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

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    Author
    Milne, GJ; Halder, N; Kelso, JK; Barr, IG; Moyes, J; Kahn, K; Twine, R; Cohen, C
    Date
    2016-07-01
    Source Title
    Influenza and Other Respiratory Viruses
    Publisher
    WILEY-BLACKWELL
    University of Melbourne Author/s
    Barr, Ian
    Affiliation
    Microbiology and Immunology
    Metadata
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    Document Type
    Journal Article
    Citations
    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 Access
    URI
    http://hdl.handle.net/11343/259599
    DOI
    10.1111/irv.12367
    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.

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