Influenza vaccines and national policy - the good, the bad and the ugly...


This month VacZine Analytics releases its newly updated value/volume forecast for the global market for seasonal influenza vaccines. The influenza vaccine recommendations for 35 countries (13 Western and 21 Emerging/ROW) have been assessed, with some interesting findings.

Annual seasonal influenza epidemics typically affect 5-15% of the population mainly with upper respiratory tract infections. On a global basis around 3-5 million cases of severe illness due to influenza are estimated to occur each year with an associated 250,000 - 650,000 deaths (WHO figures). Importantly: 9,000-105,000 annual deaths occur in children < 5 years.

Influenza vaccination is the most effective method for preventing influenza virus infection and its complications. Recommended groups for influenza vaccination are usually those most vulnerable and include the elderly, very young and those with underlying chronic diseases. In the USA, influenza vaccination recommendations are comprehensive and now include every person >6 mos. In the USA, enough influenza vaccine is distributed to vaccinate ~44% of the population. However, some of the most populous countries of the world such as India, China and Indonesia have little or no influenza vaccine national policy and consume very little of global vaccine output. A large disparity occurs between different nations (both rich and poor) on how each tackle the annual burden exerted by the influenza virus, especially for young children.

Influenza vaccines are still predominantly of the trivalent inactivated format (TIV) although latest advances include the addition of another B virus strain to form Quadrivalent (QIV) vaccines. QIV vaccines are now forming the majority of supply in the US and now with new approvals in Europe and ROW countries are forecast to drive a further switch in coming years. Higher dose (HD) vaccine formats with additional haemagluttinin (HA) antigen content have shown increased protection in older age groups. Other differentiated vaccines such as those produced in recombinant-based systems, e.g. cell-based could eventually displace egg-based vaccines especially if less sensitive to mismatch with circulating strains.

VacZine Analytics’ latest MarketVIEW product: Seasonal Influenza vaccines (June 2018) is a comprehensive MS Excel-based model (>120 worksheets) + Executive presentation (~ 220 .pdf slides) which forecasts the potential commercial volume and value of seasonal influenza vaccines across 13 major Western and 21 emerging or “rest of world” markets to 2034. The model contains validated volume (mio doses) estimates for all recommended target groups per country based on a thorough investigation of national recommendations and policy and detailed country-specific vaccine coverage rates. Country market values are ascertained by a detailed pricing methodology based upon public/private sector prices for TIVs, QIVs, high dose (HD), LAIV and other forms where the impact of discounting has been explored. The analysis contains a detailed US forecast by product type and individual competitor including Seqirus' new QIV (Flucelvax)MF-59 adjuvanted FLUAD and Sanofi’s new HD portfolio (Fluzone + Flublok). An updated methodology is introduced to estimate the adoption of QIV products outside of the key US market looking at 9 ROW suppliers. An updated analysis of the UK childhood program is included with the hypothetical value of further childhood programs also assessed. 

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