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Caini S, Meijer A, Nunes MC, Henaff L, Zounon M, Boudewijns B, Del Riccio M, Paget J. Probable extinction of influenza B/Yamagata and its public health implications: a systematic literature review and assessment of global surveillance databases. THE LANCET. MICROBE 2024:S2666-5247(24)00066-1. [PMID: 38729197 DOI: 10.1016/s2666-5247(24)00066-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 05/12/2024]
Abstract
Early after the start of the COVID-19 pandemic, the detection of influenza B/Yamagata cases decreased globally. Given the potential public health implications of this decline, in this Review, we systematically analysed data on influenza B/Yamagata virus circulation (for 2020-23) from multiple complementary sources of information. We identified relevant articles published in PubMed and Embase, and data from the FluNet, Global Initiative on Sharing All Influenza Data, and GenBank databases, webpages of respiratory virus surveillance systems from countries worldwide, and the Global Influenza Hospital Surveillance Network. A progressive decline of influenza B/Yamagata detections was reported across all sources, in absolute terms (total number of cases), as positivity rate, and as a proportion of influenza B detections. Sporadically reported influenza B/Yamagata cases since March, 2020 were mostly vaccine-derived, attributed to data entry errors, or have yet to be definitively confirmed. The likelihood of extinction necessitates a rapid response in terms of reassessing the composition of influenza vaccines, enhanced surveillance for B/Yamagata, and a possible change in the biosafety level when handling B/Yamagata viruses in laboratories.
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Affiliation(s)
- Saverio Caini
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands.
| | - Adam Meijer
- National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Marta C Nunes
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie, Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Université Claude Bernard 1, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France; South African Medical Research Council, Vaccines & Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Laetitia Henaff
- Centre International de Recherche en Infectiologie, Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Université Claude Bernard 1, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Malaika Zounon
- Center of Excellence in Respiratory Pathogens (CERP), Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie, Team Public Health, Epidemiology and Evolutionary Ecology of Infectious Diseases, Université Claude Bernard 1, Inserm U1111, CNRS UMR5308, ENS de Lyon, Lyon, France
| | - Bronke Boudewijns
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
| | - Marco Del Riccio
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands; Department of Health Sciences, University of Florence, Florence, Italy
| | - John Paget
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands
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Fratty IS, Jurkowicz M, Zuckerman N, Nemet I, Atari N, Kliker L, Gur-Arie L, Rosenberg A, Glatman-Freedman A, Lustig Y, Mandelboim M. Influenza vaccine compatibility among hospitalized patients during and after the COVID-19 pandemic. Front Microbiol 2024; 14:1296179. [PMID: 38322758 PMCID: PMC10844098 DOI: 10.3389/fmicb.2023.1296179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/29/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction Following the significant decrease in SARS-CoV-2 cases worldwide, Israel, as well as other countries, have again been faced with a rise in seasonal influenza. This study compared circulating influenza A and B in hospitalized patients in Israel with the influenza strains in the vaccine following the 2021-2022 winter season which was dominated by the omicron variant. Methods Nasopharyngeal samples of 16,325 patients were examined for the detection of influenza A(H1N1)pdm09, influenza A(H1N1)pdm09 and influenza B. Phylogenetic trees of hemagglutinin were then prepared using sanger sequencing. Vaccine immunogenicity was also performed using the hemagglutination inhibition test. Results Of the 16,325 nasopharyngeal samples collected from hospitalized patients between September 2021 (Week 40) and April 2023 (Week 15), 7.5% were found to be positive for influenza. Phylogenetic analyses show that in the 2021-2022 winter season, the leading virus subtype was influenza A(H3N2), belonging to clade 3C.2a1b.2a.2. However, the following winter season was dominated by influenza A(H1N1)pdm09, which belongs to clade 6B.aA.5a.2. The circulating influenza A(H1N1)pdm09 strain showed a shift from the vaccine strain, while the co-circulating influenza A(H3N2) and influenza B strains were similar to those of the vaccine. Antigenic analysis coincided with the sequence analysis. Discussion Influenza prevalence during 2022-2023 returned to typical levels as seen prior to the emergence of SARS-CoV-2, which may suggest a gradual viral adaptation to SARS-CoV-2 variants. Domination of influenza A(H1N1)pdm09 was observed uniquely in Israel compared to Europe and USA and phylogenetic and antigenic analysis showed lower recognition of the vaccine with the circulating influenza A(H1N1)pdm09 in Israel compared to the vaccine.
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Affiliation(s)
- Ilana S. Fratty
- Central Virology Laboratory, Public Health Services, Ministry of Health and Sheba Medical Center, Ramat-Gan, Israel
- The Israel Center for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel
| | - Menucha Jurkowicz
- Central Virology Laboratory, Public Health Services, Ministry of Health and Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Department of Epidemiology and Preventive Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Neta Zuckerman
- Central Virology Laboratory, Public Health Services, Ministry of Health and Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Department of Epidemiology and Preventive Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ital Nemet
- Central Virology Laboratory, Public Health Services, Ministry of Health and Sheba Medical Center, Ramat-Gan, Israel
| | - Nofar Atari
- Central Virology Laboratory, Public Health Services, Ministry of Health and Sheba Medical Center, Ramat-Gan, Israel
| | - Limor Kliker
- Central Virology Laboratory, Public Health Services, Ministry of Health and Sheba Medical Center, Ramat-Gan, Israel
| | - Lea Gur-Arie
- The Israel Center for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel
| | - Alina Rosenberg
- The Israel Center for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel
| | - Aharona Glatman-Freedman
- The Israel Center for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel
- Faculty of Medicine, Department of Epidemiology and Preventive Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yaniv Lustig
- Central Virology Laboratory, Public Health Services, Ministry of Health and Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Department of Epidemiology and Preventive Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michal Mandelboim
- Central Virology Laboratory, Public Health Services, Ministry of Health and Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Department of Epidemiology and Preventive Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Carregaro RL, Roscani ANCP, Raimundo ACS, Ferreira L, Vanni T, da Graça Salomão M, Probst LF, Viscondi JYK. Immunogenicity and safety of inactivated quadrivalent influenza vaccine compared with the trivalent vaccine for influenza infection: an overview of systematic reviews. BMC Infect Dis 2023; 23:563. [PMID: 37644401 PMCID: PMC10463610 DOI: 10.1186/s12879-023-08541-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Influenza infection is a highly preventable transmissible viral disease associated with mild upper respiratory symptoms and more severe conditions such as lethal pneumonia. Studies have shown that a broader spectrum influenza vaccine could reduce influenza's burden of disease in low- and middle-income countries. A considerable number of systematic reviews reported that quadrivalent influenza vaccines are considered more effective compared to trivalent vaccines, hence, there is a need for an overview in order to synthesize the current evidence pertaining to the comparison between quadrivalent and trivalent inactivated influenza vaccines. OBJECTIVE The aim was to summarize the evidence from systematic reviews that investigated the immunogenicity and safety of the Influenza's inactivated quadrivalent vaccine (QIV) compared to the trivalent vaccine (TIV), in the general population. METHODS We searched articles up to December 2022 at: Web of Science, EMBASE, MEDLINE, Cochrane Library, and SCOPUS. The search strategy was conducted following the PICO model. We included systematic reviews comparing the primary outcomes of immunogenicity (seroprotection rate and seroconversion rate) and adverse events using risk ratios. The AMSTAR 2 and ROBIS were used for quality assessments, and GRADE was used for evidence certainty assessments. FINDINGS We included five systematic reviews, totalling 47,740 participants. The Quadrivalent Inactivated Influenza Vaccine (QIV) exhibited enhanced immunogenicity in the context of B-lineage mismatch when compared to the Trivalent Inactivated Influenza Vaccine (TIV). While the safety profile of QIV was found to be comparable to that of TIV, the QIV showed a higher incidence of solicited local pain among children and adolescents, as well as an increased frequency of local adverse events within the adult population. CONCLUSION Our findings suggest that the QIV provides a superior immunogenicity response compared to the TIV in all age groups evaluated, especially when a lineage mismatch occurred. The safety of QIV was considered similar to the TIV, with no serious or systemic solicited or unsolicited adverse events; tough pain at the injection site was greater for QIV. We recommend caution owing to the high risk of bias in the selection process and no protocol registration.
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Affiliation(s)
- Rodrigo Luiz Carregaro
- Center for Evidence and Health Technology Assessment (NETecS), Universidade de Brasília (UnB), Campus UnB Ceilândia, Centro Metropolitano, Ceilândia Sul, CEP: 72220-275, Brasília/DF, Brazil.
- Health Technology Assessment Unit, MBA in Health Technology Assessment, Oswaldo Cruz German Hospital (HAOC), São Paulo, Brazil.
| | - Alessandra N C P Roscani
- Universidade de Campinas (UNICAMP), Clinical Hospital Unity, Campinas, Brasil
- Health Technology Assessment Unit, MBA in Health Technology Assessment, Oswaldo Cruz German Hospital (HAOC), São Paulo, Brazil
| | - Augusto Cesar Sousa Raimundo
- Faculty of Dentistry, Universidade de Campinas (UNICAMP), Piracicaba, Brasil
- Health Technology Assessment Unit, MBA in Health Technology Assessment, Oswaldo Cruz German Hospital (HAOC), São Paulo, Brazil
| | - Larissa Ferreira
- Institute of Health Strategy Management of the Federal District, Department of Health of the Federal District (SES/DF), Brasília, Brazil
- Health Technology Assessment Unit, MBA in Health Technology Assessment, Oswaldo Cruz German Hospital (HAOC), São Paulo, Brazil
| | - Tazio Vanni
- Hospital de Base, Secretaria de Estado de Saúde do Distrito Federal, Brasília, Brazil
| | | | - Livia Fernandes Probst
- Health Technology Assessment Unit, MBA in Health Technology Assessment, Oswaldo Cruz German Hospital (HAOC), São Paulo, Brazil
| | - Juliana Yukari K Viscondi
- Health Technology Assessment Unit, MBA in Health Technology Assessment, Oswaldo Cruz German Hospital (HAOC), São Paulo, Brazil
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Zhang Y, Wang Y, Jia C, Li G, Zhang W, Li Q, Chen X, Leng W, Huang L, Xie Z, Zhang H, You W, An R, Jiang H, Zhao X, Cheng S, Tan J, Cui W, Gao F, Lu W, Wang Y, Yang Y, Xia S, Wang S. Immunogenicity and safety of an egg culture-based quadrivalent inactivated non-adjuvanted subunit influenza vaccine in subjects ≥3 years: A randomized, multicenter, double-blind, active-controlled phase III, non-inferiority trial. Vaccine 2022; 40:4933-4941. [PMID: 35810063 DOI: 10.1016/j.vaccine.2022.06.078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022]
Abstract
Subunit influenza vaccine only formulated with surface antigen proteins has better safety profiles relative to split-virion influenza vaccine. Compared to the traditional quadrivalent split-virion influenza vaccine, a novel quadrivalent subunit influenza vaccine is urgently needed in China. We completed a phase 3, randomized, double-blind, active-controlled, non-inferiority clinical study at two sites in Henan Province, China. Eligible volunteers were split into four age cohorts (3-8 years, 9-17 years, 18-64 years, and ≥ 65 years, based on their dates of birth) and randomly assigned (1:1) to the subunit and the split-virion ecNAIIV4 groups. All volunteers were intramuscularly administered a single vaccine dose at baseline, and children aged 3-8 years received a boosting dose at day 28. And the immune response was evaluated by measuring hemagglutinin-inhibition antibody titers against the four vaccine strains in blood samples. Safety profiles had nonsignificant differences between the study groups in ≥ 3 years cohort. Most adverse reactions post-vaccination, both local and systemic, were mild to moderate and resolved within 3 days. And no serious adverse events occurred. The immunogenicity of the trial vaccine was non-inferior to the comparator. Further, a two-dose vaccine series can provide better seroprotection than that of a one-dose series in children aged 3-8 years, with clinically acceptable safety profiles. Clinical Trials Registration. ChiCTR2100049934.
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Affiliation(s)
| | - Yanxia Wang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | | | | | - Wei Zhang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Qin Li
- Ab&b Biotec Co., Ltd, Taizhou, China.
| | | | | | - Lili Huang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Zhiqiang Xie
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | | | - Wangyang You
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Rui An
- Ab&b Biotec Co., Ltd, Taizhou, China.
| | | | - Xue Zhao
- Ab&b Biotec Co., Ltd, Taizhou, China.
| | | | - Jiebing Tan
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Weiyang Cui
- Puyang Centre for Disease Control and Prevention, Henan, China.
| | - Feilong Gao
- Kaifeng Municipal Centre for Disease Control and Prevention, Henan, China.
| | - Weifeng Lu
- Kaifeng Municipal Centre for Disease Control and Prevention, Henan, China.
| | - Yuping Wang
- Puyang Centre for Disease Control and Prevention, Henan, China.
| | - Yongli Yang
- Department of Epidemiology and Public Health, College of Public Health, Zhengzhou University, Zhenzhou, China.
| | - Shengli Xia
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Shuai Wang
- Ab&b Biotec Co., Ltd, Taizhou, China; Yither Biotech Co., Ltd, Shanghai, China.
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