High-Dose Flu Vaccine Could Benefit Younger Adults With Chronic Conditions

Expansion of the high-dose influenza vaccine recommendation could benefit middle-aged adults with chronic health conditions, such as diabetes, lung disease, or cancer, and save on healthcare costs, according to the results of a recent study.

Currently, the high-dose influenza vaccine is recommended for adults aged 65 years and older due to diminishing immune responses with increasing age. However, the researchers noted that these options— high-dose trivalent inactive influenza vaccine (HD-IIV3) and recombinant trivalent influenza vaccine (RIV)—could provide better protection against influenza in adults aged 50 to 64 years with conditions that increase the risk of influenza complications.
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Using Markov model CE analysis, the researchers compared 5 strategies in 50 to 64 year old patients: no vaccination; standard-dose IIV3 (SD-IIV3 only), quadrivalent influenza vaccine (SD-IIV4 only); high-risk patients receiving HD-IIV3, others receiving SD-IIV3 (HD-IIV3 & SD-IIV3); and high-risk patients receiving HD-IIV3, others receiving SD-IIV4 (HD-IIV3 & SD-IIV4). In a secondary analysis, RIV replaced HD-IIV3.

Overall, the least expensive strategy was SD-IIV3 only, costing $99.84 per person. SD-IIV4 only cost an additional $0.91 per person, and HD-IIV3 & SD-IIV4 cost $1.06 more than SD-IIV4 only.

 “The growing proportion of middle-aged adults with chronic health conditions coupled with the modest effectiveness of the standard-dose influenza vaccine prompted us to explore whether existing vaccines already recommended for the elderly also could protect younger people,” said Jonathan Raviotta, MPH, CPH, senior research specialists with The Pittsburgh Vaccination Research Group.

“Sure enough, expanding the recommendation does seem like a good policy — in silico. Before making such a recommendation, real world clinical trials are needed.”

—Michael Potts

References:

1. Raviotta JM, Smith KJ, DePasse J, et al. Cost-effectiveness and public health impact of alternative influenza vaccination strategies in high-risk adults [published online September 7, 2017]. Vaccine. Doi:https://doi.org/10.1016/j.vaccine.2017.07.069.
2. Flu vaccine used in elderly may benefit middle-aged adults with chronic conditions [press release]. September 21, 2017. Pittsburgh, Pennsylvania. http://www.upmc.com/media/NewsReleases/2017/Pages/raviotta-flu.aspx.