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Introduction <p> The aim of this study was&#xa0;to assess the relative vaccine effectiveness (rVE) of cell-based versus egg-based quadrivalent influenza vaccines (QIVc versus QIVe) in preventing test-confirmed influenza during the 2023–2024 US influenza season.</p> Methods <p>rVE was estimated using a test-negative design applied to a large, linked, real-world dataset. QIVc or QIVe recipients aged 6&#xa0;months–64&#xa0;years who were tested for influenza within ± 7&#xa0;days of an acute respiratory or febrile illness were included. rVE was estimated using doubly robust logistic regression. Analyses were performed for the full, pediatric, adult, outpatient and high-risk populations and by influenza type. Public health impact was assessed using a compartmental influenza burden averted model.</p> Results <p>The analysis included 2119 QIVc-cases, 14,750 QIVc-controls, 14,559 QIVe-cases, and 75,351 QIVe-controls. QIVc was superior to QIVe in preventing test-confirmed influenza with an rVE of 19.8% (95% CI 15.7–23.8%) in the full population, and with rVEs of 19.6% (13.6–25.3%) in the pediatric population aged 6&#xa0;months–17&#xa0;years and 18.5% (12.1–24.5%) in adults aged 18–64&#xa0;years. Consistent results were observed for all sensitivity and subgroup analyses against any influenza. If all vaccinated individuals aged 6&#xa0;months–64&#xa0;years in the US received QIVc over QIVe, an estimated 2,379,395 additional symptomatic illnesses would have been prevented, with proportionate reductions in related complications.</p> Conclusions <p>Our analysis showed superior effectiveness of QIVc over QIVe in preventing test-confirmed influenza among persons aged 6&#xa0;months–64&#xa0;years, and provided the first demonstration of superiority in pediatric populations from 6&#xa0;months of age.</p> <p>A Graphical Abstract is availible for this article.</p>

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Superior Effectiveness and Estimated Public Health Impact of Cell- Versus Egg-Based Influenza Vaccines in Children and Adults During the US 2023–2024 Season

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月3日

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  • Alicia N. Stein,
  • Anusorn Thanataveerat,
  • Kimberly McDermott,
  • Alex Dean,
  • Stephanie Wall,
  • Cory Pack,
  • Ian McGovern,
  • Sheena G. Sullivan,
  • Mendel Haag

摘要

Introduction

The aim of this study was to assess the relative vaccine effectiveness (rVE) of cell-based versus egg-based quadrivalent influenza vaccines (QIVc versus QIVe) in preventing test-confirmed influenza during the 2023–2024 US influenza season.

Methods

rVE was estimated using a test-negative design applied to a large, linked, real-world dataset. QIVc or QIVe recipients aged 6 months–64 years who were tested for influenza within ± 7 days of an acute respiratory or febrile illness were included. rVE was estimated using doubly robust logistic regression. Analyses were performed for the full, pediatric, adult, outpatient and high-risk populations and by influenza type. Public health impact was assessed using a compartmental influenza burden averted model.

Results

The analysis included 2119 QIVc-cases, 14,750 QIVc-controls, 14,559 QIVe-cases, and 75,351 QIVe-controls. QIVc was superior to QIVe in preventing test-confirmed influenza with an rVE of 19.8% (95% CI 15.7–23.8%) in the full population, and with rVEs of 19.6% (13.6–25.3%) in the pediatric population aged 6 months–17 years and 18.5% (12.1–24.5%) in adults aged 18–64 years. Consistent results were observed for all sensitivity and subgroup analyses against any influenza. If all vaccinated individuals aged 6 months–64 years in the US received QIVc over QIVe, an estimated 2,379,395 additional symptomatic illnesses would have been prevented, with proportionate reductions in related complications.

Conclusions

Our analysis showed superior effectiveness of QIVc over QIVe in preventing test-confirmed influenza among persons aged 6 months–64 years, and provided the first demonstration of superiority in pediatric populations from 6 months of age.

A Graphical Abstract is availible for this article.