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Since 2012, WHO has been recommending annually that influenza B viruses of both Yamagata and Victoria strains be included in seasonal influenza vaccines.1
TRIVALENT influenza vaccines contain antigens from 3 strains of influenza virus
The addition of strain 4 to the QUADRIVALENT influenza vaccines provides greater protection against influenza B viruses of both strains (Yamagata and Victoria)
The effect of influenza B virus strain mismatch on vaccine efficacy
The efficacy of 3-valent vaccines may be reduced by 20-25% if there is an antigenic mismatch of the influenza B2 virus strains2
SYSTEMATIC REVIEW AND META-ANALYSIS OF VACCINE COMPARATIVE EFFICACY Vaccination efficacy when influenza B strains match Vaccination efficacy when influenza B strains mismatch
Efficacy against influenza B of both lines 30 RCCT 1976-2011 90 000 subjects Children (LAIV ** ) and adults (TIV * ) % 95% CL % 95%
71 52-82 49 32-61
34 RCCT 2003-2011 95 000 subjects adults (TIV * ) 77 18-94 52 19-72
* TIV - Trivalent Inactivated influenza vaccines, ** LAIV - Live influenza vaccines
4-valent influenza vaccines have greater prophylactic and pharmacoeconomic efficacy than 3-valent vaccines
The Center for Disease Control and Prevention 2014-2034 (CDC, USA) estimates that the clinical outcomes and costs of replacing 3-valent with 4-valent vaccine will allow:33
to decrease the incidence of influenza B by 16 million cases
to decrease the number of lethal outcomes by 137,6 thousand cases
to decrease the number of lethal outcomes by 16,1 thousand cases
In Russia, a switch from the 3-valent to the 4-valent vaccine could prevent up to 265,8 thou cases of influenza per season4
Quadrivalent vaccines are included in National Immunization Programs in various countries of the world5
Regulatory body
Year when the recommendation was made Age/group of vaccinated persons
WHO 2012 Pregnant, children under 5 years old, health care professionals, elderly, persons with chronic diseases
Germany 2013 Pregnant; children under 5 years old; health care professionals, elderly; persons with chronic diseases;
USA 2013 Children from 6 months and adults
Hong Kong 2013 Children over the age of 3 and adults
Canada 2014 6 months and over
France 2014 Children over the age of 3 and adults
Belgium 2015 Over the age of 2
Brazil 2014 Elderly over 60 years old
Australia 2015 6 months and over
Great Britain 2013 Children 2-7 years old and children at risk 2-18 years old


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