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Abstract
The 2017–2018 seasonal influenza epidemics were severe in the US and Australia where the A(H3N2) subtype viruses predominated. Although circulating A(H3N2) viruses did not differ antigenically from that recommended by the WHO for vaccine production, overall interim vaccine effectiveness estimates were below historic averages (33%) for A(H3N2) viruses. The majority (US) or all (Australian) vaccine doses contained multiple amino-acid changes in the hemagglutinin protein, resulting from the necessary adaptation of the virus to embryonated hen’s eggs used for most vaccine manufacturing. Previous reports have suggested a potential negative impact of egg-driven substitutions on vaccine performance. With BARDA support, two vaccines licensed in the US are produced in cell culture: recombinant influenza vaccine (RIV, Flublok™) manufactured in insect cells and inactivated mammalian cell-grown vaccine (ccIIV, Flucelvax™). Quadrivalent ccIIV (ccIIV4) vaccine for the 2017–2018 influenza season was produced using an A(H3N2) seed virus propagated exclusively in cell culture and therefore lacking egg adaptative changes. Sufficient ccIIV doses were distributed (but not RIV doses) to enable preliminary estimates of its higher effectiveness relative to the traditional egg-based vaccines, with study details pending. The increased availability of comparative product-specific vaccine effectiveness estimates for cell-based and egg-based vaccines may provide critical clues to inform vaccine product improvements moving forward.
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Details
1 The Peter Doherty Institute For Infection And Immunity, WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Australia (GRID:grid.483778.7)
2 Influenza and Emerging Infectious Diseases Division, Biomedical Advanced Research and Development Authority, Washington, USA (GRID:grid.476870.a)
3 Centers for Disease Control and Prevention (CDC), Influenza Division, Atlanta, USA (GRID:grid.416738.f) (ISNI:0000 0001 2163 0069)
4 The Francis Crick Institute, WHO Collaborating Centre for Reference and Research on Influenza, Crick Worldwide Influenza Centre, London, UK (GRID:grid.451388.3) (ISNI:0000 0004 1795 1830)
5 Influenza Virus Research Center, WHO Collaborating Centre for Reference and Research on Influenza, National Institute of Infectious Diseases, Musashi-Murayama-shi, Japan (GRID:grid.410795.e) (ISNI:0000 0001 2220 1880)
6 Am Pharmapark, IDT Biologika GmbH, Dessau-Rosslau, Germany (GRID:grid.498615.7) (ISNI:0000 0004 0615 3657)
7 Takeda Vaccines (USA), Cambridge, USA (GRID:grid.419849.9) (ISNI:0000 0004 0447 7762)