Objective  To analyze the cost-effectiveness of mass vaccination of quadrivalent influenza vaccine (QIV) compared with that of trivalent influenza vaccine (TIV) using incremental net benefit (INB) method newly developed.

  Methods  We searched four databases (PubMed, Web of science, Chinese National Knowledge Infrastructure CNKI, and Wanfang Data Knowledge Service Platform) for literatures on cost-effectiveness analysis of quadrivalent influenza vaccine versus trivalent influenza vaccine published from January 1998 to August 7th, 2018. We then conducted a meta-analysis using Stata/SE version 12.0 to estimate total incremental net benefit (TINB) of the QIV and TIV vaccination in targeted population.

  Results  Totally 5 researches involving 96 727 891 participants were included in this study. The meta-analysis resulted in a combined TINB value of 308 (95% confidence interval 95% CI: 303 – 313) for all the QIV and TIV vaccinations under the assessment. After subtracting a research with small coefficient, the TINB of the researches was 307 (95% CI: 302 – 313) and very similar to that before the subgroup analysis, suggesting that a reliable result of the study. Publication bias may be resulted from the study due to the limitation in the number of literatures included in the study.

  Conclusion  The mass vaccination of quadrivalent influenza vaccine is more cost-effective compared with that of trivalent influenza vaccine.