title: Inactivated quadrivalent split-virus seasonal influenza vaccine (Fluarix® quadrivalent): a review of its use in the prevention of disease caused by influenza A and B.
abstract: The inactivated quadrivalent split-virus seasonal influenza vaccine [Fluarix® quadrivalent, manufactured in Dresden (D-QIV)] contains 15 μg haemagglutinin from each of the four influenza virus strains expected to circulate in the upcoming influenza season. Unlike seasonal trivalent influenza vaccines (TIVs), which have been used previously, quadrivalent influenza vaccines (QIVs) contain two influenza A subtype viruses and two B type viruses. As two different B viruses have co-circulated in recent years, incorporating both B lineages reduces the risk of the dominant B strain not being included in the vaccine. D-QIV is approved for active immunization of individuals aged ≥3 years to prevent disease caused by the influenza A subtype viruses and B type viruses contained in the vaccine. In large randomized, controlled trials, D-QIV was highly immunogenic in healthy adults (including individuals aged ≥65 years) and children, and exceeded the criteria for vaccine licensure. Immune responses for D-QIV, compared with those for TIVs, were non-inferior against influenza A strains and common B strains and superior against the additional B strain. D-QIV was generally well tolerated in all age groups studied and, overall, reactogenicity and tolerability were generally similar to observations with TIVs. Quadrivalent influenza vaccines are expected to offer substantial cost-effectiveness benefits in seasons where the B lineage selected for inclusion in TIVs does not match the dominant circulating strain. Thus, by incorporating both circulating influenza B lineages, vaccination with D-QIV is likely to reduce the risk of the dominant circulating B type virus not matching the strain selected for the vaccine and, therefore, more effectively protect target populations from influenza than TIVs.
authors.forename: Kate
authors.initials: K
authors.lastname: McKeage
mesh_terms: D017321:Clinical Trials, Phase I as Topic; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D009980:Influenza A virus / Q000276:immunology*; D009981:Influenza B virus / Q000276:immunology*; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology; D007251:Influenza, Human / Q000276:immunology* / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012621:Seasons; D014611:Vaccination / Q000379:methods; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000276:immunology
chemical_list: D007252:Influenza Vaccines; D015164:Vaccines, Inactivated; C510903:fluarix
references.citation: Int J Infect Dis. 2007 Jan;11(1):40-7
references.pmid: 16678464
references.citation: Clin Infect Dis. 2003 Feb 1;36(3):299-305
references.pmid: 12539071
references.citation: Hum Vaccin Immunother. 2012 Jan;8(1):81-8
references.pmid: 22252006
references.citation: J Infect Dis. 2013 Jun 15;207(12):1878-87
references.pmid: 23470848
references.citation: J Microbiol Immunol Infect. 2004 Apr;37(2):95-8
references.pmid: 15181490
references.citation: Vaccine. 2005 Jul 8;23 Suppl 1:S10-25
references.pmid: 15908062
references.citation: Vaccine. 2010 Feb 25;28(9):2149-56
references.pmid: 20003926
references.citation: MMWR Recomm Rep. 2010 Aug 6;59(RR-8):1-62
references.pmid: 20689501
references.citation: Drugs. 2012 Dec 3;72(17):2177-85
references.pmid: 23110610
references.citation: MMWR Morb Mortal Wkly Rep. 2010 Aug 27;59(33):1057-62
references.pmid: 20798667
references.citation: JAMA. 2004 Sep 15;292(11):1333-40
references.pmid: 15367555
references.citation: Vaccine. 2012 Mar 2;30(11):1993-8
references.pmid: 22226861
references.citation: BMC Med. 2013 Jun 25;11:153
references.pmid: 23800265
references.citation: JAMA. 2003 Jan 8;289(2):179-86
references.pmid: 12517228
references.citation: BMC Infect Dis. 2013 May 20;13:224
references.pmid: 23688546
references.citation: MMWR Morb Mortal Wkly Rep. 2012 Aug 17;61(32):613-8
references.pmid: 22895385
references.citation: J Infect Dis. 2004 Oct 15;190(8):1369-73
references.pmid: 15378427
references.citation: Vaccine. 2010 Sep 7;28 Suppl 4:D45-53
references.pmid: 20713260
references.citation: J Infect Dis. 2009 Dec 15;200(12):1861-9
references.pmid: 19909082
references.citation: Drugs. 2010 Aug 20;70(12):1519-43
references.pmid: 20687619
references.citation: Vaccine. 2007 Jun 28;25(27):5086-96
references.pmid: 17544181