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Influenza Other Respir Viruses. 2016 Jul;10(4):324-32. doi: 10.1111/irv.12367. Epub 2016 Feb 8.

Trivalent and quadrivalent influenza vaccination effectiveness in Australia and South Africa: results from a modelling study.

Author information

1
School of Computer Science and Software Engineering, University of Western Australia, Perth, WA, Australia.
2
World Health Organization (WHO) Collaborating Centre for Reference and Research on Influenza, Melbourne, Vic., Australia.
3
Centre for Respiratory Disease and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.
4
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Science, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
5
Faculty of Health Science, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

BACKGROUND:

A modelling study was conducted to determine the effectiveness of trivalent (TIV) and quadrivalent (QIV) vaccination in South Africa and Australia.

OBJECTIVES:

This study aimed to determine the potential benefits of alternative vaccination strategies which may depend on community-specific demographic and health characteristics.

METHODS:

Two influenza A and two influenza B strains were simulated using individual-based simulation models representing specific communities in South Africa and Australia over 11 years. Scenarios using TIV or QIV, with alternative prioritisation strategies and vaccine coverage levels, were evaluated using a country-specific health outcomes process.

RESULTS:

In South Africa, approximately 18% fewer deaths and hospitalisations would be expected to result from the use of QIV compared to TIV over the 11 modelled years (P = 0·031). In Australia, only 2% (P = 0·30) fewer deaths and hospitalisations would result. Vaccinating 2%, 5%, 15% or 20% of the population with TIV using a strategy of prioritising vulnerable age groups, including HIV-positive individuals, resulted in reductions in hospitalisations and mortality of at least 7%, 18%, 57% and 66%, respectively, in both communities.

CONCLUSIONS:

The degree to which QIV can reduce health burden compared to TIV is strongly dependent on the number of years in which the influenza B lineage in the TIV matches the circulating B lineages. Assuming a moderate level of B cross-strain protection, TIV may be as effective as QIV. The choice of vaccination prioritisation has a greater impact than the QIV/TIV choice, with strategies targeting those most responsible for transmission being most effective.

KEYWORDS:

Influenza vaccination; quadrivalent influenza vaccine; seasonal influenza

PMID:
26663701
PMCID:
PMC4910176
DOI:
10.1111/irv.12367
[Indexed for MEDLINE]
Free PMC Article

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