A study of patient data from the 2019-20 US flu season found that the MF59-adjuvanted flu vaccine was more effective than the high-dose flu vaccine at preventing serious flu complications in older adults with risk factors, researchers reported late last week in Open Forum Infectious Diseases.
The MF59-adjuvanted trivalent influenza vaccine (aTIV) and the high-dose trivalent influenza vaccine (HD-TIV) are both designed for adults age 65 and older, who are at serious risk from serious flu complications. An adjuvant is an immune-boosting agent added to vaccines.
Previous studies have found the two vaccines to have similar effectiveness in older adults, including those who have at least one underlying health condition known to increase their risk of experiencing severe flu. But there is limited research on how multiple concurrent high-risk conditions affect vaccine effectiveness.
aTIV more effective in adults with multiple risk factors
Using electronic health record data linked with pharmacy and medical claims, researchers estimated the relative vaccine effectiveness (rVE) in 1,115,725 aTIV recipients and 2,561,718 HD-TIV recipients from August 2019 through January 2020. The primary measure was prevention of influenza-related medical encounters (IRMEs). The secondary outcome was outpatient IRME and flu- and pneumonia-related hospitalizations.
Among older adults with risk factors for complications, aTIV was more effective than HD-TIV at preventing any IRME, with an rVE of 12.5% (95% confidence interval [CI], 10.0% to 15.0%) for adults with 1 or more risk factor, 18.4% (95% CI, 13.7% to 22.8%) for adults with 1 or 2 risk factors, and 10.4% (95% CI, 7.4% to 13.3%) for adults 3 or more risk factors. No difference in rVE was observed among older adults with no risk factors.
The same trends were observed for the secondary outcomes of outpatient IRMEs and flu- or pneumonia-related hospitalizations.
The study authors suggest the broader immune response provide by the MF59 adjuvant may account for the higher vaccine effectiveness observed among the most vulnerable in the population study, but say further research is needed to investigate how the immune response generated by aTIV contributes to overall vaccine effectiveness across populations with different risk profiles.