The New Quadrivalent Adjuvanted Influenza Vaccine for the Italian Elderly: A Health Technology Assessment

Giovanna Elisa Calabro'*, Sara Boccalini, Donatella Panatto, Caterina Rizzo, Maria Luisa Di Pietro, Fasika Molla Abreha, Marco Ajelli, Daniela Amicizia, Angela Bechini, Irene Giacchetta, Piero Luigi Lai, Stefano Merler, Chiara Primieri, Filippo Trentini, Sara Violi, Paolo Bonanni, Chiara De Waure

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo in rivista


Background. The elderly, commonly defined as subjects aged ≥65 years, are among the at-risk subjects recommended for annual influenza vaccination in European countries. Currently, two new vaccines are available for this population: the MF59-adjuvanted quadrivalent influenza vaccine (aQIV) and the high-dose quadrivalent influenza vaccine (hdQIV). Their multidimensional assessment might maximize the results in terms of achievable health benefits. Therefore, we carried out a Health Technology Assessment (HTA) of the aQIV by adopting a multidisciplinary policy-oriented approach to evaluate clinical, economic, organizational, and ethical implications for the Italian elderly. Methods. A HTA was conducted in 2020 to analyze influenza burden; characteristics, efficacy, and safety of aQIV and other available vaccines for the elderly; cost-effectiveness of aQIV; and related organizational and ethical implications. Comprehensive literature reviews/analyses were performed, and a transmission model was developed in order to address the above issues. Results. In Italy, the influenza burden on the elderly is high and from 77.7% to 96.1% of influenza-related deaths occur in the elderly. All available vaccines are effective and safe; however, aQIV, such as the adjuvanted trivalent influenza vaccine (aTIV), has proved more immunogenic and effective in the elderly. From the third payer’s perspective, but also from the societal one, the use of aQIV in comparison with egg-based standard QIV (eQIV) in the elderly population is cost-effective. The appropriateness of the use of available vaccines as well as citizens’ knowledge and attitudes remain a challenge for a successful vaccination campaign. Conclusions. The results of this project provide decision-makers with important evidence on the aQIV and support with scientific evidence on the appropriate use of vaccines in the elderly.
Lingua originaleEnglish
pagine (da-a)1-14
Numero di pagine14
RivistaInternational Journal of Environmental Research and Public Health
Stato di pubblicazionePubblicato - 2022


  • Adjuvants, Immunologic
  • Aged
  • Cost-Benefit Analysis
  • HTA
  • Health Technology Assessment
  • Humans
  • Influenza Vaccines
  • Influenza, Human
  • Technology Assessment, Biomedical
  • Vaccination
  • elderly
  • influenza
  • quadrivalent adjuvanted influenza vaccine
  • vaccination
  • vaccines


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