With the influenza (flu) vaccination season approaching, competition in the vaccine market for adults aged 65 and over is anticipated.

The government has switched the National Immunization Program (NIP) vaccine to a three-valent vaccine and lowered the procurement price. The introduction of the four-valent vaccine in the non-reimbursed medicine market is likely to be a variable.


According to the Korea Disease Control and Prevention Agency (KDCA), the 2025-2026 seasonal influenza National Immunization Program (NIP) will begin on the 22nd of this month and run until April of next year.

Free vaccinations will be provided to high-risk groups, including children aged 6 months to 13 years (born between January 1, 2012, and August 31, 2025), pregnant women, and individuals aged 65 and over (born before January 1, 1956).

Considering that influenza vaccinations typically begin with the NIP, the competition between Samjin Pharm-CSL Seqirus and Sanofi is expected to heat up from October.

Samjin Pharm-CSL Seqirus and Sanofi are aiming to expand their market influence by promoting an adjuvanted vaccine and a high-dose vaccine, respectively.

First, Samjin Pharma, in cooperation with CSL Seqirus, is scheduled to supply 'Fluad Quad,' an adjuvanted vaccine for elderly individuals, and 'Flucelvax Quad,' the cell-based flu vaccine.

Samjin Pharma offers a specialized line of prescription drugs for treating chronic diseases and product lines related to pediatrics, such as Trestan. The company anticipates synergy with its existing sales capabilities.

A Samjin Pharma official said, "The company has long strived to provide good treatments for chronic disease patients, who are a high-risk group for influenza," and added, "As our product portfolio is focused on chronic disease treatments, we intend to ensure that Fluad Quad, an adjuvanted influenza vaccine, can be administered to the chronic disease patients we have been focusing on."

Sanofi is expected to pursue a continuous market strategy, building on its efforts from last year.

Sanofi has already been prepared for inclusion of its product in the NIP, including the publication of a cost-effectiveness analysis in the international journal 'Human Vaccines & Immunotherapeutics' in November 2023, which compares its high-dose vaccine with a standard-dose vaccine using national health insurance big data.

A Sanofi official emphasized, "Efluelda is the only product among the high immunogenicity flu vaccines recommended by the Korean Society of Infectious Diseases that has proven preventive efficacy in a randomized clinical trial," and added, "Efluelda will contribute to reducing the socioeconomic burden caused by influenza and pneumonia in adults aged 65 and over."


One of the variables is the shift of the NIP vaccine to a three-valent formulation. Previously, a four-valent vaccine containing antigens for four types of viruses, including influenza A virus (H1N1 and H3N2) and influenza B virus (Victoria and Yamagata), was used in the NIP.

However, based on the World Health Organization's (WHO) recommendation earlier this year, this season's vaccine will be a three-valent vaccine that excludes the influenza B/Yamagata virus antigen. Consequently, the procurement price has been lowered compared to the previous four-valent vaccine, and the four-valent vaccine that was previously administered will now be a non-reimbursed vaccine.

It means that the adjuvanted vaccine and high-dose vaccine, which previously competed with the NIP-included four-valent vaccine, will now have to compete for market share with both the NIP-included three-valent vaccine and the (non-reimbursed) four-valent vaccine.

Both the adjuvanted vaccine and the high-dose vaccine claim to offer higher preventive efficacy in elderly individuals than the conventional influenza vaccine, but a price barrier could be an issue.

However, a prediction also exists that, in the long run, as both vaccines aim to enter the NIP, they will focus on expanding the market for vaccines specifically designed for elderly individuals, rather than just competing with each other.

In a previous press conference, Professor Choi Min-joo of the Department of Infectious Diseases at Korea University Guro Hospital said, "Research results indicate that the switch from a standard influenza vaccine to an adjuvanted vaccine is a rational choice not only in terms of medical benefits but also from an economic perspective," and added, "These results suggest that an adjuvanted vaccine like Fluad could be a worthy subject for policy consideration in future discussions for selecting NIP vaccines for the elderly."

An individual from the vaccine industry said, "The promotions by Samjin Pharma-CSL Seqirus and Sanofi will likely involve considering various factors beyond simple market share competition, including their products' potential inclusion in the NIP and vaccination patterns." They added, "Since both companies are already emphasizing not only their vaccination efficacy but also their cost-effectiveness through research, We believe they will consider growing the overall market pie."