The rationale for quadrivalent influenza vaccines

Ambrose, Christopher S.; Levin, Myron J.

doi:10.4161/hv.8.1.17623

Cited by 337 publications

(326 citation statements)

References 24 publications

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“…This result is lower than reported in the United States (46%, from 2001/2002 to 2010/2011 seasons) and the Europe (58%, between 2003/2004 and 2010/2011 seasons) 18. Again, this varies by regions and influenza season globally 14, 18…”

Section: Discussionmentioning

confidence: 71%

“…These two lineages of influenza B are antigenically and genetically different and studies in ferrets found no cross‐reactivity between the two strains 16. In recent decades, both lineages have cocirculated with varying relative intensity in the same season in many parts of the world including Australia 17, 18…”

Section: Introductionmentioning

confidence: 99%

“…Trivalent influenza vaccine only includes one B lineage and thus mismatch with the dominant circulating lineage can occur. Mismatch between the TIV's influenza B lineage and the circulating B lineage occurs at approximately two‐ to four‐year intervals in many countries 18. In Australia, partial or complete mismatches of B with circulating lineage have been reported 33.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of influenza B in Australia: 2001‐2014 influenza seasons

Moa

Muscatello

Turner

et al. 2016

Influenza Resp Viruses

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BackgroundInfluenza B is characterised by two antigenic lineages: B/Victoria and B/Yamagata. These lineages circulate together with influenza A during influenza seasons, with varying incidence from year to year and by geographic region.ObjectiveTo determine the epidemiology of influenza B relative to influenza A in Australia.MethodsLaboratory‐confirmed influenza notifications between 2001 and 2014 in Australia were obtained from the Australian National Notifiable Diseases Surveillance System.ResultsA total of 278 485 laboratory‐confirmed influenza cases were notified during the study period, comprising influenza A (82.2%), B (17.1%) and ‘other and untyped’ (0.7%). The proportion of notifications that were influenza B was highest in five‐ to nine‐year‐olds (27.5%) and lowest in persons aged 85 years and over (11.5%). Of all B notifications with lineage determined, 77.1% were B/Victoria and 22.9% were B/Yamagata infections. Mismatches between the dominant B lineage in a season and the trivalent vaccine B lineage occurred in over one‐third of seasons during the study years. In general, influenza B notifications peaked later than influenza A notifications.ConclusionThe proportion of circulating influenza B in Australia during 2001‐2014 was slightly lower than the global average and was dominated by B/Victoria. Compared with influenza A, influenza B infection was more common among older children and young adults and less common in the very elderly. Influenza B lineage mismatch with the trivalent vaccine occurred about one‐third of the time.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epidemiology of influenza B in Australia: 2001‐2014 influenza seasons

Moa

Muscatello

Turner

et al. 2016

Influenza Resp Viruses

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“…[5][6][7][8] Type C strain infections are usually regarded as very mild and uncommon although outbreaks of symptomatic disease have been described and sero-prevalence studies suggest widespread infection among some populations. 9 Due to their generally mild nature, C virus types are not included in the currently available influenza vaccines.…”

Section: Influenza Diseasementioning

confidence: 99%

Evaluating the case for trivalent or quadrivalent influenza vaccines

Baxter

2016

Human Vaccines & Immunotherapeutics

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Influenza viruses circulate widely throughout the world and it is estimated that they affect between 5 and 15% of the population annually. Since 1977, four viruses co-circulate -two A Viruses (H1N1 and H3N2) and two B viruses (B Yamagata and B Victoria). Type A viruses generally cause up to two thirds of annual infections, although single country studies have shown that B infections may be the predominant virus in the one year in four.Influenza vaccines have traditionally included the hamagglutinins and neuraminidases from the two circulating A viruses and either B Yamagata or B Victoria -however, selecting the B strain for inclusion in these trivalent vaccines has variable success. The alternative approach is to include both B strains in a quadrivalent vaccine. Immunological studies of such vaccines show non-inferiority with a trivalent vaccine comparator, and significant superiority to the additional B strain.Quadrivalent vaccines are more expensive than trivalent preparations but theoretical evidence would suggest they are likely to be more effective and therefore play a much greater role in national immunisation programmes in the future.

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“…Although public health agencies continued to recommend the influenza B lineage thought most likely to prevail in the upcoming influenza season, the predominant circulating strain often was different from the recommended strain, indicating a need for development of a vaccine that would provide protection against both types of influenza B 15, 16. At the present time, four quadrivalent influenza vaccines have been licensed in the United States: FluMist Quadrivalent ® (MedImmune—2012), Fluarix Quadrivalent ® (GSK – 2012), Fluzone Quadrivalent ® (Sanofi Pasteur—2013), and FluLaval Quadrivalent ® (IDB—2013).…”

Section: Regulatory Experience and Challenges With New And Novel Inflmentioning

confidence: 99%

An overview of the regulation of influenza vaccines in the United States

Weir

Gruber

2016

Influenza Resp Viruses

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Influenza virus vaccines are unique among currently licensed viral vaccines. The vaccines designed to protect against seasonal influenza illness must be updated periodically in an effort to match the vaccine strain with currently circulating viruses, and the vaccine manufacturing timeline includes multiple, overlapping processes with a very limited amount of flexibility. In the United States (U.S.), over 150 million doses of seasonal trivalent and quadrivalent vaccine are produced annually, a mammoth effort, particularly in the context of a vaccine with components that usually change on a yearly basis. In addition, emergence of an influenza virus containing an HA subtype that has not recently circulated in humans is an ever present possibility. Recently, pandemic influenza vaccines have been licensed, and the pathways for licensure of pandemic vaccines and subsequent strain updating have been defined. Thus, there are formidable challenges for the regulation of currently licensed influenza vaccines, as well as for the regulation of influenza vaccines under development. This review describes the process of licensing influenza vaccines in the U.S., the process and steps involved in the annual updating of seasonal influenza vaccines, and some recent experiences and regulatory challenges faced in development and evaluation of novel influenza vaccines.

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The rationale for quadrivalent influenza vaccines

Cited by 337 publications

References 24 publications

Epidemiology of influenza B in Australia: 2001‐2014 influenza seasons

Epidemiology of influenza B in Australia: 2001‐2014 influenza seasons

Evaluating the case for trivalent or quadrivalent influenza vaccines

An overview of the regulation of influenza vaccines in the United States

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