Flublok Quadrivalent Influenza Vaccine ACIP RECOMMENDED

DEMONSTRATED TO PREVENT INFLUENZA AND ITS COMPLICATIONS2,3

Higher-dose influenza vaccine with recombinant DNA technology for adults 18+2,3


3X THE ANTIGEN: 45 micrograms (mcg) of hemagglutinin (HA) vs 15 mcg of HA in a standard-dose influenza vaccine3

Flublok Quadrivalent is a vaccine indicated for active immunization against disease caused by influenza A subtype viruses and influenza type B viruses contained in the vaccine. Flublok Quadrivalent is approved for use in persons 18 years of age and older.

ADULTS AND THE RISK FOR INFLUENZA

Adults in the US are at high risk for influenza4

Influenza vaccine coverage is low in these age groups⁴:
38% ADULTS AGED 18-49
54% ADULTS AGED 50-64
2020-2021 influenza season

2019-2020 Influenza Season as Reported by the CDCᵃ

~1 in 3

of all influenza-related deaths occurred among adults aged 18 to 64⁴

~2 in 5

of all influenza-related hospitalizations occurred in adults aged 18 to 64⁴

~15 MILLION

influenza cases in adults aged 18 to 49⁴

ᵃThese updated preliminary flu burden estimates were reported by the CDC for the 2019-2020 season.
CDC=Centers for Disease Control and Prevention.

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RECOMBINANT TECHNOLOGY

RECOMBINANT TECHNOLOGY MAY PROVIDE UNIQUE FEATURES TO AN INFLUENZA VACCINE BECAUSE RECOMBINANT DNA TECHNOLOGY ALLOWS FOR BROADER ACCESS TO CONSERVED ANTIGENIC SITES6,7

ENSURES EXACT STRAIN MATCH

to WHO- and FDA-selected strains⁶

AVOID MUTATIONS

in manufacturing that could lead to reduced vaccine effectiveness⁶

MAY PROVIDE CROSS PROTECTION

Recombinant technology provides broader access to antigenic sites, allowing greater accessibility for an immune response⁶

CROSS PROTECTION MAY BE A RESULT OF SIMPLER GLYCOSYLATION BECAUSE RECOMBINANT DNA TECHNOLOGY ALLOWS FOR BROADER ACCESS TO CONSERVED ANTIGENIC SITES6

Glycosylation occurs during viral replication and in the vaccine manufacturing process, blocking access to antigenic sites on HA proteins, which are necessary for developing an immune response. Complex glycosylation interferes with antigenic site access. 6,8

GLYCOSYLATION WITH TRADITIONAL IIV TECHNOLOGY⁶

More complex glycosylation makes it more difficult for HA proteins to bind to antigenic sites

Blue Circles = carbohydrates
Blue Circles = carbohydrates

VS

GLYCOSYLATION WITH RECOMBINANT DNA TECHNOLOGY⁶

With less complex glycosylation, there is more accessibility to antigenic sites on HA proteins

Stalk Image = HA protein amino acids
Stalk Image = HA protein amino acids

Graphical representation is for illustrative purposes only.
FDA=US Food and Drug Administration; HA=hemagglutinin; WHO=World Health Organization.

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HOW IT'S MADE

RECOMBINANT DNA TECHNOLOGY ELIMINATES THE NEED TO GROW INFLUENZA VIRUS AND AVOIDS THE POSSIBILITY OF MUTATION OR ADAPTATION3

WHO-/FDA-Selected Strain Identified
WHO-/FDA-Selected Strain Identified
Adapt
Adapt
Replicate HA Gene
Replicate HA Gene
Infect Egg/Cell
Infect Egg/Cell
Recombine
Recombine
Grow
Grow
Translate rHA Antigen
Translate rHA Antigen
Inactivate & Purify
Inactivate & Purify
Harvest & Purify
Harvest & Purify
Inactivated Influenza Vaccine
Inactivated Influenza Vaccine
Recombinant Influenza Vaccine
Recombinant Influenza Vaccine

Graphical representation is for illustrative purposes only.
FDA=US Food and Drug Administration; HA=hemagglutinin; rHA=recombinant hemagglutinin; WHO=World Health Organization.

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EFFICACY STUDY

PROVEN TO PREVENT MORE INFLUENZA IN ADULTS AGED 50+ COMPARED TO A STANDARD-DOSE QUADRIVALENT INFLUENZA VACCINE IN AN RCT2

PRIMARY ENDPOINT Relative vaccine efficacy (rVE) against influenza due to ANY PCR-confirmed circulating strains2,3
Number of influenza cases
Standard-dose
Flublok Quadrivalent
30% (95% CI: 10-47)
FEWER INFLUENZA CASES
SECONDARY ENDPOINT rVE against influenza due to ANY culture-confirmed circulating strains2,3
Number of influenza cases
Standard-dose
Flublok Quadrivalent
43% (95% CI: 21-59)
FEWER INFLUENZA CASES
STUDY DESIGN²
1:1 randomized controlled trial | Flublok Quadrivalent vs standard-dose inactivated quadrivalent influenza vaccine (Fluarix Quadrivalent®) | Subjects: ~9000 adults aged 50+ | Influenza season: 2014-2015 | Characteristics: A (H3N2) predominant and antigenically mismatched

Graphical representation is for illustrative purposes only.
PCR=polymerase chain reaction; RCT=randomized controlled trial.

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REAL-WORLD EVIDENCE

2019-2020: RECOMBINANT INFLUENZA VACCINE WAS ASSOCIATED WITH SIGNIFICANTLY FEWER INFLUENZA HOSPITAL ENCOUNTERS COMPARED WITH STANDARD-DOSE INFLUENZA VACCINES9

STUDY DESIGN: RETROSPECTIVE OBSERVATIONAL COHORT9

SUBJECTS 12.7 million adults aged 65+ HD-IIV3=~7.1 million; aIIV3=~2.5 million; IIV4=~1.5 million; cIIV4=~0.8 million; RIV4=~0.6 million
DATA SOURCE Medicare fee-for-service claims
AUTHOR AFFILIATIONS FDA and Centers for Medicare and Medicaid Services

RELATIVE VACCINE EFFECTIVENESS (rVE) AGAINST INFLUENZA HOSPITAL ENCOUNTERS (95% CI)9,a

COHORT
VS EGG-BASED STANDARD-DOSE QUADRIVALENT
Cell-based quadrivalent
2.8%
-2.8
8.2
Recombinant quadrivalent
13.3%
7.4
18.9
High-dose trivalent
6.8%
3.3
10.1
Adjuvanted trivalent
8.2%
4.2
12.0
-4%
-2%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%

aThe data shown is 1 of 3 primary analyses. Two additional primary analyses were conducted: 2 vaccine analyses comparing cIIV4 with IIV4 and RIV4 with IIV4.

aIIV3=egg-based adjuvanted trivalent; HD-IIV3=egg-based high-dose trivalent; FDA=US Food and Drug Administration; cIIV4=cell-cultured standard-dose quadrivalent; IIV4=egg-based standard-dose quadrivalent; RIV4=recombinant quadrivalent.

STUDY LIMITATIONS

Lack of access to virological case confirmation may have led to underestimation of the magnitude of differences

Residual confounding by unmeasured covariates could have affected results

The observation period was cut off at the end of February to avoid potential bias from the overlap between influenza season and the escalation of the COVID-19 pandemic in the US

2019-2020 SEASON CHARACTERISTICS

Influenza A (H1N1) and influenza B Victoria were predominating strains with no significant circulation of influenza A (H3N2)

An H1N1 strain with an amino acid change emerged late in the season and likely did not substantially affect the vaccine efficacy during the study period

Trivalent vaccines contained the influenza B Victoria lineage

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SAFETY

SIMILAR SAFETY PROFILE COMPARED TO A STANDARD-DOSE QUADRIVALENT INFLUENZA VACCINE2

ADULTS AGED 18-49: REACTIONS, ANY GRADE

SOLICITED INJECTION-SITE REACTIONS

Tenderness
Pain
Firmness/ Swelling
Redness

SYSTEMIC ADVERSE REACTIONS

Headache
Fatigue
Muscle Pain
Joint Pain
Nausea
Shivering/Chills
Fever (≥100.4°F)
0%
20%
40%
60%
80%
100%
In an immunogenicity and safety trial in adults aged 18 to 49, rates of local and systemic adverse reactions were similar (within 7 days of administration) among Flublok Quadrivalent and standard-dose quadrivalent inactivated influenza vaccine recipients.2
Fluarix Quadrivalent (Influenza Vaccine) n=332
Flublok Quadrivalent (Influenza Vaccine) n=996

ADULTS AGED 50+: REACTIONS, ANY GRADE

SOLICITED INJECTION-SITE REACTIONS

Tenderness
Pain
Firmness/ Swelling
Redness

SYSTEMIC ADVERSE REACTIONS

Headache
Fatigue
Muscle Pain
Joint Pain
Nausea
Shivering/Chills
Fever (≥100.4°F)
0%
20%
40%
60%
80%
100%
In the relative efficacy and safety trial of adults aged 50+, rates of local and systemic adverse reactions were similar (within 7 days of administration) among Flublok Quadrivalent and standard-dose quadrivalent inactivated influenza vaccine recipients.2
Fluarix Quadrivalent (Influenza Vaccine) n=4327
Flublok Quadrivalent (Influenza Vaccine) n=4312
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The first and only recombinant influenza vaccine demonstrated to prevent influenza and its complications2,3,9:

good

UNIQUE RECOMBINANT DNA TECHNOLOGY2

Click here for more information.

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PROVEN EFFICACY3

to prevent more influenza when compared with a standard-dose quadrivalent influenza vaccine in a clinical trial of adults aged 50+.

Click here for full data.

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HIGHER DOSE WITH 3X THE ANTIGEN3

compared with a standard-dose influenza vaccine.

Click here for full data.

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DEMONSTRATED TO REDUCE INFLUENZA-RELATED HOSPITAL ENCOUNTERS9

in adults aged 65+ compared with standard-dose influenza vaccines.

Click here for full data.

For Flublok Quadrivalent, in adults 50 years of age and older, the most common injection-site reactions were tenderness and pain; the most common solicited systemic adverse reactions were headache and fatigue.2

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INDICATIONS

Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent are vaccines indicated for active immunization against disease caused by influenza A subtype viruses and type B viruses contained in the vaccine. Fluzone Quadrivalent is approved for use in persons 6 months of age and older. Flublok Quadrivalent is approved for use in persons 18 years of age and older. Fluzone High-Dose Quadrivalent is approved for use in persons 65 years of age and older.

IMPORTANT SAFETY INFORMATION

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Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent should not be administered to anyone who has had a severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine (including egg protein for Fluzone Quadrivalent and Fluzone High-Dose Quadrivalent). In addition, Fluzone Quadrivalent and Fluzone High-Dose Quadrivalent should not be administered to anyone who has had a severe allergic reaction after previous dose of any influenza vaccine.

Appropriate medical treatment and supervision must be available to manage possible anaphylactic reactions following administration of the vaccine.

If Guillain-Barré syndrome has occurred within 6 weeks following previous influenza vaccination, the decision to give Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent should be based on careful consideration of the potential benefits and risks.

If Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent are administered to immunocompromised persons, including those receiving immunosuppressive therapy, the immune response may be lower than expected.

Vaccination with Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent may not protect all recipients.

Syncope (fainting) has been reported following vaccination with Fluzone Quadrivalent and Fluzone High-Dose Quadrivalent. Procedures should be in place to avoid injury from fainting.

For Fluzone Quadrivalent, in children 6 months through 35 months of age, the most common injection-site reactions were pain or tenderness, erythema, and swelling; the most common solicited systemic adverse reactions were irritability, abnormal crying, malaise, drowsiness, appetite loss, myalgia, vomiting, and fever. In children 3 years through 8 years of age, the most common injection-site reactions were pain, erythema, and swelling; the most common solicited systemic adverse reactions were myalgia, malaise, and headache. In adults 18 years and older, the most common injection-site reaction was pain; the most common solicited systemic adverse reactions were myalgia, headache, and malaise.

For Flublok Quadrivalent, in adults 18 through 49 years of age, the most common injection-site reactions were tenderness and pain; the most common solicited systemic adverse reactions were headache, fatigue, myalgia, and arthralgia. In adults 50 years of age and older, the most common injection-site reactions were tenderness and pain; the most common solicited systemic adverse reactions were headache and fatigue.

For Fluzone High-Dose Quadrivalent, in adults 65 years of age and older, the most common injection-site reaction was pain; the most common solicited systemic adverse reactions were myalgia, headache, and malaise.

For Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent, other adverse reactions may occur.

Before administration, please see the full Prescribing Information for Fluzone Quadrivalent, Flublok Quadrivalent, or Fluzone High-Dose Quadrivalent . Also, please see complete Patient Information for Fluzone Quadrivalent or Fluzone High-Dose Quadrivalent .

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