Future epidemiological and economic impacts of universal influenza vaccines

Proc Natl Acad Sci U S A. 2019 Oct 8;116(41):20786-20792. doi: 10.1073/pnas.1909613116. Epub 2019 Sep 23.


The efficacy of influenza vaccines, currently at 44%, is limited by the rapid antigenic evolution of the virus and a manufacturing process that can lead to vaccine mismatch. The National Institute of Allergy and Infectious Diseases (NIAID) recently identified the development of a universal influenza vaccine with an efficacy of at least 75% as a high scientific priority. The US Congress approved $130 million funding for the 2019 fiscal year to support the development of a universal vaccine, and another $1 billion over 5 y has been proposed in the Flu Vaccine Act. Using a model of influenza transmission, we evaluated the population-level impacts of universal influenza vaccines distributed according to empirical age-specific coverage at multiple scales in the United States. We estimate that replacing just 10% of typical seasonal vaccines with 75% efficacious universal vaccines would avert ∼5.3 million cases, 81,000 hospitalizations, and 6,300 influenza-related deaths per year. This would prevent over $1.1 billion in direct health care costs compared to a typical season, based on average data from the 2010-11 to 2018-19 seasons. A complete replacement of seasonal vaccines with universal vaccines is projected to prevent 17 million cases, 251,000 hospitalizations, 19,500 deaths, and $3.5 billion in direct health care costs. States with high per-hospitalization medical expenses along with a large proportion of elderly residents are expected to receive the maximum economic benefit. Replacing even a fraction of seasonal vaccines with universal vaccines justifies the substantial cost of vaccine development.

Keywords: mathematical model; medical cost; seasonal vaccine.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Cost-Benefit Analysis*
  • Female
  • Health Care Costs / statistics & numerical data*
  • Hospitalization / economics*
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza A virus / isolation & purification
  • Influenza Vaccines / economics*
  • Influenza Vaccines / therapeutic use
  • Influenza, Human / economics*
  • Influenza, Human / epidemiology
  • Influenza, Human / prevention & control*
  • Male
  • Middle Aged
  • Seasons
  • United States / epidemiology
  • Vaccination / economics*
  • Vaccination / methods
  • Young Adult


  • Influenza Vaccines