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The rationale for quadrivalent influenza vaccines.

Ambrose CS, Levin MJ - Hum Vaccin Immunother (2012)

Bottom Line: Consequently, seasonal influenza vaccines could be improved by inclusion of influenza B strains of both lineages.Multiple manufacturers have initiated clinical studies of quadrivalent influenza vaccines.Data from those studies, taken together with epidemiologic data regarding the burden of disease caused by influenza B infections, will determine the safety, effectiveness, and benefit of utilizing quadrivalent vaccines for the prevention of seasonal influenza disease.

View Article: PubMed Central - PubMed

Affiliation: MedImmune, LLC, Gaithersburg, MD, USA. AmbroseC@MedImmune.com

ABSTRACT
Two antigenically distinct lineages of influenza B viruses have circulated globally since 1985. However, licensed trivalent seasonal influenza vaccines contain antigens from only a single influenza B virus and thus provide limited immunity against circulating influenza B strains of the lineage not present in the vaccine. In recent years, predictions about which B lineage will predominate in an upcoming influenza season have been no better than chance alone, correct in only 5 of the 10 seasons from 2001 to 2011. Consequently, seasonal influenza vaccines could be improved by inclusion of influenza B strains of both lineages. The resulting quadrivalent influenza vaccines would allow influenza vaccination campaigns to respond more effectively to current global influenza epidemiology. Manufacturing capacity for seasonal influenza vaccines has increased sufficiently to supply quadrivalent influenza vaccines, and methods to identify the influenza B strains to include in such vaccines are in place. Multiple manufacturers have initiated clinical studies of quadrivalent influenza vaccines. Data from those studies, taken together with epidemiologic data regarding the burden of disease caused by influenza B infections, will determine the safety, effectiveness, and benefit of utilizing quadrivalent vaccines for the prevention of seasonal influenza disease.

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Figure 1. Influenza B circulation as a proportion of circulating influenza strains: US and European data for 2001 to 2011. US data (A) were extracted from cumulative data reported in the final CDC weekly influenza surveillance report for each season (available at www.cdc.gov/flu/weekly/pastreports.htm). Data for 2008–2009 represent cumulative data through April 18, 2009. EU data (B) were extracted from cumulative Euroflu sentinel site data reported in the final weekly influenza surveillance bulletin for each season beginning with the 2003–2004 season (available at www.euroflu.org/cgi-files/bulletin_v2.cgi). Because Euroflu bulletins issued before 2003–2004 do not provide cumulative season data, data presented for the 2001–2002 and 2002–2003 influenza seasons were extracted from the final cumulative European Influenza Surveillance Scheme report issued in 2007 (available at www.euroflu.org/documents/eiss_annual_report_2006-2007.pdf).
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Figure 1: Figure 1. Influenza B circulation as a proportion of circulating influenza strains: US and European data for 2001 to 2011. US data (A) were extracted from cumulative data reported in the final CDC weekly influenza surveillance report for each season (available at www.cdc.gov/flu/weekly/pastreports.htm). Data for 2008–2009 represent cumulative data through April 18, 2009. EU data (B) were extracted from cumulative Euroflu sentinel site data reported in the final weekly influenza surveillance bulletin for each season beginning with the 2003–2004 season (available at www.euroflu.org/cgi-files/bulletin_v2.cgi). Because Euroflu bulletins issued before 2003–2004 do not provide cumulative season data, data presented for the 2001–2002 and 2002–2003 influenza seasons were extracted from the final cumulative European Influenza Surveillance Scheme report issued in 2007 (available at www.euroflu.org/documents/eiss_annual_report_2006-2007.pdf).

Mentions: The incidence of influenza B can vary dramatically between influenza seasons. According to data from the US. Centers for Disease Control and Prevention (CDC), from 2001–2002 through 2010–2011 (excluding the 2009–2010 pandemic), influenza B was responsible for < 1% to 44% of influenza-positive samples submitted by participating laboratories (Fig. 1A). On average, 24% of influenza samples during this period were positive for influenza B. European surveillance data from the same seasons was similar, with influenza B being responsible for 1% to 60% of influenza-positive samples and a season average of 23% (Fig. 1B). These data are consistent with a Dutch study that systematically examined cases of influenza-like illness from 1992–1993 through 2006–2007 and found the proportion of influenza cases caused by influenza B to range from 0% to 82% by season, with a season average of 29%.9 Influenza B was responsible for more than 30% of cases in 7 of the 15 seasons. Similarly, in data from Finland from 1980 to 1999, influenza B accounted for 20% of influenza cases among children <17 y of age, and was the predominant cause of influenza illness in 5 of the 20 seasons.10


The rationale for quadrivalent influenza vaccines.

Ambrose CS, Levin MJ - Hum Vaccin Immunother (2012)

Figure 1. Influenza B circulation as a proportion of circulating influenza strains: US and European data for 2001 to 2011. US data (A) were extracted from cumulative data reported in the final CDC weekly influenza surveillance report for each season (available at www.cdc.gov/flu/weekly/pastreports.htm). Data for 2008–2009 represent cumulative data through April 18, 2009. EU data (B) were extracted from cumulative Euroflu sentinel site data reported in the final weekly influenza surveillance bulletin for each season beginning with the 2003–2004 season (available at www.euroflu.org/cgi-files/bulletin_v2.cgi). Because Euroflu bulletins issued before 2003–2004 do not provide cumulative season data, data presented for the 2001–2002 and 2002–2003 influenza seasons were extracted from the final cumulative European Influenza Surveillance Scheme report issued in 2007 (available at www.euroflu.org/documents/eiss_annual_report_2006-2007.pdf).
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC3350141&req=5

Figure 1: Figure 1. Influenza B circulation as a proportion of circulating influenza strains: US and European data for 2001 to 2011. US data (A) were extracted from cumulative data reported in the final CDC weekly influenza surveillance report for each season (available at www.cdc.gov/flu/weekly/pastreports.htm). Data for 2008–2009 represent cumulative data through April 18, 2009. EU data (B) were extracted from cumulative Euroflu sentinel site data reported in the final weekly influenza surveillance bulletin for each season beginning with the 2003–2004 season (available at www.euroflu.org/cgi-files/bulletin_v2.cgi). Because Euroflu bulletins issued before 2003–2004 do not provide cumulative season data, data presented for the 2001–2002 and 2002–2003 influenza seasons were extracted from the final cumulative European Influenza Surveillance Scheme report issued in 2007 (available at www.euroflu.org/documents/eiss_annual_report_2006-2007.pdf).
Mentions: The incidence of influenza B can vary dramatically between influenza seasons. According to data from the US. Centers for Disease Control and Prevention (CDC), from 2001–2002 through 2010–2011 (excluding the 2009–2010 pandemic), influenza B was responsible for < 1% to 44% of influenza-positive samples submitted by participating laboratories (Fig. 1A). On average, 24% of influenza samples during this period were positive for influenza B. European surveillance data from the same seasons was similar, with influenza B being responsible for 1% to 60% of influenza-positive samples and a season average of 23% (Fig. 1B). These data are consistent with a Dutch study that systematically examined cases of influenza-like illness from 1992–1993 through 2006–2007 and found the proportion of influenza cases caused by influenza B to range from 0% to 82% by season, with a season average of 29%.9 Influenza B was responsible for more than 30% of cases in 7 of the 15 seasons. Similarly, in data from Finland from 1980 to 1999, influenza B accounted for 20% of influenza cases among children <17 y of age, and was the predominant cause of influenza illness in 5 of the 20 seasons.10

Bottom Line: Consequently, seasonal influenza vaccines could be improved by inclusion of influenza B strains of both lineages.Multiple manufacturers have initiated clinical studies of quadrivalent influenza vaccines.Data from those studies, taken together with epidemiologic data regarding the burden of disease caused by influenza B infections, will determine the safety, effectiveness, and benefit of utilizing quadrivalent vaccines for the prevention of seasonal influenza disease.

View Article: PubMed Central - PubMed

Affiliation: MedImmune, LLC, Gaithersburg, MD, USA. AmbroseC@MedImmune.com

ABSTRACT
Two antigenically distinct lineages of influenza B viruses have circulated globally since 1985. However, licensed trivalent seasonal influenza vaccines contain antigens from only a single influenza B virus and thus provide limited immunity against circulating influenza B strains of the lineage not present in the vaccine. In recent years, predictions about which B lineage will predominate in an upcoming influenza season have been no better than chance alone, correct in only 5 of the 10 seasons from 2001 to 2011. Consequently, seasonal influenza vaccines could be improved by inclusion of influenza B strains of both lineages. The resulting quadrivalent influenza vaccines would allow influenza vaccination campaigns to respond more effectively to current global influenza epidemiology. Manufacturing capacity for seasonal influenza vaccines has increased sufficiently to supply quadrivalent influenza vaccines, and methods to identify the influenza B strains to include in such vaccines are in place. Multiple manufacturers have initiated clinical studies of quadrivalent influenza vaccines. Data from those studies, taken together with epidemiologic data regarding the burden of disease caused by influenza B infections, will determine the safety, effectiveness, and benefit of utilizing quadrivalent vaccines for the prevention of seasonal influenza disease.

Show MeSH
Related in: MedlinePlus