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Vanni T, da Graça Salomão M, Viscondi JYK, Braga PE, da Silva A, de Oliveira Piorelli R, do Prado Santos J, Gattás VL, Lucchesi MBB, de Oliveira MMM, Koike ME, Campos LMA, Coelho EB, Weckx LY, Lara AN, Paiva TM, Timenetsky MDCST, Precioso AR. A randomized, double-blind, non-inferiority trial comparing the immunogenicity and safety of two seasonal inactivated influenza vaccines in adults. Vaccine 2023; 41:3454-3460. [PMID: 37121800 DOI: 10.1016/j.vaccine.2023.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/02/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND To enhance the production and availability of influenza vaccines in different regions of the world is paramount to mitigate the global burden of this disease. Instituto Butantan developed and manufactured an embryonated egg-based inactivated split-virion trivalent seasonal influenza vaccine as part of a technology transfer partnership with Sanofi Pasteur. METHODS This is a phase IV, randomized, double-blind, active-controlled, multicenter clinical trial including adults 18-60 and > 60 years recruited during the 2019 southern hemisphere influenza season. Subjects were randomized 1:1 to receive either the Sanofi Pasteur Trivalent Seasonal Influenza Vaccine (SP-TIV) or Instituto Butantan Trivalent Seasonal Influenza Vaccine (IB-TIV). Hemagglutinin inhibition antibody titers were assessed pre-vaccination and 21 days post-vaccination. RESULTS 624 participants were randomized and vaccinated. In both intention-to-treat and per-protocol analysis, non-inferiority of the SP-TIV versus IB-TIV was demonstrated for the three influenza strains. In the per-protocol analysis, the SP-GMT/IB-GMT ratios for H1N1, H3N2, and B were 0.9 (95%CI, 0.7-1.1), 1.2 (95%CI, 1.0-1.4), and 1.1 (95%CI, 0.9-1.3), respectively. Across vaccination groups, the most common adverse reactions (AR) were limited to the injection-site, including pain and tenderness. The majority of the ARs were graded 1 and/or 2 and lasted less than one day. No serious adverse reaction was observed. CONCLUSION This study demonstrated the non-inferiority of the immunogenicity of a single-dose of Instituto Butantan versus a single dose of the Sanofi Pasteur Seasonal Trivalent Influenza Vaccine in adults. Both vaccines were well tolerated and presented similar safety profiles.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Lucia M A Campos
- Child Institute of the Clinics Hospital of the School of Medicine of University of São Paulo, São Paulo, Brazil
| | - Eduardo B Coelho
- Clinics Hospital of the Medical School of Ribeirão Preto of the University of São Paulo, Ribeirão Preto, Brazil
| | | | - Amanda Nazareth Lara
- Clinics Hospital of the School of Medicine of University of São Paulo, São Paulo, Brazil
| | | | | | - Alexander Roberto Precioso
- Butantan Institute, São Paulo, Brazil; Child Institute of the Clinics Hospital of the School of Medicine of University of São Paulo, São Paulo, Brazil
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Krzywański J, Kuchar E, Pokrywka A, Mikulski T, Pilchowska I, Młyńczak M, Krysztofiak H, Jurczyk J, Ziemba A, Nitsch-Osuch A. Safety and Impact on Training of the Influenza Vaccines in Elite Athletes Participating in the Rio 2016 Olympics. Clin J Sport Med 2021; 31:423-429. [PMID: 32032168 DOI: 10.1097/jsm.0000000000000808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/27/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the safety and tolerance of influenza vaccines for the northern and southern hemispheres in Polish elite athletes participating in the Rio 2016 Olympics. DESIGN Prospective, observational, cohort study. SETTING Institutional level. PARTICIPANTS Ninety-seven athletes vaccinated only with the northern hemisphere vaccine; 98 athletes received the southern hemisphere vaccine alone, whereas 39 athletes were vaccinated with both vaccines. INTERVENTIONS The athletes were vaccinated with a trivalent, inactivated influenza vaccine recommended for the northern hemisphere 2015/2016 and then with the vaccine recommended for the southern hemisphere 2016. Athletes kept a diary of adverse events and effects (if any) on training for 6 days after vaccination. MAIN OUTCOME MEASURES The percentage of general and local adverse events, number of lost or modified training sessions. RESULTS Significantly more local adverse events (pain and redness) were found in the group immunized with the vaccine for the northern hemisphere. There were no differences in the frequency of general adverse events and influence on training between groups. Of total 273 athletes who had 1911 training days during 6 days after vaccination, 6 athletes (2.2%) lost 13 training days (0.7%) and 16 athletes (5.9%) had to modify 34 (1.7%) training days within first 2 days after vaccination. CONCLUSIONS Athletes tolerated influenza immunization well. If they are going to travel to the other hemisphere during the influenza season, the use of the second influenza vaccine should be advised. Athletes should anticipate modification of trainings for 2 days after vaccination.
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Affiliation(s)
| | - Ernest Kuchar
- Department of Pediatrics with Medical Assessment Unit, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Pokrywka
- National Centre for Sports Medicine, Warsaw, Poland
- Department of Applied and Clinical Physiology, University of Zielona Gora, Zielona Gora, Poland
| | - Tomasz Mikulski
- Department of Applied Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Iwona Pilchowska
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Marcel Młyńczak
- Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, Warsaw, Poland ; and
| | - Hubert Krysztofiak
- National Centre for Sports Medicine, Warsaw, Poland
- Department of Applied Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | | | - Andrzej Ziemba
- Department of Applied Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
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Serradell L, Wagué S, Moureau A, Nissilä M, Chabanon AL. Enhanced passive safety surveillance of a trivalent and a quadrivalent influenza vaccine in Denmark and Finland during the 2018/2019 season. Hum Vaccin Immunother 2021; 17:1205-1210. [PMID: 32966139 PMCID: PMC8018492 DOI: 10.1080/21645515.2020.1804247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The European Medicines Agency requires Enhanced Passive Safety Surveillance (EPSS) for all seasonal influenza vaccines. Here, we report the EPSS results for the trivalent inactivated influenza vaccine (IIV3; Vaxigrip®) and the quadrivalent inactivated influenza vaccine (IIV4; VaxigripTetraTM) during the 2018/19 influenza season in Denmark and Finland. The primary objective was to estimate the rates of suspected adverse reactions (ARs) occurring within 7 days following routine vaccination. Between October and November 2018, 1000 safety report cards (SRCs) for IIV3 were distributed in Denmark, and 996 SRCs for IIV4 were distributed in Finland. Participants were instructed to report any ARs by telephone or e-mail using the information provided on the SRC. All participants vaccinated with IIV3 were aged ≥18 years. Most participants vaccinated with IIV4 (95.5%) were aged 18 − 65 years, 2.2% were aged 6 months to 17 years, and 2.3% were aged >65 years. Fifty-five ARs were reported by 12 participants (1.2%) vaccinated with IIV3 and 162 ARs were reported by 53 participants (5.3%) vaccinated with IIV4. The most frequent ARs were vaccination site pain and fever for IIV3, and vaccination site pain, vaccination site inflammation, myalgia, and headache for IIV4. The 2018/19 AR rates for IIV3 were comparable to 2017/18 rates. The 2018/19 AR rates for IIV4 were higher than those in 2017/18 but were still lower than the expected AR rates listed in the IIV4 Summary of Product Characteristics. In conclusion, the 2018/19 EPSS showed no clinically significant change from the expected safety profiles of IIV3 and IIV4 vaccines.
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Affiliation(s)
- Laurence Serradell
- Risk-Benefit & Epidemiology, Sanofi Pasteur, Campus Sanofi Lyon, Lyon, France
| | - Sophie Wagué
- Medical Operations, Sanofi Pasteur, Campus Sanofi Lyon, Lyon, France
| | - Annick Moureau
- Global Biostatistical Sciences, Sanofi Pasteur, Marcy l'Etoile France
| | - Markku Nissilä
- Terveystalo Clinical Research and Biobank, Turku, Finland
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Active pharmacovigilance of the seasonal trivalent influenza vaccine produced by Instituto Butantan: A prospective cohort study of five target groups. PLoS One 2021; 16:e0246540. [PMID: 33571237 PMCID: PMC7877614 DOI: 10.1371/journal.pone.0246540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 01/21/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Active pharmacovigilance studies are pivotal to better characterize vaccine safety. Methods These are multicenter prospective cohort studies to evaluate the safety of the 2017 and 2018 seasonal trivalent influenza vaccines (TIVs) manufactured by Instituto Butantan, by means of active pharmacovigilance practices. Elderly, children, healthcare workers, pregnant women, and women in the puerperium period were invited to participate in the study during the 2017 and 2018 Brazilian national seasonal influenza vaccination campaigns. Following immunization, participants were observed for 30 minutes and they received a participant card to register adverse events information. All safety information registered were checked at a clinical site visit 14 days after immunization and by a telephone contact 42 days after immunization for unsolicited Adverse Events (AE) and Guillain-Barré Syndrome (GBS). Results A total of 942 volunteers participated in the two studies: 305 elderly, 109 children, 108 pregnant women, 32 women in the postpartum period, and 388 health workers. Overall, the median number of AR per participant ranged from 1 to 4. The lowest median number of AR per participant was observed among healthcare workers (1 AR per participant) and the highest among pregnant women (4 AR per participant). Overall, local pain (46.6%) was the most frequent solicited local AR. The most frequent systemic ARs were: headache (22.5%) followed by fatigue (16.0%), and malaise (11.0%). The majority of solicited ARs (96%) were mild, Grades 1 or 2), only 3% were Grade 3, and 1% was Grade 4. No serious AEs, including Guillain-Barré Syndrome, were reported up to 42 days postvaccination. Conclusion The results from the two studies confirmed that the 2017 and 2018 seasonal trivalent influenza vaccines produced by Instituto Butantan were safe and that active pharmacovigilance studies should be considered, when it is feasible, as an important initiative to monitor vaccine safety in the post-marketing period.
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Tao YY, Li JX, Hu YM, Hu YS, Zeng G, Zhu FC. Quadrivalent influenza vaccine (Sinovac Biotech) for seasonal influenza prophylaxis. Expert Rev Vaccines 2021; 20:1-11. [PMID: 33434084 DOI: 10.1080/14760584.2021.1875823] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Quadrivalent Influenza Vaccine (Sinovac Biotech) is a quadrivalent split-virion-inactivated influenza vaccine approved in China in June 2020 for individuals ≥3 years of age. It contains 15 µg hemagglutinin per strain including A/H1N1, A/H3N2, B/Victoria, and B/Yamagata, which could potentially improve protection against influenza B viruses. AREAS COVERED In this review, we summarize the development of quadrivalent influenza vaccines in China and foreign countries, and assess the immunogenicity and safety from the phase I and III clinical trials of Quadrivalent Influenza Vaccine in individuals ≥3 years of age. We also discuss the potential application of Quadrivalent Influenza Vaccine in young children 6-35 months of age according to the results of the phase III trial. EXPERT COMMENTARY The immunogenicity and safety profiles of Quadrivalent Influenza Vaccine containing two A and two B strains were comparable to the trivalent vaccines for the shared strains. The addition of a second B strain to the trivalent vaccine could induce superior immune responses for the alternate B strain. Since the two B strains co-circulated worldwide, the introduction of quadrivalent influenza vaccines has been expected to be a cost-effective strategy.
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Affiliation(s)
- Yan-Yang Tao
- School of Public Health, Southeast University; Nanjing, China
| | - Jing-Xin Li
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yue-Mei Hu
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuan-Sheng Hu
- Clinical Research Department, Sinovac Biotech Co., LTD., Beijing, China
| | - Gang Zeng
- Clinical Research Department, Sinovac Biotech Co., LTD., Beijing, China
| | - Feng-Cai Zhu
- School of Public Health, Southeast University; Nanjing, China.,NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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Lopandić Z, Dragačević L, Popović D, Andjelković U, Minić R, Gavrović-Jankulović M. BanLec-eGFP Chimera as a Tool for Evaluation of Lectin Binding to High-Mannose Glycans on Microorganisms. Biomolecules 2021; 11:180. [PMID: 33525574 PMCID: PMC7912117 DOI: 10.3390/biom11020180] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/11/2022] Open
Abstract
Fluorescently labeled lectins are useful tools for in vivo and in vitro studies of the structure and function of tissues and various pathogens such as viruses, bacteria, and fungi. For the evaluation of high-mannose glycans present on various glycoproteins, a three-dimensional (3D) model of the chimera was designed from the crystal structures of recombinant banana lectin (BanLec, Protein Data Bank entry (PDB): 5EXG) and an enhanced green fluorescent protein (eGFP, PDB 4EUL) by applying molecular modeling and molecular mechanics and expressed in Escherichia coli. BanLec-eGFP, produced as a soluble cytosolic protein of about 42 kDa, revealed β-sheets (41%) as the predominant secondary structures, with the emission peak maximum detected at 509 nm (excitation wavelength 488 nm). More than 65% of the primary structure was confirmed by mass spectrometry. Competitive BanLec-eGFP binding to high mannose glycans of the influenza vaccine (Vaxigrip®) was shown in a fluorescence-linked lectin sorbent assay (FLLSA) with monosaccharides (mannose and glucose) and wild type BanLec and H84T BanLec mutant. BanLec-eGFP exhibited binding to mannose residues on different strains of Salmonella in flow cytometry, with especially pronounced binding to a Salmonella Typhi clinical isolate. BanLec-eGFP can be a useful tool for screening high-mannose glycosylation sites on different microorganisms.
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Affiliation(s)
- Zorana Lopandić
- Department of Biochemistry, Faculty of Chemistry, University of Belgrade, 11000 Belgrade, Serbia;
| | - Luka Dragačević
- Institute of Virology, Vaccines and Sera, 11152 Belgrade, Serbia; (L.D.); (R.M.)
| | - Dragan Popović
- Institute of Chemistry, Technology and Metallurgy, National Institute of the Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (D.P.); (U.A.)
| | - Uros Andjelković
- Institute of Chemistry, Technology and Metallurgy, National Institute of the Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia; (D.P.); (U.A.)
- Department of Biotechnology, University of Rijeka, 5100 Rijeka, Croatia
| | - Rajna Minić
- Institute of Virology, Vaccines and Sera, 11152 Belgrade, Serbia; (L.D.); (R.M.)
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Amiche A, Tanriover MD, Bellier L, Ugur B, Akin L. Cost Utility of Switching From Trivalent to Quadrivalent Influenza Vaccine in Turkey. Value Health Reg Issues 2021; 25:15-22. [PMID: 33485248 DOI: 10.1016/j.vhri.2020.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Trivalent influenza vaccines (TIVs) are widely used but protect against only 1 of the 2 co-circulating influenza B virus lineages. Quadrivalent influenza vaccines (QIVs) include a B strain from each lineage to overcome mismatches. The main objective of this study was to determine the cost-utility and budget impact of switching from vaccination with TIV to QIV in the population recommended for influenza vaccination in Turkey. METHODS A static cohort cost-effectiveness model was developed to predict influenza-related costs and outcomes under a QIV versus a TIV program during an influenza season. The model was informed by data from Turkey on influenza strain distribution, influenza-attributable outcomes, and associated costs over the seasons 2010/2011 to 2016/2017. The effectiveness of each strategy was measured through quality-adjusted life-years (QALYs), and comparisons were based on the incremental cost-effectiveness ratio. RESULTS In an average influenza season, the model showed that switching from TIV to QIV would prevent an additional 15 092 cases of influenza, 6311 general practitioner visits, 94 hospitalizations, 13 deaths, and gain 440 QALYs. From the societal perspective, this amounted to total cost savings of international dollars (I$) 1102 710 (US$388 643). The incremental cost-effectiveness ratio when using QIV over TIV was I$55 248/QALY gained. Switching to QIV is mostly cost-effective among older adults with I$36 413.38/QALY. Sensitivity analysis showed that vaccine effectiveness, B strain mismatch, and influenza visits highly impact the cost-effectiveness results. CONCLUSION Switching from TIV to QIV is likely to be cost-effective in Turkey, yet highly dependent on the severity of the influenza season, B strain epidemiology, and vaccine effectiveness.
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Affiliation(s)
| | - Mine Durusu Tanriover
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Attitudes of Nursing Home Staff Towards Influenza Vaccination: Opinions and Factors Influencing Hesitancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061851. [PMID: 32178426 PMCID: PMC7143910 DOI: 10.3390/ijerph17061851] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 11/17/2022]
Abstract
Seasonal influenza is recognized to be a significant public health problem and a cause of death, especially in fragile persons. In nursing homes (NHs), vaccination for both residents and staff is the best preventive strategy. However, professionals' immunization rates are far from reaching the international recommended values. This study aims to describe the adherence and attitudes of NH staff towards flu vaccination and to explore staff hesitancy. A questionnaire was developed based on a literature review and on the 3Cs (confidence, complacency, convenience) of the WHO framework and administered among the staff of four NHs of a province in the northeast of Italy. Results demonstrated a low adherence towards annual vaccination (i.e., only 3% declared getting the flu vaccination each year). Complacency, confidence and convenience all showed a significant impact on the attitude towards vaccination both in univariate and multivariable analysis, with complacency being the most strongly associated area. The area of confidence resulted in strongly challenging factors. Only 24.8% of interviewees appeared trustful towards the efficacy of receiving immunization and 34% declared safety issues. Insights from the study can support the implementation of effective interventions to improve vaccination adherence in NHs. Specifically, increasing complacency by raising awareness related to the risks of influenza appears to be an essential strategy to effectively promote vaccination uptake.
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Sarsenbayeva G, Issagulov T, Kassenov M, Abitay R, Orynbayev M, Stukova M, Pisareva M, Davlyatshin T, Lespek K, Khairullin B. Safety and immunogenicity of trivalent inactivated influenza vaccine in adults 60 years of age and older: a phase II, a randomized, comparative trial in Kazakhstan. Hum Vaccin Immunother 2020; 16:1791-1797. [PMID: 32048890 DOI: 10.1080/21645515.2019.1705691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The study was aimed at comparative evaluation of seasonal influenza vaccine RIBSP versus commercial vaccine VAXIGRIP® for immunogenicity and safety in the course of clinical trial phase II on healthy subjects up to 60 years. METHODS The trial involved 150 subjects in randomized 2:1 groups that received either RIBSP vaccine or comparator vaccine VAXIGRIP®. One dose (0.5 ml) of either vaccine contained 15 µg of hemagglutinin of each influenza virus strain recommended by WHO for the Northern hemisphere in 2016-2017 flu season. The observation period lasted 21 days. The trial was registered at ClinicalTrials.gov identifier NCT03016143. RESULTS Assessment of immunogenic activity of the vaccine under study showed that in 21 days the portion of participants with 4-fold seroconversions was 80.0% to А/H1N1; 65.0% to А/H3N2 and 64.0% to B virus. Antibody titer increase factor in the group of subjects that received RIBSP vaccine was 13.4 for А/H1N1; 5.2 for А/H3N2 and 5.2 for B virus. The subjects that received RIBSP vaccine demonstrated 88% seroprotection rate against А/H1N1; 75% against А/H3N2 and 61% against B virus. In the course of evaluating the vaccine safety, no serious adverse events were recorded. All changes of laboratory data were slight and single in most cases. All recorded local reactions have been light in character and these have been predicted reactions observed at vaccination against influenza. CONCLUSION Comparison vaccines RIBSP and VAXIGRIP®, showed similar immunogenic activity. The RIBSP vaccine is safe and immunogenic for the elderly and conforms to international criteria in CPMP/BWP/214/96.
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Affiliation(s)
| | - Timur Issagulov
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Markhabat Kassenov
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Ruslan Abitay
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Mukhit Orynbayev
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Marina Stukova
- Influenza Research Institute , St. Petersburg, Russian Federation
| | - Maria Pisareva
- Influenza Research Institute , St. Petersburg, Russian Federation
| | | | - Kutumbetov Lespek
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
| | - Berik Khairullin
- Research Institute for Biological Safety Problems , Gvardeysk, Kazakhstan
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Lan PT, Toan NT, Thang HA, Thang TC, Be LV, Thai DH, Huong VM, Nga NT, Tang Y, Holt R, Francesco BS, Flores J, Tewari T. A phase 2/3 double-blind, randomized, placebo-controlled study to evaluate the safety and immunogenicity of a seasonal trivalent inactivated split-virion influenza vaccine (IVACFLU-S) in healthy adults in Vietnam. Hum Vaccin Immunother 2019; 15:2933-2939. [PMID: 31070986 PMCID: PMC6930107 DOI: 10.1080/21645515.2019.1613127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Background: Under the WHO's Global Action Plan for influenza vaccines, we conducted a phase 2-3 study of IVACFLU-S, a trivalent, seasonal inactivated influenza vaccine candidate.Methods: In the phase 2 portion of the study, 252 participants received one dose of 15 mcg hemagglutinin (HA) vaccine per strain or placebo. Following determination of safety, 636 additional participants were randomized in phase 3 to receive vaccine or placebo. Immunogenicity was assessed in a subset of the participants in the phase 3 study.Results: Higher proportion (70%) of participants in the IVACFLU-S arm reported solicited local adverse events (AEs) (p < .0001) as compared to placebo (25%). Mild injection site pain and tenderness were most common AEs seen in 55% and 60% of participants in the vaccine group. The solicited systemic AEs were comparable (p = .4149). The majority of solicited and unsolicited AEs were mild to moderate in severity. In the vaccine arm for the combined age group of 18-60 years of age, seroconversion against antigens A/H1N1, A/H3N2, and B was achieved in 70.3%, 76.1%, and 54.1% of participants respectively; seroprotection against antigens A/H1N1, A/H3N2, and B was achieved in 83.3%, 86.6%, and 60.3% of participants respectively; and the geometric mean fold rise for the hemagglutinin-inhibition (HI) antibody titers against antigen A/H1N1, A/H3N2, and B were 13.15, 11.85, and 5.87, respectively.Conclusion: This study demonstrates the local reactogenicity, other safety, and immunogenicity of IVACFLU-S, first domestically produced influenza vaccine in Vietnam.ClinicalTrials.gov number NCT03095599 (March 29, 2017).
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Affiliation(s)
| | | | | | | | - Le Van Be
- Institute of Vaccines and Medical Biologicals, Nha Trang, Viet Nam
| | - Duong Huu Thai
- Institute of Vaccines and Medical Biologicals, Nha Trang, Viet Nam
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Gandhi-Banga S, Chabanon AL, Eymin C, Caroe T, Butler K, Moureau A. Enhanced passive safety surveillance of three marketed influenza vaccines in the UK and the Republic of Ireland during the 2017/18 season. Hum Vaccin Immunother 2019; 15:2154-2158. [PMID: 30897026 PMCID: PMC6773376 DOI: 10.1080/21645515.2019.1581538] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Safety surveillance is required for each season’s influenza vaccines to rapidly detect and evaluate potential new safety concerns before the peak period of immunization. Here we report the results of an enhanced passive safety surveillance for a trivalent split-virion inactivated influenza vaccine (IIV3; Vaxigrip®), an intradermal version of this vaccine (IIV3-ID; Intanza® 15 µg), and a recently licensed quadrivalent version (IIV4; VaxigripTetraTM) during the 2017/18 influenza season in the UK and Republic of Ireland. The primary objective was to determine the rates of adverse reactions (ARs) occurring within 7 days following routine vaccination. Between September and November 2017, 979 safety report cards were distributed to vaccinees receiving IIV3-ID, 1005 to those receiving IIV3, and 957 to those receiving IIV4. At least one AR was reported by 28 participants (2.9%) vaccinated with IIV3-ID, 14 participants (1.4%) vaccinated with IIV3, and 20 participants (2.1%) vaccinated with IIV4. The most frequent ARs were injection-site reactions and headache. One participant vaccinated with IIV3-ID reported two suspected serious ARs (dyskinesia and a shock symptom), although these could not be confirmed as vaccine-related. Rates of ARs for IIV3 and IIV3-ID for 2017/18 did not differ from the 2016/17 rates. For IIV4, in its first season since licensure, AR frequencies were similar to those in the Summary of Product Characteristics. In conclusion, no change was found compared to the known or expected AR rates for IIV3, IIV3-ID, or IIV4 during the 2017/18 season.
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Affiliation(s)
| | | | | | - Timothy Caroe
- Lighthouse Medical Practice , Eastbourne , East Sussex , UK
| | - Karina Butler
- Our Lady's Children's Hospital , Dublin , Crumlin , Ireland
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Jairaj A, Shirisha P, Abdul MSM, Fatima U, Tiwari RVC, Moothedath M. Adult Immunization - Need of the Hour. J Int Soc Prev Community Dent 2018; 8:475-481. [PMID: 30596036 PMCID: PMC6280562 DOI: 10.4103/jispcd.jispcd_347_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 10/16/2018] [Indexed: 11/15/2022] Open
Abstract
Immunization is the process of making individuals immune. Childhood immunization is a common process for various aliments, but adult immunization in the Indian scenario is obscure. Officially, India has been declared polio-free, which is an achievement despite cultural, political, economic, geographic, and so many other factors. The changing demographics of adult, geriatric population and growing cost of health-care maintenance are a concern in developing countries like India. Thus, promoting healthy lifestyle needs prevention, early detection, and management of various diseases and disorders. Certainly, prevention in adults is yet to be tapped completely, so that goal of 100% prevention can be achieved. Various fraternities of medical association have come up with guidelines for adult immunization schedules in India. The present paper reviews infectious diseases such as anthrax, chikungunya, cholera, dengue, influenza, and malaria in this section of the review. We humbly request all health-care professionals and educators to educate the mass for adult immunization. So that, cost involved for treatment and workforce for the management of diseases can be better utilized in some other needed areas.
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Affiliation(s)
| | - P Shirisha
- Department of Humanities and Social Sciences, IIT Madras, Chennai, Tamil Nadu, India
| | | | - Urooj Fatima
- Skin and Laser Care Centre, Dr. Sulaiman Al Habib Hospital, Riyadh, Saudi Arabia
| | - Rahul Vinay Chandra Tiwari
- Department of Oral and Maxillofacial Surgery and Dentistry, Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala, India
| | - Muhamood Moothedath
- Department of Public Health Dentistry, College of Applied Health Sciences in Ar Rass, Qassim University, Buraydah, Saudi Arabia
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Mosnier A, Launay O, Martinez L, Gavazzi G, Josset L, Crepey P, Hannoun C, Weil-Olivier C, Gaillat J. [Quadrivalent influenza vaccine: What is changed and what are the benefits?]. Presse Med 2018; 47:842-853. [PMID: 30219205 DOI: 10.1016/j.lpm.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022] Open
Abstract
Currently, circulating viruses responsible for annual seasonal influenza epidemics belong to two influenza A subtypes, A(H1N1) and A(H3N2), and to two antigenically distinct type B lineages, B/Yamagata and B/Victoria lineages. Like diseases due to influenza A virus, influenza B virus diseases may have severe consequences and should be prevented. Until now, in France, the vaccines used to prevent seasonal influenza were trivalent, systematically targeting viruses belonging to both A subtypes and to one or other of the B lineages. The protective efficacy of trivalent vaccines is diminished during the seasons when viruses belonging to both B lineages cocirculated or when the circulating dominant type B virus belonged to a lineage different from that targeted by the vaccine strain. By targeting viruses belonging to both B lineages, quadrivalent vaccines improve the antigenic concordance between circulating and vaccine type B strains. Three inactivated quadrivalent vaccines are authorized for marketing in France and should be available for the 2018-2019 season. It is expected that, by providing enlarged protection, these quadrivalent influenza vaccines will improve vaccine efficacy, the confidence in immunization of the public, the satisfaction of health professionals, and ultimately will help to complete immunization coverage.
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Affiliation(s)
- Anne Mosnier
- Open Rome & Réseau des GROG, 67, rue du Poteau, 75018 Paris, France
| | - Odile Launay
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | | | - Gaëtan Gavazzi
- CHU Grenoble-Alpes, clinique universitaire de gériatrie, pavillon Elisée-Chatin, et GREPI EA 7408, université Grenoble-Alpes, CS 10217, 38043 Grenoble cedex 9, France
| | - Laurence Josset
- Institut des agents infectieux, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | | | | | | | - Jacques Gaillat
- Centre hospitalier Annecy-Genevois, 1, avenue de l'Hôpital, 74370 Metz-Tessy, France.
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Mondini G, Braga PE, Lopes MH, Sartori AMC, Miyaji KT, Infante V, Randi BA, Timenetsky MDCST, Ferreira JCDOA, Sakita NK, Precioso AR. Prospective cohort studies to evaluate the safety and immunogenicity of the 2013, 2014, and 2015 seasonal influenza vaccines produced by Instituto Butantan. Rev Inst Med Trop Sao Paulo 2018; 60:e37. [PMID: 30066805 PMCID: PMC6069271 DOI: 10.1590/s1678-9946201860037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/02/2018] [Indexed: 11/21/2022] Open
Abstract
Annual vaccination is the most effective way to prevent seasonal influenza illness. Instituto Butantan (IB) performed clinical studies with its 2013, 2014 and 2015 seasonal trivalent influenza vaccines (inactivated split-virion). Prospective cohort studies were carried out to describe the safety and immunogenicity of Instituto Butantan influenza vaccines, in healthy adults and elderly, from 2013 to 2015. Immediately after the informed consent was signed, participants underwent blood collection followed by vaccination. On study days 1, 2 and 3 post-vaccination participants were contacted by the staff to evaluate the occurrence of solicited (local and systemic) and non-solicited adverse reactions. On study day 21 (+7) subjects returned to the clinical site for final safety assessments and blood collection to evaluate post-vaccination immunogenicity. The immunogenicity analyses were performed by means of hemagglutination inhibition (HI) assay. The immunogenicity endpoints were: seroprotection (SPR) and seroconversion (SCR) rates and the geometric mean HI antibody titer ratio (GMTR). The 2013 study was conducted at the Centro de Referência para Imunobiológicos Especiais (CRIE) and at the Centro de Pesquisa Clínica do Instituto da Criança, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo while the 2014 and 2015 studies were conducted at CRIE. The vaccine composition followed the WHO recommendation for the Southern hemisphere seasonal influenza vaccine. Forty-seven healthy adults and 13 elderly participated in the 2013 study, 60 healthy adults and 60 elderly in the 2014 study, and 62 healthy adults and 57 elderly in the 2015 study. In the 2013, 2014 and 2015 studies, pain was the most frequent local adverse reaction and headache the most frequent systemic adverse reaction. All observed adverse reactions were classified as mild or moderate and none as severe. SPR >70% and SPR >60% were observed in adults and elderly, respectively, for the three vaccine viruses, in the 2013, 2014 and 2015 studies. SCR >40% was observed in adults, for the three vaccine viruses, only in the 2014 study and SCR >30% was observed in the elderly, for the three vaccine viruses, only in the 2013 and 2014 studies. GMTR >2.5 among adults, for the three vaccine viruses was only observed in the 2013 study and GMTR >2.0 was observed among elderly, for the three vaccine viruses, in the 2013, 2014 and 2015 studies. The 2013, 2014 and 2015 seasonal influenza vaccines produced by Instituto Butantan were safe and immunogenic according to the immunogenicity criteria defined by the European Medicines Agency (EMA).
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Affiliation(s)
- Gabriella Mondini
- Instituto Butantan, Divisão de Ensaios Clínicos e
Farmacovigilância, São Paulo, São Paulo, Brazil
| | - Patricia Emilia Braga
- Instituto Butantan, Divisão de Ensaios Clínicos e
Farmacovigilância, São Paulo, São Paulo, Brazil
| | - Marta Heloisa Lopes
- Universidade de São Paulo, Faculdade de Medicina, Hospital das
Clínicas, Centro de Referência para Imunobiológicos Especiais (CRIE), São Paulo,
São Paulo, Brazil
| | - Ana Marli Christovam Sartori
- Universidade de São Paulo, Faculdade de Medicina, Hospital das
Clínicas, Centro de Referência para Imunobiológicos Especiais (CRIE), São Paulo,
São Paulo, Brazil
| | - Karina Takesaki Miyaji
- Universidade de São Paulo, Faculdade de Medicina, Hospital das
Clínicas, Centro de Referência para Imunobiológicos Especiais (CRIE), São Paulo,
São Paulo, Brazil
| | - Vanessa Infante
- Universidade de São Paulo, Faculdade de Medicina, Hospital das
Clínicas, Centro de Referência para Imunobiológicos Especiais (CRIE), São Paulo,
São Paulo, Brazil
| | - Bruno Azevedo Randi
- Universidade de São Paulo, Faculdade de Medicina, Hospital das
Clínicas, Centro de Referência para Imunobiológicos Especiais (CRIE), São Paulo,
São Paulo, Brazil
| | | | | | - Neusa Keico Sakita
- Universidade de São Paulo, Faculdade de Medicina, Hospital das
Clínicas, Instituto da Criança, São Paulo, São Paulo, Brazil
| | - Alexander Roberto Precioso
- Instituto Butantan, Divisão de Ensaios Clínicos e
Farmacovigilância, São Paulo, São Paulo, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Departamento
de Pediatria, São Paulo, São Paulo, Brazil
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Law N, Kumar D. Post-transplant Viral Respiratory Infections in the Older Patient: Epidemiology, Diagnosis, and Management. Drugs Aging 2018; 34:743-754. [PMID: 28965331 PMCID: PMC7100819 DOI: 10.1007/s40266-017-0491-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Organ and stem cell transplantation has been one of the greatest advances in modern medicine, and is the primary treatment modality for many end-stage diseases. As our population ages, so do the transplant recipients, and with that comes many new challenges. Respiratory viruses have been a large contributor to the mortality and morbidity of solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Respiratory viruses are generally a long-term complication of transplantation and primarily acquired in the community. With the emergence of molecular methods, newer respiratory viruses are being detected. Respiratory viruses appear to cause severe disease in the older transplant population. Influenza vaccine remains the mainstay of prevention in transplant recipients, although immunogenicity of current vaccines is suboptimal. Limited therapies are available for other respiratory viruses. The next decade will likely bring newer antivirals and vaccines to the forefront. Our goal is to provide the most up to date knowledge of respiratory viral infections in our aging transplant population.
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Affiliation(s)
- Nancy Law
- Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, PMB 11-174, 585 University Avenue, Toronto, ON, M5G 2N2, Canada
| | - Deepali Kumar
- Transplant Infectious Diseases and Multi-Organ Transplant Program, University Health Network, PMB 11-174, 585 University Avenue, Toronto, ON, M5G 2N2, Canada.
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Sarsenbayeva G, Volgin Y, Kassenov M, Issagulov T, Bogdanov N, Sansyzbay A, Stukova M, Buzitskaya Z, Кulmagambetov I, Davlyatshin T, Khairullin B. Immunogenicity and safety of a novel seasonal influenza preservative-free vaccine manufactured in Kazakhstan: Results of a randomized, comparative, phase II clinical trial in adults. Hum Vaccin Immunother 2017; 14:609-614. [PMID: 29112488 DOI: 10.1080/21645515.2017.1387345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The study was aimed at comparative evaluation of seasonal influenza vaccine RIBSP versus commercial vaccine VAXIGRIP® for immunogenicity and safety in the course of clinical trial phase II on healthy volunteers aged 18-60 years. METHODS The trial involved 150 subjects in randomized 2:1 groups that received either RIBSP vaccine or comparator vaccine VAXIGRIP®. One dose (0.5 ml) of either vaccine contained 15 μg of hemagglutinin of each influenza virus strain recommended by WHO for the Northern hemisphere in 2016-2017 flu season. The observation period lasted 21 day. The trial was registered at ClinicalTrials.gov identifier NCT 03016143. RESULTS Assessment of immunogenic activity of the vaccine under study showed that in 21 day the portion of participants with 4-fold seroconversions was 87.0% to A/H1N1; 63.0% to A/H3N2 and 59.0% to B virus. Antibody titer increase factor in the group of subjects that received RIBSP vaccine was 23.3 for A/H1N1; 4.4 for A/H3N2 and 4.5 for B virus. The volunteers that received RIBSP vaccine demonstrated 95% seroprotection level against A/H1N1; 84% against A/H3N2 and 80% against B virus. RIBSP vaccine met the CHMP criteria of the Committee for Medicinal Products for Human Use (CPMP/BWP/214/96). In the course of evaluating the vaccine safety no serious undesirable effects were recorded. All changes of laboratory data were slight and single in most cases. All recorded local reactions have been light in character and these have been predicted reactions observed at vaccination against influenza. CONCLUSION Comparison of the allantoic inactivated split vaccine obtained in vaccines RIBSP and VAXIGRIP®, showed similar immunogenic activity. Both vaccines were safe for the study participants.
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Affiliation(s)
- Gulbanu Sarsenbayeva
- a Laboratory of Technology and Biopreparation Control , Research Institute for Biological Safety Problems , Gvardeysk , Kazakhstan
| | - Yevgeniy Volgin
- a Laboratory of Technology and Biopreparation Control , Research Institute for Biological Safety Problems , Gvardeysk , Kazakhstan
| | - Markhabat Kassenov
- a Laboratory of Technology and Biopreparation Control , Research Institute for Biological Safety Problems , Gvardeysk , Kazakhstan
| | - Timur Issagulov
- a Laboratory of Technology and Biopreparation Control , Research Institute for Biological Safety Problems , Gvardeysk , Kazakhstan
| | - Nikolay Bogdanov
- a Laboratory of Technology and Biopreparation Control , Research Institute for Biological Safety Problems , Gvardeysk , Kazakhstan
| | - Abylay Sansyzbay
- a Laboratory of Technology and Biopreparation Control , Research Institute for Biological Safety Problems , Gvardeysk , Kazakhstan
| | - Marina Stukova
- b Vector Vaccine Laboratory , Influenza Research Institute , St. Petersburg , Russian Federation
| | - Zhanna Buzitskaya
- b Vector Vaccine Laboratory , Influenza Research Institute , St. Petersburg , Russian Federation
| | | | | | - Berik Khairullin
- a Laboratory of Technology and Biopreparation Control , Research Institute for Biological Safety Problems , Gvardeysk , Kazakhstan
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Gresset-Bourgeois V, Leventhal PS, Pepin S, Hollingsworth R, Kazek-Duret MP, De Bruijn I, Samson SI. Quadrivalent inactivated influenza vaccine (VaxigripTetra™). Expert Rev Vaccines 2017; 17:1-11. [PMID: 29157068 DOI: 10.1080/14760584.2018.1407650] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION VaxigripTetra™ (IIV4; Sanofi Pasteur) is a quadrivalent split-virion influenza vaccine approved in Europe in 2016 for individuals ≥ 3 years of age. IIV4 builds on the well-established record of the trivalent split-virion influenza vaccine (Vaxigrip®). Areas covered: This literature review summarizes the rationale for developing quadrivalent influenza vaccines and discusses the phase III clinical trial results supporting the immunogenicity, safety, and tolerability of IIV4. Expert commentary: IIV4 is immunogenic and well tolerated. Adding a second B strain to the trivalent split-virion influenza vaccine provides a superior immune response for the additional strain but does not reduce the immune response for the three other strains or negatively affect the safety profile. By offering broader protection against co-circulating influenza B lineages, IIV4 has the potential to further reduce influenza-related morbidity and mortality beyond that achieved with trivalent vaccines.
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Affiliation(s)
| | | | - Stéphanie Pepin
- c Clinical Development , Sanofi Pasteur , Marcy l'Étoile , France
| | | | | | - Iris De Bruijn
- c Clinical Development , Sanofi Pasteur , Marcy l'Étoile , France
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