QUADRIVALENT INFLUENZA VACCINES
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
H1N1
+
H3N2
+
Victoria
or
Yamagata
The addition of strain 4 to the
QUADRIVALENT
influenza vaccines
provides greater protection against influenza B viruses of both strains (Yamagata and Victoria)
H1N1
+
H3N2
+
Victoria
+
Yamagata
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
| Country/ 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 |