51 Influenza Vaccine Programs with the Cell-Based Quadrivalent Influenza Vaccine and Adjuvanted Trivalent Influenza Vaccine are Highly Cost Effective in Canada
Bibliographic record
Abstract
Abstract Background Influenza vaccination with quadrivalent egg-based vaccines (QIVe) in adults ≥ 65 years may be less effective due to immunosenescence. An MF59®-adjuvanted trivalent influenza vaccine (aTIV) has been developed to provide stronger, broader and longer protection in older adults. For the younger age groups, lower effectiveness may be associated to the mutagenesis of influenza viruses that are propagated in eggs. A cell- based quadrivalent influenza vaccine (QIVc) was developed to improve the vaccine effectiveness by eliminating egg-adaptation. Objectives The objective of this analysis was to evaluate the potential public health impact on the utilization of both vaccines in Canada. Design/Methods An SEIR dynamic-transmission model was created and adapted to four influenza strains for the 2013-2019 seasons. Strain-specific circulation was obtained from Canada’s national surveillance system. Influenza incidence estimates were calibrated using CDC published data. The model used rVE from peer reviewed publications for QIVc and aTIV showing superiority to QIVe vaccines. Frequency of egg-based genetic changes were estimated from a published review of Crick Institute reports. Estimates of specific vaccines efficacy and economic assumptions were derived from the published literature. Different vaccination scenarios, based on the provincial vaccination programs, were modelled. Results Replacing QIVe with QIVc in subjects 6 months-64 years led to an annual reduction of 462 156 symptomatic cases; 58 122 GP visits; 40,871 emerging consultations; 3 788 hospitalizations and 662 deaths versus a QIVe-for-all scenario. The adoption of QIVc and aTIV will be highly cost effective over the use of QIVe. aTIV would also be more cost effective than QIVHD. Table 1 provides the detailed results for the others scenario. Sensitivity analyses confirmed the robustness of the assumptions used in the analysis. Conclusion The greatest public health impact is obtained by using QIVc and aTIV in influenza vaccine programs in Canada versus other combinations of available vaccine.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".