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White CL, Chiem K, Perez DR, Santos J, Cardenas Garcia S, Nogales A, Martínez-Sobrido L. A New Master Donor Virus for the Development of Live-Attenuated Influenza B Virus Vaccines. Viruses 2021; 13:1278. [PMID: 34208979 DOI: 10.3390/v13071278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/27/2021] [Accepted: 06/27/2021] [Indexed: 12/23/2022] Open
Abstract
Influenza B viruses (IBV) circulate annually, with young children, the elderly and immunocompromised individuals being at high risk. Yearly vaccinations are recommended to protect against seasonally influenza viruses, including IBV. Live attenuated influenza vaccines (LAIV) provide the unique opportunity for direct exposure to the antigenically variable surface glycoproteins as well as the more conserved internal components. Ideally, LAIV Master Donor Viruses (MDV) should accurately reflect seasonal influenza strains. Unfortunately, the continuous evolution of IBV have led to significant changes in conserved epitopes compared to the IBV MDV based on B/Ann Arbor/1/1966 strain. Here, we propose a recent influenza B/Brisbane/60/2008 as an efficacious MDV alternative, as its internal viral proteins more accurately reflect those of circulating IBV strains. We introduced the mutations responsible for the temperature sensitive (ts), cold adapted (ca) and attenuated (att) phenotype of B/Ann Arbor/1/1966 MDV LAIV into B/Brisbane/60/2008 to generate a new MDV LAIV. In vitro and in vivo analysis demonstrated that the mutations responsible of the ts, ca, and att phenotype of B/Ann Arbor/1/1966 MDV LAIV were able to infer the same phenotype to B/Brisbane/60/2008, demonstrating its potential as a new MDV for the development of LAIV to protect against contemporary IBV strains.
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Mira-Iglesias A, López-Labrador FX, Baselga-Moreno V, Tortajada-Girbés M, Mollar-Maseres J, Carballido-Fernández M, Schwarz-Chavarri G, Puig-Barberà J, Díez-Domingo J, On Behalf Of The Valencia Hospital Network For The Study Of Influenza And Respiratory Viruses Disease. Influenza vaccine effectiveness against laboratory-confirmed influenza in hospitalised adults aged 60 years or older, Valencia Region, Spain, 2017/18 influenza season. ACTA ACUST UNITED AC 2020; 24. [PMID: 31387672 PMCID: PMC6685101 DOI: 10.2807/1560-7917.es.2019.24.31.1800461] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction Influenza immunisation is recommended for elderly people each season. The influenza vaccine effectiveness (IVE) varies annually due to influenza viruses evolving and the vaccine composition. Aim To estimate, in inpatients ≥ 60 years old, the 2017/18 trivalent IVE, overall, by vaccine type and by strain. The impact of vaccination in any of the two previous seasons (2016/17 and 2015/16) on current (2017/18) IVE was also explored. Methods This was a multicentre prospective observational study within the Valencia Hospital Surveillance Network for the Study of Influenza and Respiratory Viruses Disease (VAHNSI, Spain). The test-negative design was applied taking laboratory-confirmed influenza as outcome and vaccination status as main exposure. Information about potential confounders was obtained from clinical registries and/or by interviewing patients; vaccine information was only ascertained by registries. Results Overall, 2017/18 IVE was 9.9% (95% CI: −15.5 to 29.6%), and specifically, 48.3% (95% CI: 13.5% to 69.1%), −29.9% (95% CI: −79.1% to 5.8%) and 25.7% (95% CI: −8.8% to 49.3%) against A(H1N1)pdm09, A(H3N2) and B/Yamagata lineage, respectively. For the adjuvanted and non-adjuvanted vaccines, overall IVE was 10.0% (95% CI: −24.4% to 34.9%) and 7.8% (95% CI: −23.1% to 31.0%) respectively. Prior vaccination significantly protected against influenza B/Yamagata lineage (IVE: 50.2%; 95% CI: 2.3% to 74.6%) in patients not vaccinated in the current season. For those repeatedly vaccinated against influenza A(H1N1)pdm09, IVE was 46.4% (95% CI: 6.8% to 69.2%). Conclusion Our data revealed low vaccine effectiveness against influenza in hospitalised patients ≥60 years old in 2017/18. Prior vaccination protected against influenza A(H1N1)pdm09 and B/Yamagata-lineage.
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Affiliation(s)
- Ainara Mira-Iglesias
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | - F Xavier López-Labrador
- Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.,Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | - Víctor Baselga-Moreno
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | | | | | - Mario Carballido-Fernández
- Universidad CEU Cardenal Herrera, Castellón, Spain.,Hospital General Universitario de Castellón, Castellón, Spain
| | | | - Joan Puig-Barberà
- Centro de Salud Pública de Castellón, Castellón, Spain.,Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
| | - Javier Díez-Domingo
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO-Public Health), Valencia, Spain
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Rivas MJ, Alegretti M, Cóppola L, Ramas V, Chiparelli H, Goñi N. Epidemiology and Genetic Variability of Circulating Influenza B Viruses in Uruguay, 2012-2019. Microorganisms 2020; 8:microorganisms8040591. [PMID: 32325860 PMCID: PMC7232498 DOI: 10.3390/microorganisms8040591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/31/2020] [Accepted: 04/05/2020] [Indexed: 02/07/2023] Open
Abstract
Influenza B viruses (IBV) are an important cause of morbidity and mortality during interpandemic periods in the human population. Two phylogenetically distinct IBV lineages, B/Yamagata and B/Victoria, co-circulate worldwide and they present challenges for vaccine strain selection. Until the present study, there was little information regarding the pattern of the circulating strains of IBV in Uruguay. A subset of positive influenza B samples from influenza-like illness (ILI) outpatients and severe acute respiratory illness (SARI) inpatients detected in sentinel hospitals in Uruguay during 2012–2019 were selected. The sequencing of the hemagglutinin (HA) and neuraminidase (NA) genes showed substitutions at the amino acid level. Phylogenetic analysis reveals the co-circulation of both lineages in almost all seasonal epidemics in Uruguay, and allows recognizing a lineage-level vaccine mismatch in approximately one-third of the seasons studied. The epidemiological results show that the proportion of IBV found in ILI was significantly higher than the observed in SARI cases across different groups of age (9.7% ILI, 3.2% SARI) and patients between 5–14 years constituted the majority (33%) of all influenza B infection (p < 0.05). Interestingly, we found that individuals >25 years were particularly vulnerable to Yamagata lineage infections.
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Affiliation(s)
- María José Rivas
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
| | - Miguel Alegretti
- Departamento de Vigilancia en Salud, Ministerio de Salud, Montevideo 11200, Uruguay;
| | - Leticia Cóppola
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
| | - Viviana Ramas
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
| | - Héctor Chiparelli
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
| | - Natalia Goñi
- Centro Nacional de Referencia de Influenza, Unidad de Virología, Departamento de Laboratorios de Salud Pública, Ministerio de Salud, Montevideo 11600, Uruguay; (M.J.R.); (L.C.); (V.R.); (H.C.)
- Correspondence: ; Tel.: +598-99191211
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Chang CY, Cho CY, Lai CC, Lu CY, Chang LY, Hung MC, Huang LM, Wu KG. Immunogenicity and safety of a quadrivalent inactivated influenza vaccine in healthy subjects aged 3 to 17 years old: A phase III, open label, single-arm study. Vaccine 2020; 38:3839-3846. [PMID: 32284272 DOI: 10.1016/j.vaccine.2020.03.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/20/2020] [Accepted: 03/27/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Quadrivalent influenza vaccines are particularly valuable during seasons in which a mismatch occurs between the predicted influenza B lineage for the trivalent influenza vaccine and the circulating strain. This study evaluated the immunogenicity and safety of a quadrivalent inactivated influenza vaccine AdimFlu-S manufactured in Taiwan for the 2016-2017 influenza season in healthy children. METHODS A total of 174 healthy children aged 3 to 17 years old were separated into 3 groups (Group A: 3-8 years old, vaccine naïve; Group B: 3-8 years old, vaccine non-naïve; Group C: 9-17 years old, any vaccine status). Sera was collected pre and post vaccination for each participant. A hemagglutination inhibition (HAI) assay was utilized to calculate geometric mean titer (GMT), seroprotection rate, and seroconversion rate. RESULTS All enrolled participants completed the study. For the four vaccine strains four weeks after the last vaccination, geometric mean titer ratios (GMTRs) were between 2.9 and 20.9, seroconversion rates were between 42.9% and 90.9%, and seroprotection rates were all above 96.4%. This achieved all immunogenicity endpoints and fulfilled the criteria of the European Medical Agency's Committee for Medicinal Products for Human Use (CHMP). No serious adverse events (AEs) were reported during the follow-up period of 6 months. CONCLUSION This quadrivalent influenza vaccine is demonstrated to be well tolerated and displays robust immunogenicity for each influenza strain. This could potentially improve protection against the antigenically distinct B/Yamagata and B/Victoria lineages.
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Affiliation(s)
- Chia-Yuan Chang
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Ching-Yi Cho
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Chou-Cheng Lai
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Chun-Yi Lu
- Departments of Pediatrics, National Taiwan University Children's Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Luan-Yin Chang
- Departments of Pediatrics, National Taiwan University Children's Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Miao-Chiu Hung
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Li-Min Huang
- Departments of Pediatrics, National Taiwan University Children's Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Keh-Gong Wu
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan.
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Oh YN, Kim S, Choi YB, Woo SI, Hahn YS, Lee JK. Clinical similarities between influenza A and B in children: a single-center study, 2017/18 season, Korea. BMC Pediatr 2019; 19:472. [PMID: 31796033 PMCID: PMC6889424 DOI: 10.1186/s12887-019-1862-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 11/28/2019] [Indexed: 11/25/2022] Open
Abstract
Background The global burden of seasonal influenza on medical care has been one of the greatest in the pediatric population. The attention drawn to influenza B was relatively low compared to influenza A, probably because the influenza B virus was thought to be less virulent and have a lower pandemic potential. This study aimed to compare the clinical features of influenza A and B in children. Methods This retrospective study included children diagnosed and treated for influenza as inpatients or outpatients during the 2017/18 influenza season at a tertiary referral hospital. Data regarding clinical characteristics, diagnoses, laboratory results, and vaccination histories were collected and reviewed. Results Over the study period, 128 patients with influenza A and 109 patients with influenza B were identified. The mean age of patients with influenza B was significantly higher than that of patients with influenza A (5.6 ± 4.4 vs 4.1 ± 4.4 years, p = 0.010). Fever was the most common manifestation of influenza followed by respiratory symptoms. No single symptom was specifically associated with either type of influenza. The total duration of fever (4.3 ± 2.3 vs 3.7 ± 2.6 days), ‘time from fever onset to initiation of antivirals’, and ‘time from initiation of antivirals to defervescence’ were similar between the two influenza types, even though all three time periods tended to be longer for influenza B. The platelet counts and proportions of neutrophils were higher for influenza A than for influenza B infections, although the values were within normal limits for both influenza types. Conclusions We found overall clinical similarities between influenza A and B with no less clinical significance or severity of influenza B compared to those of influenza A. Equal levels of awareness and attention should be paid to both influenza types.
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Affiliation(s)
- Yu Na Oh
- Department of Pediatrics, Chungbuk National University Hospital, 776 1-Sunhwan-ro, Seowon-gu, Cheongju, 28644, Korea
| | - San Kim
- Department of Pediatrics, Chungbuk National University Hospital, 776 1-Sunhwan-ro, Seowon-gu, Cheongju, 28644, Korea
| | - Young Bae Choi
- Department of Pediatrics, Chungbuk National University Hospital, 776 1-Sunhwan-ro, Seowon-gu, Cheongju, 28644, Korea
| | - Sung Il Woo
- Department of Pediatrics, Chungbuk National University Hospital, 776 1-Sunhwan-ro, Seowon-gu, Cheongju, 28644, Korea
| | - Youn-Soo Hahn
- Department of Pediatrics, Chungbuk National University Hospital, 776 1-Sunhwan-ro, Seowon-gu, Cheongju, 28644, Korea
| | - Joon Kee Lee
- Department of Pediatrics, Chungbuk National University Hospital, 776 1-Sunhwan-ro, Seowon-gu, Cheongju, 28644, Korea.
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Tsedenbal N, Tsend-Ayush A, Badarch D, Jav S, Pagbajab N. Influenza B viruses circulated during last 5 years in Mongolia. PLoS One 2018; 13:e0206987. [PMID: 30439983 PMCID: PMC6237300 DOI: 10.1371/journal.pone.0206987] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/23/2018] [Indexed: 12/17/2022] Open
Abstract
Influenza B virus-caused illness has recently been considered as an urgent public health problem due to substantial morbidity, mortality and life-threatening medical complications. In this study, we have reported the main characteristics of influenza B virus in Mongolia, including prevalence, lineages, suitability with vaccine strains and drug susceptibility against the virus. 15768 specimens were tested by qPCR for detecting influenza viruses. From positive specimens for influenza B virus, the clinical isolates were isolated using MDCK cells. Sequencing analysis, hemagglutination inhibition assay and Neuraminidase inhibitor (NAI) drug susceptibility testing were performed for the clinical isolates. Influenza B virus was around in 3.46% of the samples in Mongolia, and B/Victoria clade-1A and B/Yamagata clade-3 lineages were predominant. Importantly, it was confirmed that the lineages corresponded to the vaccine strains. Moreover, drug susceptibility tests revealed that some Mongolian clinical isolates showed reduced susceptibility to antiviral agents. Interestingly, G104R was identified as a novel mutation, which might have a significant role in drug resistance of the virus. These results describe the characteristics of influenza B viruses that have caused respiratory illness in the population of Mongolia between 2013 and 2017.
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Affiliation(s)
- Naranzul Tsedenbal
- National Influenza Center, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Altansukh Tsend-Ayush
- School of Bio-Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Darmaa Badarch
- National Influenza Center, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
| | - Sarantuya Jav
- School of Bio-Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- * E-mail:
| | - Nymadawa Pagbajab
- National Influenza Center, National Center for Communicable Diseases, Ministry of Health, Ulaanbaatar, Mongolia
- Mongolian Academy of Medical Sciences, Ulaanbaatar, Mongolia
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Popescu CP, Florescu SA, Lupulescu E, Zaharia M, Tardei G, Lazar M, Ceausu E, Ruta SM. Neurologic Complications of Influenza B Virus Infection in Adults, Romania. Emerg Infect Dis 2018; 23:574-581. [PMID: 28322689 PMCID: PMC5367398 DOI: 10.3201/eid2304.161317] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Infection with this virus should be considered as an etiologic factor for encephalitis. We characterized influenza B virus–related neurologic manifestations in an unusually high number of hospitalized adults at a tertiary care facility in Romania during the 2014–15 influenza epidemic season. Of 32 patients with a confirmed laboratory diagnosis of influenza B virus infection, neurologic complications developed in 7 adults (median age 31 years). These complications were clinically diagnosed as confirmed encephalitis (4 patients), possible encephalitis (2 patients), and cerebellar ataxia (1 patient). Two of the patients died. Virus sequencing identified influenza virus B (Yam)-lineage clade 3, which is representative of the B/Phuket/3073/2013 strain, in 4 patients. None of the patients had been vaccinated against influenza. These results suggest that influenza B virus can cause a severe clinical course and should be considered as an etiologic factor for encephalitis.
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Yang F, Ma L, Zhou J, Wu Y, Gao J, Song S, Geng X, Guo Q, Li Z, Li W, Liao G, Li Y. Development and identification of a new Vero cell-based live attenuated influenza B vaccine by a modified classical reassortment method. Expert Rev Vaccines 2017; 16:855-863. [PMID: 28581345 DOI: 10.1080/14760584.2017.1337514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND It was to generate a new Vero and cold-adapted live attenuated influenza B vaccine with enough safety and immunogenicity. METHODS According to modified classical reassortment method, the donor strain was B/Yunnan/2/2005Vca(B), and the parental virus strain was B/Brisbane/60/2008wt. After co-infection in Vero cells, the prepared antibody serum inhibited the donor strain growth, and screening conditions inhibited the parental virus growth, which induced the growth of the new reassortant virus B/Brisbane/60/2008Vca(B) grow. Through intraperitoneal injection (i.j.) and intranasal injection (n.j.) we evaluated the safety and immunogenicity of the vaccine. RESULTS A high-yield of the reassortant virus was produced in Vero cells at 25°C, similar to the donor strains. After sequencing, it was found that B/Brisbane/60/2008Vca(B) Hemagglutinin (HA) and Neuraminidase (NA) gene fragments were from B/Brisbane/60/2008wt, while the other 6 gene fragments were from B/Yunnan/2/2005Vca(B). The n.j. immune pathway experiments showed no significant differences between the treatment and the PBS control group with respect to weight changes (P > 0.5). Furthermore, the new strain had a sufficient geometric mean titter (GMT) against B/Brisbane/60/2008wt. CONCLUSION The new reassortant live attenuated influenza B vaccine was safe and having enough immune stimulating ability.
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Affiliation(s)
- Fan Yang
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China.,b Medical Faculty , Kunming University of Science and Technology , Kunming , People's Republic of China
| | - Lei Ma
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Jian Zhou
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Yinjie Wu
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Jingxia Gao
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Shaohui Song
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Xingliang Geng
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Qi Guo
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Zhuofan Li
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Weidong Li
- c The Department of Production Administration, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Guoyang Liao
- a The fifth Department of Biological products, Institute of Medical Biology , Chinese Academy of Medical Science and Peking Union Medical College , Kunming , People's Republic of China
| | - Yufeng Li
- d Department of Cardiology , Chinese PLA General Hospital , Beijing , People's Republic of China
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Rondy M, Launay O, Castilla J, Costanzo S, Puig-Barberà J, Gefenaite G, Larrauri A, Rizzo C, Pitigoi D, Syrjänen RK, Machado A, Kurečić Filipović S, Krisztina Horváth J, Paradowska-Stankiewicz I, Marbus S, Moren A. Repeated seasonal influenza vaccination among elderly in Europe: Effects on laboratory confirmed hospitalised influenza. Vaccine 2017; 35:4298-4306. [PMID: 28709555 DOI: 10.1016/j.vaccine.2017.06.088] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/26/2017] [Accepted: 06/29/2017] [Indexed: 11/19/2022]
Abstract
In Europe, annual influenza vaccination is recommended to elderly. From 2011 to 2014 and in 2015-16, we conducted a multicentre test negative case control study in hospitals of 11 European countries to measure influenza vaccine effectiveness (IVE) against laboratory confirmed hospitalised influenza among people aged ≥65years. We pooled four seasons data to measure IVE by past exposures to influenza vaccination. We swabbed patients admitted for clinical conditions related to influenza with onset of severe acute respiratory infection ≤7days before admission. Cases were patients RT-PCR positive for influenza virus and controls those negative for any influenza virus. We documented seasonal vaccination status for the current season and the two previous seasons. We recruited 5295 patients over the four seasons, including 465A(H1N1)pdm09, 642A(H3N2), 278 B case-patients and 3910 controls. Among patients unvaccinated in both previous two seasons, current seasonal IVE (pooled across seasons) was 30% (95%CI: -35 to 64), 8% (95%CI: -94 to 56) and 33% (95%CI: -43 to 68) against influenza A(H1N1)pdm09, A(H3N2) and B respectively. Among patients vaccinated in both previous seasons, current seasonal IVE (pooled across seasons) was -1% (95%CI: -80 to 43), 37% (95%CI: 7-57) and 43% (95%CI: 1-68) against influenza A(H1N1)pdm09, A(H3N2) and B respectively. Our results suggest that, regardless of patients' recent vaccination history, current seasonal vaccine conferred some protection to vaccinated patients against hospitalisation with influenza A(H3N2) and B. Vaccination of patients already vaccinated in both the past two seasons did not seem to be effective against A(H1N1)pdm09. To better understand the effect of repeated vaccination, engaging in large cohort studies documenting exposures to vaccine and natural infection is needed.
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Affiliation(s)
| | - Odile Launay
- Inserm, F-CRIN, Innovative Clinical Research Network in Vaccinology (I-REIVAC), Paris, France; CIC De Vaccinologie, Cochin-Pasteur, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Jesus Castilla
- Instituto de Salud Pública de Navarra, IdiSNA, Pamplona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli (Isernia), Italy
| | - Joan Puig-Barberà
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain; Centro de Salud Pública de Castellón, Castellón, Spain
| | - Giedre Gefenaite
- Department of Infectious Diseases of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Spain
| | - Caterina Rizzo
- Epidemiology Unit Department of Infectious Disease, Istituto Superiore di Sanità, Rome, Italy
| | | | - Ritva K Syrjänen
- Impact Assessment Unit, National Institute for Health and Welfare (THL), Tampere, Finland
| | - Ausenda Machado
- Epidemiology Research Unit, Epidemiology Department, National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | | | - Judit Krisztina Horváth
- National Centre for Epidemiology, Department of Communicable Disease Prevention and Surveillance, Budapest, Hungary
| | | | - Sierk Marbus
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Beyer W, Palache A, Boulfich M, Osterhaus A. Rationale for two influenza B lineages in seasonal vaccines: A meta-regression study on immunogenicity and controlled field trials. Vaccine 2017; 35:4167-4176. [DOI: 10.1016/j.vaccine.2017.06.038] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/12/2017] [Accepted: 06/13/2017] [Indexed: 11/29/2022]
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de Boer PT, van Maanen BM, Damm O, Ultsch B, Dolk FCK, Crépey P, Pitman R, Wilschut JC, Postma MJ. A systematic review of the health economic consequences of quadrivalent influenza vaccination. Expert Rev Pharmacoecon Outcomes Res 2017; 17:249-265. [PMID: 28613092 DOI: 10.1080/14737167.2017.1343145] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Quadrivalent influenza vaccines (QIVs) contain antigens derived from an additional influenza type B virus as compared with currently used trivalent influenza vaccines (TIVs). This should overcome a potential reduced vaccine protection due to mismatches between TIV and circulating B viruses. In this study, we systematically reviewed the available literature on health economic evaluations of switching from TIV to QIV. Areas covered: The databases of Medline and Embase were searched systematically to identify health economic evaluations of QIV versus TIV published before September 2016.A total of sixteen studies were included, thirteen cost-effectiveness analyses and three cost-comparisons. Expert commentary: Published evidence on the cost-effectiveness of QIV suggests that switching from TIV to QIV would be a valuable intervention from both the public health and economic viewpoint. However, more research seems mandatory. Our main recommendations for future research include: 1) more extensive use of dynamic models in order to estimate the full impact of QIV on influenza transmission including indirect effects, 2) improved availability of data on disease outcomes and costs related to influenza type B viruses, and 3) more research on immunogenicity of natural influenza infection and vaccination, with emphasis on cross-reactivity between different influenza B viruses and duration of protection.
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Affiliation(s)
- Pieter T de Boer
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands
| | - Britt M van Maanen
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands
| | - Oliver Damm
- b Department of Health Economics and Health Care Management, School of Public Health , Bielefeld University , Bielefeld , Germany
| | - Bernhard Ultsch
- c Immunisation Unit , Robert Koch Institute , Berlin , Germany
| | - Franklin C K Dolk
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands
| | - Pascal Crépey
- d Department of Quantitative Methods in Public Health , EHESP Rennes , Sorbonne Paris Cité, Rennes , France.,e UPRES-EA-7449 Reperes, University of Rennes 1 , Rennes , France
| | | | - Jan C Wilschut
- g Department of Medical Microbiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Maarten J Postma
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands.,h Department of Epidemiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.,i Institute of Science in Healthy Aging & healthcaRE (SHARE) , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
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Santos JJS, Finch C, Sutton T, Obadan A, Aguirre I, Wan Z, Lopez D, Geiger G, Gonzalez-Reiche AS, Ferreri L, Perez DR. Development of an Alternative Modified Live Influenza B Virus Vaccine. J Virol 2017; 91:e00056-17. [PMID: 28381580 DOI: 10.1128/JVI.00056-17] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/31/2017] [Indexed: 12/27/2022] Open
Abstract
Influenza B virus (IBV) is considered a major human pathogen, responsible for seasonal epidemics of acute respiratory illness. Two antigenically distinct IBV hemagglutinin (HA) lineages cocirculate worldwide with little cross-reactivity. Live attenuated influenza virus (LAIV) vaccines have been shown to provide better cross-protective immune responses than inactivated vaccines by eliciting local mucosal immunity and systemic B cell- and T cell-mediated memory responses. We have shown previously that incorporation of temperature-sensitive (ts) mutations into the PB1 and PB2 subunits along with a modified HA epitope tag in the C terminus of PB1 resulted in influenza A viruses (IAV) that are safe and effective as modified live attenuated (att) virus vaccines (IAV att). We explored whether analogous mutations in the IBV polymerase subunits would result in a stable virus with an att phenotype. The PB1 subunit of the influenza B/Brisbane/60/2008 strain was used to incorporate ts mutations and a C-terminal HA tag. Such modifications resulted in a B/Bris att strain with ts characteristics in vitro and an att phenotype in vivo Vaccination studies in mice showed that a single dose of the B/Bris att candidate stimulated sterilizing immunity against lethal homologous challenge and complete protection against heterologous challenge. These studies show the potential of an alternative LAIV platform for the development of IBV vaccines.IMPORTANCE A number of issues with regard to the effectiveness of the LAIV vaccine licensed in the United States (FluMist) have arisen over the past three seasons (2013-2014, 2014-2015, and 2015-2016). While the reasons for the limited robustness of the vaccine-elicited immune response remain controversial, this problem highlights the critical importance of continued investment in LAIV development and creates an opportunity to improve current strategies so as to develop more efficacious vaccines. Our laboratory has developed an alternative strategy, the incorporation of 2 amino acid mutations and a modified HA tag at the C terminus of PB1, which is sufficient to attenuate the IBV. As a LAIV, this novel vaccine provides complete protection against IBV strains. The availability of attenuated IAV and IBV backbones based on contemporary strains offers alternative platforms for the development of LAIVs that may overcome current limitations.
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Abstract
The prediction of the lineage dynamics of influenza B viruses for the next season is one of the largest obstacles for constructing an appropriate influenza trivalent vaccine. Seasonal fluctuation of transmissibility and epidemiological interference between the two major influenza B lineages make the lineage dynamics complicated. Here we construct a parsimonious model describing the lineage dynamics while taking into account seasonal fluctuation of transmissibility and epidemiological interference. Using this model we estimated the epidemiological and evolutional parameters with the time-series data of the lineage specific isolates in Japan from the 2010-2011 season to the 2014-2015 season. The basic reproduction number is similar between Victoria and Yamagata, with a minimum value during one year as 0.82 (95% highest posterior density (HPD): 0.77-0.87) for the Yamagata and 0.83 (95% HPD: 0.74-0.92) for Victoria, the amplitude of seasonal variation of the basic reproduction number is 0.77 (95% HPD:0.66-0.87) for Yamagata and 1.05 (95% HPD: 0.89-1.02) for Victoria. The duration for which the acquired immunity is effective against infection by the Yamagata lineage is shorter than the acquired immunity for Victoria, 424.1days (95% HPD:317.4-561.5days). The reduction rate of susceptibility due to immune cross-reaction is 0.51 (95% HPD: 0.084-0.92) for the immunity obtained from the infection with Yamagata against the infection with Victoria and 0.62 (95% HPD: 0.42-0.80) for the immunity obtained from the infection with Victoria against the infection with Yamagata. Using estimated parameters, we predicted the dominant lineage in 2015-2016 season. The accuracy of this prediction is 68.8% if the emergence timings of the two lineages are known and 61.4% if the emergence timings are unknown. Estimated seasonal variation of the lineage specific reproduction number can narrow down the range of emergence timing, with an accuracy of 64.6% if the emergence times are assumed to be the time at which the estimated reproduction number exceeds one.
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Affiliation(s)
- Mayumbo Nyirenda
- Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Ryosuke Omori
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan
- JST, PRESTO, 4-1-8 Honcho, Kawaguchi, Saitama, 332–0012, Japan
- * E-mail:
| | - Heidi L. Tessmer
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Hiroki Arimura
- Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kimihito Ito
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, Japan
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