Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 8, Issue 1  January 2012
http://www.landesbioscience.com/journals/vaccines/toc/volume/7/issue/12/

Editor’s Corner
Special Focus: Influenza Vaccines
Susanna Esposito

We have been living with influenza for many years, and have become so used to it becoming a part of our lives to which we usually do not pay much attention. After the excitement of the initial discovery of influenza viruses in 1933 and the development of the first vaccines in the 1940s, relatively little happened in the field during the rest of the 20th century except for the development of the first serological assays, the definition of some correlates of protection, and the expansion of worldwide production capacity.

However, the coming of the 21st century brought new epidemiological data and technological innovations in the production of vaccines. The epidemiological studies showed that influenza viruses are underestimated global killers; they cause annual epidemics and occasional pandemics that have claimed the lives of millions, and the emergence of new strains continues to challenge public health authorities and scientific communities. The real-time monitoring of the evolution of influenza viruses has improved our understanding of the factors leading to viral pathogenicity and/or transmissibility, and the development of new vaccines will be critical for controlling future outbreaks of the disease. The correlates of protection continue to rely on serum antibodies, but live attenuated vaccines also employ another mechanism of protection, and the use of adjuvants and intradermal vaccination has improved the effectiveness of inactivated vaccines. Furthermore, alternatives to eggs have become available, and reverse genetics has allowed us to navigate new horizons. All of these findings have had a significant impact on public health policies and the recommendations for influenza vaccination in different age groups.

The aim of this special issue is to provide a comprehensive update of the state-of-the-art concerning influenza and its prevention. It begins with an overview of influenza viruses that also covers influenza in birds and animals, moves on to deal with the epidemiological, clinical and diagnostic aspects of the disease in different age groups, and finally discusses the various issues associated with its prevention. There are chapters on newly available influenza vaccines, the new technologies used to prepare them, and why there is a need for a quadrivalent vaccine. The recommendations concerning vaccination in children, adults and the elderly are described in detail, and the differences between countries are explained and discussed. The reasons for the low vaccination coverage rate even in high-risk categories are critically reviewed, and there is a discussion of the economic value of vaccination and its impact on public health. Finally, consideration is given to the use of influenza vaccination in special situations such as pregnancy, and there is a summary of the lessons learned from the last pandemic.

I hope that these articles by representative highly experienced authors will make this issue useful to experts in pediatrics, infectious diseases, public health and internal medicine, and believe they can make a significant contribution to our fight against influenza.

Special Focus Review
Economic value of influenza vaccination
Volume 8, Issue 1   January 2012
Chiara de Waure, Maria Assunta Veneziano, Chiara Cadeddu, Silvio Capizzi, Maria Lucia Specchia, Stefano Capri and Walter Ricciardi

Extract
Influenza epidemics are responsible for high mortality and morbidity rates in particular among elderly and high risk groups. This review is aimed at assessing the economic value of vaccination in these groups. A search of full economic evaluations of influenza vaccination in comparison with no interventions was performed on PubMed from January 1990 to May 2011. Only economic evaluations dealing with elderly and high risk groups were considered. The quality of selected articles was assessed through Drummond’s checklist. Sixteen cost-effectiveness analyses and four cost-benefit analyses were included: overall, the quality of studies was fairly good. The vaccination was demonstrated to be cost-effective or cost-saving in almost all studies, independently by the perspective and the type of analysis. Influenza vaccination is a worthwhile intervention from the pharmacoeconomic view-point, anyway a standardization of methods should be desirable in order to guarantee the comparability and transferability of results.