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

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Milne, GJ; Halder, N; Kelso, JK; Barr, IG; Moyes, J; Kahn, K; Twine, R; Cohen, CDate
2016-07-01Source Title
Influenza and Other Respiratory VirusesPublisher
WILEY-BLACKWELLUniversity of Melbourne Author/s
Barr, IanAffiliation
Microbiology and ImmunologyMetadata
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Journal ArticleCitations
Milne, G. J., Halder, N., Kelso, J. K., Barr, I. G., Moyes, J., Kahn, K., Twine, R. & Cohen, C. (2016). Trivalent and quadrivalent influenza vaccination effectiveness in Australia and South Africa: results from a modelling study. INFLUENZA AND OTHER RESPIRATORY VIRUSES, 10 (4), pp.324-332. https://doi.org/10.1111/irv.12367.Access Status
Open AccessAbstract
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.
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