The cell-culture based quadrivalent flu vaccine should only be used as a last resort for adults aged 65 years and over in the 2020/2021 flu season, the Joint Committee on Vaccination and Immunisation (JCVI) has recommended.
In its recommendations for which flu vaccines should be delivered to patients during the 2020/2021 flu season, published on 24 September 2019, the JCVI said adults aged 65 years and over should either be given the adjuvanted trivalent inactivated influenza vaccine (aTIV) or the high-dose trivalent inactivated influenza vaccine (TIV-HD).
“The quadrivalent influenza cell-culture vaccine (QIVc) is suitable for use in this age group if aTIV or TIV-HD are not available,” the recommendations state.
Healthcare professionals offering the aTIV vaccine faced issues during the 2018/2019 flu season when the manufacturer Seqirus provided the vaccine in phases; delivering 40% in September, 20% in October and 40% in December 2018, leaving pharmacies and GPs in short supply.
Meanwhile, NHS England refused to commission the TIV-HD vaccine for the 2019/2020 flu season owing to its “significantly higher list price” when compared with other vaccines that were considered equally suitable at the time.
The JCVI had previously recommended the aTIV, TIV-HD and QIVc vaccines as being “equally suitable” for use during the 2019/2020 flu season.
But in its latest recommendation document, it said: “Further comparative data are required, preferably from the same country over multiple seasons and with laboratory-confirmed influenza endpoints, to support consideration of the relative effectiveness of aTIV, TIV-HD and QIVc.”
The JCVI has now also specified that children under the age of nine years in an at-risk group — who have contraindications for use of live attenuated influenza vaccine — should be vaccinated with the quadrivalent influenza egg-culture vaccine.