ArticlePloS one2020
From trivalent to quadrivalent influenza vaccines: Public health and economic burden for different immunization strategies in Spain.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Critical assessment of uncertainty in economic evaluations on influenza vaccines for the elderly population in Spain.BMC infectious diseases · 2025Pooled it
- Optimizing influenza prevention: a systematic review of the cost-effectiveness of pediatric vaccination programs and vaccine types.Frontiers in public health · 2025Pooled it
- Cost-effectiveness analysis of influenza vaccination with high-dose vaccine versus standard-dose quadrivalent vaccine in older adults in Spain.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Drivers of Viral Spillover: An Examination of How Pathogens Spread.Pathogens (Basel, Switzerland) · 2026Review
- Estimating the economically justifiable price of nirsevimab versus standard of practice for the prevention of respiratory syncytial virus infections in neonates and infants in Spain: a cost-utility modelling study.BMJ public health · 2025Article
- Article
- Immunogenicity and safety of inactivated quadrivalent influenza vaccine compared with the trivalent vaccine for influenza infection: an overview of systematic reviews.BMC infectious diseases · 2023Review
- Article
- Trivalent SARS-CoV-2 S1 Subunit Protein Vaccination Induces Broad Humoral Responses in BALB/c Mice.Vaccines · 2023Article
- Switching from trivalent to quadrivalent inactivated influenza vaccines in Uruguay: a cost-effectiveness analysis.Human vaccines & immunotherapeutics · 2022Article
- Article
- Nasal vaccine as a booster shot: a viable solution to restrict pandemic?Clinical and experimental vaccine research · 2022Review
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- Article
- Influenza B Lineages Have More in Common Than Meets the Eye. Trivalent Influenza Vaccines Trigger Heterotypic Antibodies Against Both Influenza B Viruses.Frontiers in microbiology · 2021Article
- Mosaic Hemagglutinin-Based Whole Inactivated Virus Vaccines Induce Broad Protection Against Influenza B Virus Challenge in Mice.Frontiers in immunology · 2021Article
Corrections and comments
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Authors and funding
10 authors at 9 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeQuadrivalent influenza vaccine (QIV) includes the same strains as trivalent influenza vaccine (TIV) plus an additional B strain of the other B lineage. The aim of the study was to analyse the public health and economic impact of replacing TIV with QIV in different scenarios in Spain.
methodsA dynamic transmission model was developed to estimate the number of influenza B cases prevented under TIV and QIV strategies (<65 years (high risk) and ≥65 years). This model considers cross-protective immunity induced by different lineages of influenza B. The output of the transmission model was used as input for a decision tree model that estimated the economic impact of switching TIV to QIV. The models were populated with Spanish data whenever possible. Deterministic univariate and probabilistic multivariate sensitivity analyses were performed.
resultsReplacing TIV with QIV in all eligible patients with current vaccine coverage in Spain may have prevented 138,707 influenza B cases per season and, therefore avoided 10,748 outpatient visits, 3,179 hospitalizations and 192 deaths. The replacement could save €532,768 in outpatient visit costs, €13 million in hospitalization costs, and €3 million in costs of influenza-related deaths per year. An additional €5 million costs associated with productivity loss could be saved per year, from the societal perspective. The budget impact from societal perspective would be €6.5 million, and the incremental cost-effectiveness ratio (ICER) €1,527 per quality-adjusted life year (QALY). Sensitivity analyses showed robust results. In additional scenarios, QIV also showed an impact at public health level reducing influenza B related cases, outpatient visits, hospitalizations and deaths.
conclusionsOur results show public health and economic benefits for influenza prevention with QIV. It would be an efficient intervention for the Spanish National Health Service with major health benefits especially in the population ≥65-year.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.