CSL Seqirus is very concerned with Pharmac’s proposal not to fund recommended enhanced influenza vaccines for people aged 65 and over on the National Immunisation Program (NIP) from 2024 – 2027. Instead, Pharmac will continue funding standard influenza vaccines for this age group.
Older adults are at higher risk for influenza complications and death than the general population. Seasonal influenza is associated with over 3,240 all-cause hospitalisations and 400-500 deaths annually in New Zealand for all ages.1-3 86% of those deaths occur in people aged 65 and over.3
Countries around the world are moving away from standard influenza vaccines because there is wide recognition that enhanced vaccines offer key advantages. In 2022, Pharmac’s Immunisation Advisory Committee recommended that enhanced vaccines be funded with a high priority as they are more effective than standard influenza vaccines in people aged 65 years and over.40
The US, UK, Australia, Italy and Spain publicly fund enhanced influenza vaccines, like Fluad Quad, for people aged 65 and over and New Zealand will be lagging behind these developed countries.
Dr Jonathan Anderson, GP and CSL Seqirus Executive Medical Director says that the protecting the health of older New Zealanders should be prioritised.
“Older adults are more vulnerable to catching flu and experiencing complications that can lead to serious strife. Enhanced vaccines are designed to protect people with an older immune system and keep them out of hospital.”
“New Zealand has a lot of fantastic doctors, nurses and pharmacists but resources are really stretched due to COVID and the flu. One really important thing we can do to protect our health system is to help prevent flu in older age groups.”
“We understand that Pharmac needs to allocate its resources carefully, but enhanced vaccines have been found to be a highly cost-effective prevention for this age group. Pharmac should be given the resources they need to follow their recommendation and fund these vaccines on the NIP with a high priority.
“We’re concerned that without this funding there will be significant inequality as only people who can afford to pay will be able to access the vaccine. This can be a real barrier to accessing prevention for older adults who might be on the pension or Maori and Pasifika populations that already have lower vaccination rates.”
“We know flu can have significant population health impacts. For example, Australia experienced a particularly severe flu season in 2017 with over 6,400 deaths.5 More than 91% of reported deaths and over half of hospitalisations occurred in people aged 65 years or over.5 Funding for enhanced vaccines for this age group began the following year and they have since saved lives.”
About Enhanced Influenza Vaccines
Standard influenza vaccine effectiveness may be reduced in adults 65 years and older compared to younger, healthy adults, because the immune response to vaccines declines as people age.6-8 This means older adults are also more vulnerable to contracting influenza and developing associated complications.6-8
Enhanced influenza vaccines, like Fluad Quad, are designed with an adjuvant which aims to boost the immune response in older adults and help address these problems.9,10 Real-world evidence has consistently demonstrated the benefits of Fluad Quad in reducing hospitalisations due to influenza and influenza-related complications, compared to standard undifferentiated influenza vaccines.11-16
References
Khieu TQ, et al. 2015. Vaccine. Aug 7;33(33):4087-92. Available at: https://pubmed.ncbi.nlm.nih.gov/26143611/. Accessed June 2023.
Stats NZ. 2023. National population estimates. Available at: https://www.stats.govt.nz/information-releases/national-population-estimates-at-31-march-2023/. Accessed June 2023.
Kessaram T., et al. 2015. Influenza Other Respir Viruses. Jan;9(1):14-9. Available at:https://www.sciencedirect.com/science/article/pii/S0163445317301652. Accessed June 2023.
Record of the Immunisation Advisory Committee Meeting held on 09 September 2022. Available at:https://pharmac.govt.nz/assets/2022-09-Immunisation-Advisory-Meeting-Record.pdf Accessed May 2023.
Australian Government Department of Health, 2017 Influenza season summary. Available on Trove. Accessed May 2023.
Monto AS, Ansaldi F, Aspinall R, et al. Influenza control in the 21st century: optimizing protection of older adults. Vaccine. 2009;27(37):5043-5053. doi:10.1016/j.vaccine.2009.06.032
Schaffner W, Gravenstein S, Hopkins RH, Jernigan DB. Reinvigorating influenza prevention in US adults aged 65 years and older. Infect Dis Clin Pract. 2016;24(6):303-309.
McElhaney JE, Kuchel GA, Zhou X, Swain SL, Haynes L. T-cell immunity to influenza in older adults: a pathophysiological framework for development of more effective vaccines. Front Immunol. 2016;7:41. doi:10.3389/ fimmu.2016.00041
Di Pasquale A, Preiss S, Tavares Da Silva F, Garçon N. Vaccine adjuvants: from 1920 to 2015 and beyond. Vaccines (Basel). 2015;3(2):320-343. doi:10.3390/ vaccines3020320
Coffman RL, Sher A, Seder RA. Vaccine adjuvants: putting innate immunity to work. Immunity. 2010;33(4):492-503. doi:10.1016/j. immuni.2010.10.002
Boikos C et al. (2021a). Relative Effectiveness of Adjuvanted Trivalent Inactivated Influenza Vaccine Versus Egg-derived Quadrivalent Inactivated Influenza Vaccines and High-dose Trivalent Influenza Vaccine in Preventing Influenza-related Medical Encounters Adults ≥65 Years Duri. Clin Inf Disease, 73 (1 September), 816.
Imran M et al , Relative Effectiveness of MF59 Adjuvanted Trivalent Influenza Vaccine vs Nonadjuvanted Vaccines During the 2019–2020 Influenza Season, Open Forum Infectious Diseases, Volume 9, Issue 5, May 2022, ofac167, https://doi.org/10.1093/ofid/ofac167
Izurieta HS et al. (2019). Relative Effectiveness of Cell-Cultured and Egg-Based Influenza Vaccines Among Elderly Persons in the United States 2017-18. The Journal of Infectious Diseases, 220 (15 October), 1255.
Izurieta HS, et al. (2020a). Relative Effectiveness of Influenza Vaccines Among the United States elderly 2018-19. The Journal of Infectious Diseases, 222 (15 July), 278.
Izurieta, HS et al. (2020b). Comparative Effectiveness of Influenza Vaccines Among US Medicare Beneficiaries Ages 65 Years and Older During the 2019-20 season. Clinical Infectious Diseases, published online 19 November2020, 2021;73(11):e4251–9
Pelton SI, et. al. (2020). Evaluating the Relative Vaccine Effectiveness of Adjuvanted Trivalent Influenza Vaccine Compared to High Dose Trivalent and Other Egg-Based Influenza Vaccines among Older Adults in the US during the 2017–2018 Influenza Season.Vaccines , 8, 446.
