador
| | - Leticia Coppola
- Departamento de Laboratorio de Salud Publica (DLSP), Montevideo, Montevideo, Uruguay
| | | | - Domenica de Mora
- Instituto Nacional de Investigación en Salud Pública (INSPI), Guayaquil, Guayas, Ecuador
| | | | - Rodrigo Fasce
- Instituto de Salud Pública de Chile (ISPCH), Santiago, Santiago, Chile
| | - Jorge Fernández
- Instituto de Salud Pública de Chile (ISPCH), Santiago, Santiago, Chile
| | - Natalia Goñi
- Departamento de Laboratorio de Salud Publica (DLSP), Montevideo, Montevideo, Uruguay
| | - Irma López Martínez
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ciudad de México, Mexico, Mexico
| | | | - Fernando Motta
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jenny Ojeda
- Ministerio de Salud Pública, Quito, Pichincha, Ecuador
| | - María José Ortega
- Laboratorio Central de Salud Pública (LCSP), Ascuncion, Distrito Capital, Paraguay
| | - Erika Ospitia
- Instituto Nacional de Salud (INS), Bogota, Cundinamarca, Colombia
| | | | - Andrea Pontoriero
- Instituto Nacional de Enfermedades Infecciosas—Administración Nacional de Laboratorios e Institutos de Salud (INEI-ANLIS) "Dr. Carlos G. Malbran", Buenos Aires, Argentina
| | - Hebleen Brenes Porras
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Jose Alberto Diaz Quinonez
- Instituto de Diagnóstico y Referencia Epidemiológicos (InDRE), Ciudad de México, Mexico, Mexico
- Division of Postgraduate Studies, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Viviana Ramas
- Departamento de Laboratorio de Salud Publica (DLSP), Montevideo, Montevideo, Uruguay
| | | | | | - Marilda Mendonça Siqueira
- Laboratorio de Virus Respiratorio, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cynthia Vàzquez
- Laboratorio Central de Salud Pública (LCSP), Ascuncion, Distrito Capital, Paraguay
| | - Rakhee Palekar
- Pan American Health Organization (PAHO/WHO), Washington, DC, United States of America
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14
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Noh JY, Jang YS, Lee SN, Choi MJ, Yoon JG, Yu DH, Song JY, Cheong HJ, Kim WJ. Randomized, single-blind, active-controlled phase I clinical trial to evaluate the immunogenicity and safety of GC3114 (high-dose, quadrivalent influenza vaccine) in healthy adults. Vaccine 2019; 37:5171-5176. [PMID: 31377075 DOI: 10.1016/j.vaccine.2019.07.076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 11/27/2022]
Abstract
Influenza is a major medically attended respiratory illness. The impact of influenza on morbidity and mortality is particularly high in the elderly. Immunosenescence attenuates the immune response of influenza vaccine in the elderly. High-dose influenza vaccine contains 60 μg of hemagglutinin per strain, four times more compared with standard-dose (SD) influenza vaccine. This study is a phase I clinical trial investigating the immunogenicity and safety of the GC3114, high-dose, quadrivalent inactivated influenza vaccine (HD-QIV) in healthy adults aged 19-64 years during the 2017-2018 season. Seroprotection rates of HD-QIV were 100.0% for A/H1N1, 96.67% for A/H3N2, 83.33% for B/Yamagata, and 96.67% for B/Victoria. Seroconversion rate for A/H1N1, A/H3N2, B/Yamagata, and B/Victoria strains were 86.67%, 90.0%, 53.33%, and 53.33%, respectively, in the HD-QIV group. The post-/pre-vaccination geometric mean titer ratio (GMTR) was 15.28 for A/H1N1, 8.19 for A/H3N2, 3.56 for B/Yamagata, and 3.03 for B/Victoria in the HD-QIV group. Seroconversion rate and post-/pre-vaccination GMTR for A/H3N2 were significantly higher in the HD-QIV group than in the SD-QIV group (control). No serious adverse events were reported. In conclusion, GC3114 was safe, well-tolerated, and immunogenic in healthy adults. Clinical Trials Identifier: NCT03357263.
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Affiliation(s)
- Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ye Seul Jang
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Saem Na Lee
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Min Joo Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jin Gu Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Du Hyeon Yu
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, Republic of Korea.
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