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New Influenza Vaccine Formulations for 2010-11: A No Brainer

Date: 23 Feb 2010
Member: Jason Garner


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WHO releases recommendations for Northern Hemisphere and VRBPAC/CBER...agree without much ado.
What usually ends up being a delicately choreographed political dance, vaccine selections for the upcoming season, unlike many previously, have been relatively straightforward.

Lets start with the H3N2 component. While 2009-10 has been an unusually quiet "H3 season", thanks largely to the predominant A(H1N1) pandemic virus, the previously-selected 2007 vaccine strain, A/Brisbane/10/2007-like virus, has not been a particularly effective choice. Now, no, I do not have tons of vaccine effectiveness (VE) data to share, but from a genetic and protein sequence standpoint, it doesn't take much to correlate numerous HA SNPs with potential for decreased immunogenicity over 2 seasons. This was an easy one, and thanks to previous decisions by WHO in the southern hemisphere, A/Perth/16/2009 will do just fine...for now.

The debate over a quadravalent vaccine (with seasonal & pandemic H1N1 components) didn't last long. In fact I'm stupified it even came up. Regardless of reports of a "third wave" of pandemic virus outbreaks, the natural fact is the most likely the pandemic H1N1 virus, will simply become the new seasonal H1N1 virus...just like it did after the 1976 H1N1 pandemic. Like all viruses before it, it evolved and changed enough to require a new vaccine formulation. So, a variation of the monovalent A/California/07/2009-like vaccine released worldwide after August 2009, will now simply become the seasonal H1N1 component. Easy.

Flu B...yeah, everyone forgets about flu B. What everyone doesn't realize is that influenza B is particularly dangerous in pediatric cases. Most adults risk infection with flu A, but our kiddos have to worry about both. If nothing else this is always a riveting topic. Why? because there are two distinct lineages, and viruses from neither offer any cross reactivity to one another. So, the dilemma is first choosing a virus from the right lineage - Yamagata or Victoria. 50/50 right? Well, over the course of 15 seasons, we've gotten right 4 times. Not a good record. Based on limited 2009-2010 flu B epidemiological data, it looks like it'll be a Victoria lineage virus - B/Brisbane/60/2008-like virus. This one at least sounds good.

There you have it ladies and jellyfish...unless some last minute changes are made, your northern hemisphere 2010-11 trivalent vaccine formulation. Now, don't forget to get your shot!

jlg

Last Updated on 23 Feb 2010

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