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Epidemiology . Evaluating potential impacts of a preferential vaccine recommendation for adults aged 65 and older on United States influenza burden

tetano

Editor, Senior Moderator
Epidemiology


. 2023 Feb 21;e001603.
doi: 10.1097/EDE.0000000000001603. Online ahead of print.
Evaluating potential impacts of a preferential vaccine recommendation for adults aged 65 and older on United States influenza burden


Sinead E Morris[SUP] 1 [/SUP], Lisa A Grohskopf, Jill M Ferdinands, Carrie Reed, Matthew Biggerstaff



Affiliations

Abstract

Background: High-dose, adjuvanted, and recombinant influenza vaccines may offer improved effectiveness among older adults compared to standard-dose, unadjuvanted, inactivated vaccines. However, the Advisory Committee on Immunization Practices (ACIP) only recently recommended preferential use of these 'higher-dose or adjuvanted' vaccines. One concern was that individuals might delay or decline vaccination if a preferred vaccine is not readily available.
Methods: We mathematically model how a recommendation for preferential use of higher-dose or adjuvanted vaccines in adults ≥65 years might impact influenza burden in the United States during exemplar 'high-' and 'low-' severity seasons. We assume higher-dose or adjuvanted vaccines are more effective than standard vaccines and that such a recommendation would increase uptake of the former but could cause (i) delays in administration of additional higher-dose or adjuvanted vaccines relative to standard vaccines and/or (ii) reductions in overall coverage if individuals only offered standard vaccines forego vaccination.
Results: In a best-case scenario, assuming no delay or coverage reduction, a new recommendation could decrease hospitalizations and deaths in adults ≥65 years by 0-4% compared with current uptake. However, intermediate and worst-case scenarios, with assumed delays of 3 or 6 weeks and/or 10 or 20% reductions in coverage, included projections in which hospitalizations and deaths increased by over 7%.
Conclusions: We estimate that increased use of higher-dose or adjuvanted vaccines could decrease influenza burden in adults ≥65 in the United States provided there is timely and adequate access to these vaccines, and that standard vaccines are administered when they are unavailable.
 
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