FluMist Quadrivalent ‘unlikely’ to see great success in Japan

By Isabel Cameron

- Last updated on GMT

© Getty Images
© Getty Images

Related tags Flu Flu vaccine Vaccine Influenza Japan

Japan’s Ministry of Health, Labour, and Welfare approved FluMist Quadrivalent in March 2023, marking the first approval of an intranasal vaccine in the country’s history.

FluMist Quadrivalent is a live attenuated influenza vaccine (LAIV) comprised of four influenza strains. It will be available for use in Japan in children 2-18 years of age for the 2023/2024 flu season.

Yet four months on, awareness of FluMist Quadrivalent among healthcare providers remains limited and uptake of the vaccine may not be met with great success, says data and analytics company GlobalData.

In Japan, FluMist Quadrivalent will be marketed by Daiichi Sankyo, which received an exclusive license from AstraZeneca to develop and commercialize the vaccine in this market in 2015.

However, it was first approved as a trivalent vaccine, comprising three influenza strains, in the US and Europe in 2003 and 2011, respectively, and is now available as a quadrivalent vaccine in these markets.

FluMist Quadrivalent reported 72% vaccine effectiveness among children 2-17 years of age in the UK during the 2021/2022 flu season. 

Stephanie Kurdach, infectious disease analyst at GlobalData, comments: “LAIVs such as FluMist Quadrivalent are particularly effective because of their route of administration. Unlike traditional vaccines that are administered as injections, LAIVs enter the body via the nasopharynx – the same route as the influenza virus – thereby allowing for an increase in mucosal immunity. LAIVs are also advantageous for the pediatric population, as young children can often be resistant to needles.”

According to GlobalData, the approval of FluMist Quadrivalent in Japan has the potential to address an unmet need for more effective and convenient immunization of the pediatric population.

However, key opinion leaders in Japan, who were interviewed by GlobalData in July, demonstrated limited awareness of the vaccine and did not express plans to use it for the upcoming flu season.

Kurdach continues: “Perhaps the largest barrier for the uptake of FluMist Quadrivalent in Japan is the infrastructure surrounding health insurance policies.”

With the exception of patients over 65 years, and patients aged 60-64 years with a qualifying underlying health condition, seasonal influenza vaccines are not covered by health insurance in Japan, so parents must pay to vaccinate their children.

Additionally, doctors cannot choose which vaccine they administer to patients. Medical institutions calculate the number of vaccines needed for the entire influenza season and place an order from a single manufacturer.

Kurdach concludes: “Medical institutions may be reluctant to order FluMist Quadrivalent, as it is only approved in a subset of patients who are not covered to receive the vaccine free of charge. The uptake of FluMist Quadrivalent in Japan may not be met with much success.”

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