MF59®-adjuvanted Inactivated Quadrivalent Influenza Vaccine (Fluad® Quad) for Older Adults

This Research Review E-Learning Module is intended for New Zealand nurses and covers data relevant to the use of Fluad^® Quad for the prevention of seasonal influenza in adults aged 65 or older.  It is based on the Research Review Product Review of the same title.

Before starting the module please read the Research Review Product Review, accessed through the link below:

CLICK HERE
to access the quiz source material
Product Review - MF59^®-adjuvanted Inactivated Quadrivalent Influenza Vaccine (Fluad^® Quad) for Older Adults

The PDF can be viewed on screen, saved and printed through the link above. 

This E-Learning Module covers:

• Epidemiology of seasonal influenza in the elderly
• Risk factors for influenza-associated morbidity and mortality
• Factors affecting the efficacy of influenza vaccination in the elderly
• MF59-adjuvanted influenza vaccines and immunogenicity
• Quadrivalent influenza vaccines
• Key clinical trial data for Fluad^® Quad
• Covid-19 and influenza vaccination

Learning outcomes

After completing this module you should have an improved understanding of:

• Epidemiology of seasonal influenza in the elderly
• Risk factors for influenza-associated morbidity and mortality
• Factors affecting the efficacy of influenza vaccination in the elderly
• MF59-adjuvanted influenza vaccines and immunogenicity
• Quadrivalent influenza vaccines
• Key clinical trial data for Fluad^® Quad
• Covid-19 and influenza vaccination

Contributing experts

Expert commentary is provided by Wellington-based microbiologist and infectious diseases physician, Professor Tim Blackmore. 

Module questions have been developed by Dr Chris Tofield, who works in primary care skin cancer treatment, is clinical advisor at Bay of Plenty District Health Board, and consultant to Research Review.

Accreditation

“MF59®-adjuvanted Inactivated Quadrivalent Influenza Vaccine (Fluad® Quad) for Older Adults” E-Learning Module has been endorsed by The College of Nurses and has been approved for 1 hour professional development. Valid until 12 February 2023.
Further info

References

1. Uyeki TM. Influenza. Ann Intern Med. 2017;167(5):Itc33-itc48.
2. Pop-Vicas A, et al. Influenza in the elderly: a mini-review. Gerontology. 2011;57(5):397-404.
3. Ciabattini A, et al. Vaccination in the elderly: The challenge of immune changes with aging. Semin Immunol. 2018;40:83-94.
4. Thompson WW, et al. Influenza-associated hospitalizations in the United States. JAMA. 2004;292(11):1333-40.
5. Thompson WW, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289(2):179-86.
6. Krammer F, et al. Influenza. Nat Rev Dis Primers. 2018;4(1):3.
7. Anonymous. Influenza. In: Immunisation Handbook 2020 [Internet]. Wellington: Ministry of Health. Available from: www.health.govt.nz/publication/immunisationhandbook-2020 https://www.health.govt.nz/publication/immunisation-handbook-2020 [Date accessed: 06/09/20].
8. Osterholm MT, et al. Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12(1):36-44.
9. Jefferson T, et al. Efficacy and effectiveness of influenza vaccines in elderly people: a systematic review. Lancet. 2005;366(9492):1165-74.
10. Monto AS, et al. Influenza control in the 21st century: optimizing protection of older adults. Vaccine. 2009;27(37):5043-53.
11. McElhaney JE. The unmet need in the elderly: designing new influenza vaccines for older adults. Vaccine. 2005;23 Suppl 1:S10-25.
12. Weinberger B, et al. Biology of immune responses to vaccines in elderly persons. Clin Infect Dis. 2008;46(7):1078-84.
13. Plowden J, et al. Innate immunity in aging: impact on macrophage function. Aging Cell. 2004;3(4):161-7.
14. Hazeldine J, et al. The impact of ageing on natural killer cell function and potential consequences for health in older adults. Ageing Res Rev. 2013;12(4):1069-78.
15. O’Hagan DT, et al. Towards an evidence based approach for the development of adjuvanted vaccines. Curr Opin Immunol. 2017;47:93-102.
16. Kommareddy S, et al. Chapter 13. In: Schijns V, et al., editors. Immunopotentiators in modern vaccines. MF59: A safe and potent adjuvant for human use. Cambridge, MA: Academic Press (Elsevier). 2017: 249-62.
17. Durando P, et al. MF59-adjuvanted vaccine: a safe and useful tool to enhance and broaden protection against seasonal influenza viruses in subjects at risk. Expert Opin Biol Ther. 2010;10(4):639-51.
18. Podda A. The adjuvanted influenza vaccines with novel adjuvants: experience with the MF59-adjuvanted vaccine. Vaccine. 2001;19(17-19):2673-80.
19. Del Giudice G, et al. Inactivated and adjuvanted influenza vaccines. Curr Top Microbiol Immunol. 2015;386:151-80.
20. Domnich A, et al. Effectiveness of MF59-adjuvanted seasonal influenza vaccine in the elderly: a systematic review and meta-analysis. Vaccine. 2017;35(4):513-20.
21. Lapi F, et al. Adjuvanted versus nonadjuvanted influenza vaccines and risk of hospitalizations for pneumonia and cerebro/cardiovascular events in the elderly. Expert Rev Vaccines. 2019;18(6):663-70.
22. Subbarao K, et al. A tale of two mutations: beginning to understand the problems with egg-based influenza vaccines? Cell Host Microbe. 2019;25(6):773-5.
23. Wu NC, et al. Preventing an antigenically disruptive mutation in egg-based H3N2 seasonal influenza vaccines by mutational incompatibility. Cell Host Microbe. 2019;25(6):836-44.e5.
24. Anonymous. Fluad Quad New Zealand data sheet. Greenlane, Auckland: Seqirus (NZ) Ltd. 2020. Available from: Awaiting Medsafe Approval.
25. Del Giudice G, et al. An MF59-adjuvanted inactivated influenza vaccine containing A/Panama/1999 (H3N2) induced broader serological protection against heterovariant influenza virus strain A/Fujian/2002 than a subunit and a split influenza vaccine. Vaccine. 2006;24(16):3063-5.
26. Harding AT, et al. Efforts to improve the seasonal influenza vaccine. Vaccines (Basel). 2018;6(2):19.
27. Ambrose CS, et al. The rationale for quadrivalent influenza vaccines. Hum Vaccin Immunother. 2012;8(1):81-8.
28. Tisa V, et al. Quadrivalent influenza vaccine: a new opportunity to reduce the influenza burden. J Prev Med Hyg. 2016;57(1):E28-33.
29. Essink B, et al. Immunogenicity and safety of MF59-adjuvanted quadrivalent influenza vaccine versus standard and alternate B strain MF59-adjuvanted trivalent influenza vaccines in older adults. Vaccine. 2020;38(2):242-50.
30. Data on file. Seqirus Inc. 2019.
31. Anonymous. Influenza vaccines. Auckland: Immunisation Advisory Centre. Last update date: May 2020. Available from: https://www.immune.org.nz/vaccines/available-vaccines/influenza-vaccine [Date accessed: 14/08/20].
32. Anonymous. Flu surveillance and research: FluTracking. Auckland: Institute of Environmental Science and Research (ESR), New Zealand Government. Last update date: 19/07/20. Available from: https://www.esr.cri.nz/our-services/consultancy/flu-surveillance-and-research/ [Date accessed: 30/07/20].
33. Anonymous. Flu surveillance and research: community activity. Auckland: Institute of Environmental Science and Research (ESR), New Zealand Government. Last update date: 24/07/20. Available from: https://www.esr.cri.nz/our-services/consultancy/flu-surveillance-and-research/ [Date accessed: 30/07/20].
34. Grohskopf LA, et al. Addressing influenza vaccination disparities during the COVID-19 pandemic. JAMA. 2020;324(11):1029-1030.
35. Rubin R. What happens when COVID-19 collides with flu season? JAMA. 2020;324(10):923-5.
36. Anonymous. Influenza vaccinations for 2020. Wellington: PHARMAC. Last update date: 25 May 2020. Available from: https://pharmac.govt.nz/medicine-funding-and-supply/what-you-need-to-know-about-medicines/flu-vaccines-pharmacs-role/influenza-vaccinations-for-2020/ [Date accessed: 16/09/20].
37. Anonymous. Flu surveillance and research: vaccination. Auckland: Institute of Environmental Science and Research (ESR), New Zealand Government. Last update date: 24/07/20. Available from: https://www.esr.cri.nz/our-services/consultancy/flu-surveillance-and-research/ [Date accessed: 30/07/20].
38. Sample I. Demand for flu vaccine soars as countries plan for second Covid-19 wave. The Guardian. Issue date: 14 June 2020. Manchester: Guardian News & Media Limited.