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Routine use of new type of flu vaccine in older people 'could prevent 1,700 deaths'


Around 1,700 influenza-related deaths in the UK could be avoided every year if people over the age of 65 switched to a new type of vaccination, analysis has suggested.

If older people were switched from a conventional non-adjuvanted vaccine currently used in the UK immunisation programme to an adjuvanted trivalent influenza vaccine (aTIV), 195,600 cases of influenza could be prevented, according to estimations by researchers.

“The model demonstrated that the adjuvanted vaccine had an incremental cost-effectiveness ratio of £3,540 per quality-adjusted life year”

Dr Van Hung Nguyen

The researchers – who are linked to the firm that plans to offer the new type of vaccine in the UK – claimed this would also result in 21,800 fewer GP visits and see the number of related hospital admissions reduced by around 2,300.

Use of an aTIV would also be cost-effective for the NHS, suggested the findings, which were presented earlier this month at a European Scientific Working group on Influenza (ESWI) meeting in Riga, Latvia.

Estimations from the study – based on the price of the new aTIV being £16 – show that improvements to people’s health would represent a cost of £3,540 for every extra year lived in good health, as a result of the vaccine being used for the over 65 age cohort.

This is below the usual £20,000 measurement threshold set by the National Institute of Health and Clinical Excellence, which makes recommendations on the use of drugs for the NHS based on their cost effectiveness – though it does not routinely issue guidance on vaccines.

To become used routinely as part of a national vaccine programme, an aTIV would need to be first approved by the UK medicines safety watchdog, which one has been, and then recommended as beneficial for routine use by an expert group that advises the Department of Health.

As reported by Nursing Times, the Medicines and Healthcare products Regulatory Agency last month approved an aTIV called Fluad, which is manufactured by Seqirus and has previously been approved by drug safety agenices in the US.

However, while the use of aTIVs has gained some support from the Joint Committee on Vaccination and Immunisation (JCVI), the expert advisory group has yet to provide a recommendation to the government on whether to include it in NHS vaccination programmes.

Earlier this summer, the JCVI said it would bring forward its review of vaccination programmes for over 65s, partly in light of the fact that Fluad had been approved. The joint committee said it would consider evidence at its next meeting in October.

The new study (see poster attached below) was led by research consultant Dr Van Hung Nguyen, along with Seqirus’s senior director of policy Claudia Kelly and James Mansi, the company’s global medical lead for medical affairs.

“Health economic analyses consistently show that more effective flu vaccines are very good value in older patients”

Marco Barbieri

Dr Nguyen said:“The model demonstrated that the adjuvanted vaccine had an incremental cost-effectiveness ratio of £3,540 per quality-adjusted life year if used preferentially in those aged 65 years of age and over in the UK.

“This is well within, and actually considerably below, the National Institute of Health and Clinical Excellence’s guideline threshold of £20,000 per quality-adjusted life year for medicines,” he added.

Maidenhead-based manufacturers Seqirus announced last month that it could supply 10 million doses of Fluad in the UK for the 2018-19 flu season, if asked to do so.

Commenting on the research, Dr Marco Barbieri, from the Centre for Health Economics at the University of York, said: “Health economic analyses consistently show that more effective flu vaccines are very good value in older patients.

“They reduce the number of GP consultations, A&E visits and episodes of serious illness and, of course, they help older people to remain healthy and independent,” he said. “These data suggest that use of an adjuvanted influenza vaccine is a cost-effective option for the NHS immunisation programme.”


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Readers' comments (2)

  • This article is absolute conjecture. Dont mistake quantity for quality, when it comes to the flu vaccine there is alot of talk but very little substance. Osterholm et al (2012) Lancet meta analysis looked at 5707 influenza studies conducted over a 30 year period and found only 30 were conducted with scientitic credibility. Shockingly, There was not a single quality RCT to support flu vaccination as a worthy endeavour for seniors. The Cochrane reviews have consistently said the same thing. The flu jab for healthcare workers caring for the elderly has also never been able to reliably demonstrate a reduction in influenza deaths or hospitalizations ( De Serres et al, 2017, Thomas et al 2013)

    We have wasted millions into this empty, misguided policy based on consensus science. Adjuvanted flu vaccines like the ones suggested here have caused immune system havoc in the past ( see Pandermix with the 2009 pandemic causing narcolepsy in 1 in 55,000 European children) The adjuvanted flu vaccine for the elderly cited here uses adjuvant MF59 that has been linked to death and immune dysfunction. The trial for Fluad in the the US killed 105 seniors on the trial.

    We cannot fulfill our duty to care operating in a blind spot of evidence. Why dont you tell us the truth about what RCT's really say on this issue? Why dont we focus on quality initiatives for our elderly instead of wasted and harmful flu vaccines that only serve political agendas and pharma and not our seniors?

    Leslie Moore, MSN

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  • I'm afraid this comment is not entirely accurate. The adjuvant MF59 is quite different from other squalene or aluminium based adjuvants that were associated with the incidences of narcolepsy in 2009. The issue is one of nucleoproteins, of which MF59 contains none. Further, in terms of the trials conducted with the US, the incidence of SAE, including deaths, was no greater than the comparator -- and actually nearly half in some instances. I believe this vaccine has been available in Europe since before 2000, and has quite a unique safety and efficacy profile, particularly in the at-risk groups. Thank you.

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