NHS should consider expanding quadrivalent flu jab after fourth strain hits Europe

The NHS and other European healthcare providers should start administering quadrivalent vaccines to better protect against the influenza virus according to GlobalData, a leading data and analytics company.

In the UK, the NHS recommends that adults receive a jab known as a trivalent flu vaccine, which only protects against three of these four strains. But data suggests that the fourth strain – sometimes known as ‘Japanese flu’ – is now the most prevalent in Europe.

“By most measures, the 2017–2018 influenza season has thus far been particularly severe and the disease is currently placing a significant burden on healthcare services in Europe and North America,” Thomas Moore, Healthcare Analyst at GlobalData, said.

Each year, influenza vaccines are manufactured to protect against multiple strains based on recommendations from the World Health Organization (WHO). Vaccines can be split into two different categories: trivalent vaccines, which protect against three strains of influenza, and quadrivalent vaccines, which also protect against a fourth strain.

The more expensive quadrivalent vaccines are the most prescribed influenza vaccine in the US. However, most European patients still receive the trivalent vaccine. In the UK, the NHS only provides a quadrivalent vaccine to children below the age of 18, with all other patients receiving a trivalent vaccine. This flu season, the NHS has provided flu jabs free at the point of care to at-risk patients, with UK pharmacies offering the trivalent vaccine to elective patients for £11.

Data released by the Centers for Disease Control and Prevention (CDC) and the European Centre for Disease Prevention and Control (ECDC) on the different flu strains in circulation suggest that use of the trivalent vaccine may have caused an increased circulation of Japanese flu in Europe.

Of cases tested across Europe during the 2017–2018 season, 65% have been Influenza B, of which the most common subtype has been Japanese flu. In comparison, only nine per cent of patients in the US have been found to have Japanese flu, with the H3N2 strain—also known as ‘Aussie Flu’ —being the most prevalent at 78% of infections.

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“There are several factors that could contribute to the difference in influenza strains observed between continents. For example, a high prevalence of the H3N2 strain in Europe during the 2016–2017 season is expected to have carried over some protection against Aussie flu this year. However, it is highly likely that the stark difference in prevalence of Japanese flu between Europe and the US is affected by the continued use of trivalent vaccines,” Moore added.

The quadrivalent influenza vaccines that are currently available in the UK are GlaxoSmithKline’s Fluarix Tetra, which launched in 2013, and Sanofi Pasteur’s quadrivalent influenza vaccine, which launched in 2017. At a cost of £9.94 and £8.00 respectively, these vaccines only cost the NHS slightly more than trivalent vaccines, which cost approximately £6 per jab, depending on supplier.

Given the potential benefits of protecting against four strains over three, GlobalData believes that the extra cost of the vaccines amounts to a better long-term investment.

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