Viral Strains And Producers Of The Seasonal Flu Vaccines For 2020
The following changes and updates are taken from the first reference from the CDC:
The composition of the 2020-21 U.S. influenza vaccines includes updates to the influenza Apdm09, influenza A, and influenza B/Victoria lineage components. These updated components will be included in both trivalent and quadrivalent vaccines. Quadrivalent vaccines will include an additional influenza B virus component from the B/Yamagata lineage, which is unchanged from that included in quadrivalent influenza vaccines used during the 2019-20 season. For the 2020-21 season, U.S. egg-based influenza vaccines will contain hemagglutinin derived from an influenza A/Guangdong-Maonan/SWL1536/2019 pdm09-like virus, an influenza A/Hong Kong/2671/2019 -like virus, an influenza B/Washington/02/2019 -like virus, and an influenza B/Phuket/3073/2013 -like virus. U.S. cell culture-based inactivated and recombinant influenza vaccines will contain HA derived from an influenza A/Hawaii/70/2019 pdm09-like virus, an influenza A/Hong Kong/45/2019 -like virus, an influenza B/Washington/02/2019 -like virus, and an influenza B/Phuket/3073/2013 -like virus.
Two new influenza vaccine licensures are described:
A summary of 2020-2021vaccines is available in an extensive table at https://www.cdc.gov/flu/professionals/acip/2020-2021/acip-table.htm.
Vaccine Development In The 1980s Hepatitis B And Haemophilus Influenzae Type B
The vaccine for Haemophilus influenzae type b was licensed in 1985 and placed on the recommended schedule in 1989. When the schedule was published again in 1994, the hepatitis B vaccine had been added.
The hepatitis B vaccine was not new, as it had been licensed in 1981 and recommended for high-risk groups such as infants whose mothers were hepatitis B surface antigen positive, healthcare workers, intravenous drug users, homosexual men and people with multiple sexual partners. However, immunization of these groups didn’t effectively stop transmission of hepatitis B virus. Thats because about one-third of patients with acute disease were not in identifiable risk groups. The change of recommendation to immunize all infants in 1991 was the result of these failed attempts to control hepatitis B by only immunizing high-risk groups. Following this recommendation, hepatitis B disease was virtually eliminated in children less than 18 years of age in the United States.
1985 – 1994 | Recommended Vaccines
* Given in combination as DTP** Given in combination as MMR
Other Methods Of Manufacture
Methods of vaccine generation that bypass the need for eggs include the construction of influenza virus-like particles . VLP resemble viruses, but there is no need for inactivation, as they do not include viral coding elements, but merely present antigens in a similar manner to a virion. Some methods of producing VLP include cultures of Spodoptera frugiperdaSf9 insect cells and plant-based vaccine production . There is evidence that some VLPs elicit antibodies that recognize a broader panel of antigenically distinct viral isolates compared to other vaccines in the hemagglutination-inhibition assay .
A gene-based DNA vaccine, used to prime the immune system after boosting with an inactivated H5N1 vaccine, underwent clinical trials in 2011.
On November 20, 2012, Novartis received FDA approval for the first cell-culture vaccine. In 2013, the recombinant influenza vaccine, Flublok, was approved for use in the United States.
On September 17, 2020, the Committee for Medicinal Products for Human Use of the European Medicines Agency adopted a positive opinion, recommending the granting of a marketing authorization for Supemtek, a quadrivalent influenza vaccine . The applicant for this medicinal product is Sanofi Pasteur. Supemtek was approved for medical use in the European Union in November 2020.
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Why Do I Need The Flu Shot
Annual flu vaccination remains our best protection against contracting and spreading the flu and preventing flu-related complications, hospitalisation, and even death.
The flu virus is unpredictable because the circulating virus changes every year, says Dr Chu. The protection provided by the flu vaccine wanes, so it is best to be vaccinated each year before winter.
And for families, Dr Chu continues, getting the flu shot also protects the newborn grandchildren you cuddle that might be too young to receive their own flu shot.
Dr Chu explains that vaccines may contain weakened or inactive parts of a particular organism that trigger an immune response, creating antibodies to protect you against future infection.
Preparation is key to staying protected this winter.
Dr Chu says there are several different influenza vaccines available, of various types. And so, it is important to discuss with your GP the most appropriate way to protect yourself against the flu based on your personal health circumstances.
The Flu And You: What You Need To Know About The 2022 Flu Season
The past two years have seen record-low flu case numbers due to COVID-19 border closures, social distancing, and hygiene measures. But thats set to change.
Medical experts are now warning that while the flu took a back seat in 2020 and 2021, reduced socialising has meant we have had less exposure to flu viruses resulting in reduced herd immunity. This leaves us vulnerable to new strains of the flu virus and the potential for a devastating flu season in 2022.
Brisbane-based GP, Dr Sarah Chu is concerned this flu season will see the potential for a twindemic, where a severe flu season happens alongside COVID-19 infections.
I think we are in for a flu spike in 2022 and even the possibility of twin COVID-19 and influenza infections that will place further strain on the health care system, she says.
The ideal time for over-60s to start thinking about their seasonal flu vaccine is in April before winter begins.
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Who Should Not Get The Flu Shot
Very few children should NOT get a flu shot:
- Babies under 6 months of age. Although the vaccine is not harmful to babies less than 6 months old, it does not work.
- If your child has a serious allergy to thimerosal , a thimerosal-free vaccine should be given.
The influenza vaccine is safe for individuals with an egg allergy.
Im Pregnant Is It Safe To Get The Flu Shot
Yes, the flu shot is safe. Those who are pregnant should be immunized. Infants born during flu season to mothers who got a flu shot are usually protected against the flu for a few months. The flu shot is also safe and highly recommended for those breastfeeding. Since infants less than 6 months of age cannot get the flu shot , antibodies against the flu are transferred through breast milk.
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How Does The Flu Shot Protect You
The flu shot prompts your immune system to produce antibodies against a specific strain of the flu. If youre exposed to this particular flu virus later, youll already have antibodies ready to fight off the virus.
It usually takes about 2 weeks to build up your immunity to a flu virus after youve been vaccinated against it.
Youll have the most antibodies 1 to 2 months later. After this time, your protection begins to decline. Thats why you need a flu shot every year.
Each years vaccine is based on which strains are most likely to spread during that flu season.
The vaccine wont protect you from every strain. But if you do get sick, itll likely be less severe due to the vaccine.
The 2020-21 flu season may be complicated by the COVID-19 pandemic. The overlap of these two viral illnesses threatens to overburden hospitals, which typically get an influx of patients who have complications from the seasonal flu.
Getting your flu shot can help lower your risk of flu complications that could put you in the hospital.
Most people have little to no reaction following the vaccine. Theres no live virus in the flu shot, so it cant give you the flu.
Some people have a temporary reaction at the injection site, such as:
- tenderness
Normally, you can get a flu vaccine at your doctors office, your local pharmacy, or even at a walk-in retail clinic.
Some employers even provide flu shots for their employees at their workplace.
- Contact your
Who Should Have The Vaccine
In 2021/22 flu season, the following people are eligible to receive the flu vaccine for free:
- All children aged 2 to 15 on 31st Aug 2021
- Those aged 50 years or over
- Those in long-term residential care homes
- Carers
- Frontline health and social care workers
- Close contacts of immunocompromised individuals
- Those aged 6 months to 65 years in at-risk groups including people with the following health conditions:
- Respiratory diseases, including asthma
- Heart disease, kidney disease or liver disease
- Neurological conditions including learning disability
- Diabetes
- A severely weakened immune system , a missing spleen, sickle cell anaemia or coeliac disease
- Being seriously overweight
Babies under 6 months old are too young to receive a flu vaccine. This is because they have maternal antibodies passed on from their mother which prevent the vaccine from working so well. Flu vaccination is offered to all pregnant women in the UK . As well as protecting pregnant women themselves, this also helps to protect their newborn babies from flu.
Your doctor may recommend the flu vaccine in other circumstances as well.
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The History Of The Flu Virus
The flu is a fascinating subject. Most Australians are exposed in one way or another. Whether you yourself have had the flu or youve seen a family member go through it, you are likely aware of its effects and the illness it can cause the vulnerable, such as children and the elderly. With the 2020 flu season almost upon us, weve pulled together some interesting facts about the flu vaccine and the history of the flu in Australia.
The influenza virus was first isolated in 1933, giving rise to a new era in which all of humanity could be protected from one of the worlds most prolific killers. This breakthrough changed thinking about influenza, as previously the consensus was that the flu was caused by a bacterium known as Haemophilus Influenzae.
The Fda Approves The First Quadrivalent Vaccine
The first quadrivalent vaccine, which fights against four strains of the flutwo influenza A and two influenza B lineage strainswas approved by the FDA.
The addition of a second influenza B strain to the vaccine aimed to provide broader protection against circulating flu viruses. Although influenza B viruses have never been reported to be responsible for a pandemic, they have been reported to cause localized epidemics, and they have been the most prevalent viruses during certain flu seasons.
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Rapid Response To Pandemic Flu
The rapid development, production, and distribution of pandemic influenza vaccines could potentially save millions of lives during an influenza pandemic. Due to the short time frame between identification of a pandemic strain and need for vaccination, researchers are looking at novel technologies for vaccine production that could provide better “real-time” access and be produced more affordably, thereby increasing access for people living in low- and moderate-income countries, where an influenza pandemic may likely originate, such as live attenuated technology and recombinant technologies . As of July 2009, more than seventy known clinical trials have been completed or are ongoing for pandemic influenza vaccines. In September 2009, the FDA approved four vaccines against the 2009 H1N1 influenza virus , and expected the initial vaccine lots to be available within the following month.
In January 2020, the US Food and Drug Administration approved Audenz as a vaccine for the H5N1 flu virus. Audenz is a vaccine indicated for active immunization for the prevention of disease caused by the influenza A virus H5N1 subtype contained in the vaccine. Audenz is approved for use in persons six months of age and older at increased risk of exposure to the influenza A virus H5N1 subtype contained in the vaccine.
Available Vaccines And Vaccination Campaigns
Because new strains of influenza appear frequently, the seasonal flu vaccine usually changes each year. Each season vaccine is generally designed to protect against three strains of influenza: two A strains, and one B strain. From start to finishthe selection of which three strains to target with the vaccine, to the production of the final productthe development process for the seasonal flu vaccine can take up to eight months.
Influenza surveillance centers around the world monitor the circulating influenza strains for trends year-round. Genetic data is collected and new mutations are identified. The World Health Organization is then responsible for selecting three strains most likely to genetically resemble strains circulating in the coming winter flu season. For the northern hemisphere winter, this decision is made in February prior. In some cases, one of the strains used in the previous years vaccine may be chosen again, if that strain continues to circulate. From this point, the development and production of the vaccine can begin.
Four to five months after the three vaccine strains have been selected , the three vaccine strains developed are separately tested for purity and potency. Only after individual testing is completed are the three strains combined into a single seasonal vaccine.
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What Are Potential Side Effects Or Reactions To Flu Vaccines And Flu Vaccine Safety
In general, all medications, including intramuscular and nasal-spray vaccines, have side effects and the potential for allergic reactions. For most medicines and vaccines, the side effects or reactions are infrequent and are minimal if they do occur. Consequently, the pros far outweigh the cons for vaccination. The seasonal and pandemic vaccines are no different. What is different about the side effects of flu vaccines is that the occasional side effects seen with all flu vaccines usually resemble the flu disease. About 5%-10% of people experience mild side effects, such as headache, nasal congestion, low-grade fever, sore throat, or muscle cramps. Some individuals may experience short-term dizziness, nausea, and/or soreness or a mild rash at the inoculation site as vaccination side effects. Although these are short-lived, some people think they contracted the flu from the vaccine. This is a myth. The intramuscular vaccines contain no live virus, so the vaccine cannot transmit the disease. Although the nasal-spray vaccines contain live virus, it contains weakened virus. The vast majority of attenuated viruses will not be able to cause influenza in people with normal immune systems and good health because the attenuated viruses replicate poorly or not at all in these people. These side effects are most likely to occur in children who have not been exposed to influenza virus in the past, but they can occur in some adults.
The Schedule From 2011 To Present
Annual updates to both the childhood and adult immunization schedules offer guidance to healthcare providers in the form of new recommendations, changes to existing recommendations, or clarifications to assist with interpretation of the schedule in certain circumstances. The schedules are reviewed by committees of experts from the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the American Academy of Family Physicians.
Important changes to the schedule:
- New vaccines: meningococcal serogroup B vaccine
- Additional recommendations for existing vaccines: HPV , intranasal influenza vaccine
- Discontinuation of vaccine: intranasal influenza vaccine
2020 | Recommended Vaccines
* Given in combination as DTaP** Given in combination as MMR
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The Seventies: Genetic Reassortment
Split vaccines were widely used during the pandemic swine influenza in 1976 and in 1977, when the H1N1 subtype re-emerged worldwide. However, they were seen to be less immunogenic than whole virus vaccines in “primed” subjects who had never been vaccinated. Indeed, it was shown that two vaccine doses were needed in order to ensure effective protection .
At the beginning of the 1970s, an important innovation was introduced into the production of influenza vaccines: the genetic reassortment of influenza virus strains this technique enabled the vaccine strains to grow faster in embryonated hen eggs .
The first subunit vaccine was created between 1976 and 1977. This contained only the surface antigens, hemagglutinin and neuraminidase , which were isolated by means of successive purification steps.
This innovative tool proved to be highly immunogenic and well tolerated in humans, especially in children, although two doses were needed to guarantee vaccine effectiveness during epidemics .
The Eighties: Subunit Vaccines
In 1980, the first subunit vaccines were licensed in the United Kingdom and are currently available in several countries worldwide.
In 1978, as a result of a major mutation, a new virus strain, H1N1, appeared on the global epidemiological scene. This strain, which was similar to a virus circulating in 1958, emerged in Russia and began to co-circulate, either simultaneously or alternately, with the previous one .
Antigenic drift, caused by frequent changes in the composition of the virus, determined the need to update the vaccine composition each year. This necessity prompted both the implementation of the first surveillance systems and the production of the first trivalent vaccine, which included three formulation strains , in order to ensure effective protection during the 1978 pandemic.
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Testing And Treatment Of Respiratory Illness When Sars
While waiting on results of testing, non-hospitalized persons with acute respiratory symptoms should self-isolate at home. Even if people test negative for both SARS-CoV-2 and influenza viruses, they should self-isolate because of the potential for false negative testing results depending upon what kind of test was done and the level of SARS-CoV-2 and influenza virus transmission in the community. Persons not hospitalized with suspected or confirmed influenza who are at increased risk for complications from influenza should receive antiviral treatment for influenza as soon as possible, regardless of illness duration.
For hospitalized patients, empiric oseltamivir treatment should be started as soon as possible for patients with suspected influenza without waiting for influenza testing results. Get more information on testing and treatment when SARS-CoV-2 and flu viruses are co-circulating.
CDC has developed clinical algorithms that can help guide decisions for influenza testing and treatment when SARS-CoV-2 and influenza viruses are co-circulating.
FDA-approved antiviral medications for treatment of influenza have no activity against SARS-CoV-2 viruses, nor do they interact with medications used for treatment of COVID-19 patients. If a patient who is at higher risk for influenza complications is diagnosed with SARS-CoV-2 and influenza virus co-infection, they should receive antiviral treatment for influenza.