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Fisman D, Giglio N, Levin MJ, Nguyen VH, Pelton SI, Postma M, Ruiz-Aragón J, Urueña A, Mould-Quevedo JF. The economic rationale for cell-based influenza vaccines in children and adults: A review of cost-effectiveness analyses. Hum Vaccin Immunother 2024; 20:2351675. [PMID: 38835218 PMCID: PMC11155702 DOI: 10.1080/21645515.2024.2351675] [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: 01/12/2024] [Accepted: 05/02/2024] [Indexed: 06/06/2024] Open
Abstract
Seasonal influenza significantly affects both health and economic costs in children and adults. This narrative review summarizes published cost-effectiveness analyses (CEAs) of cell-based influenza vaccines in children and adults <65 years of age, critically assesses the assumptions and approaches used in these analyses, and considers the role of cell-based influenza vaccines for children and adults. CEAs from multiple countries demonstrated the cost-effectiveness of cell-based quadrivalent influenza vaccines (QIVc) compared with egg-based trivalent/quadrivalent influenza vaccines (TIVe/QIVe). CEA findings were consistent across models relying on different relative vaccine effectiveness (rVE) estimate inputs, with the rVE of QIVc versus QIVe ranging from 8.1% to 36.2% in favor of QIVc. Across multiple scenarios and types of analyses, QIVc was consistently cost-effective compared with QIVe, including in children and adults across different regions of the world.
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Affiliation(s)
- David Fisman
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Norberto Giglio
- Servicio de Consultorios Externos de Pediatría. Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires, Argentina
| | - Myron J. Levin
- Departments of Pedatrics and Medicine, University of Colorado School of Medicine, Denver, Colorado, United States
| | | | - Stephen I. Pelton
- Department of Health Sciences, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Maarten Postma
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
- Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands
- Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Analia Urueña
- Centro de Estudios para la Prevención y Control de Enfermedades Transmisibles, Universidad Isalud, Buenos Aires, Argentina
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Russell CA, Fouchier RAM, Ghaswalla P, Park Y, Vicic N, Ananworanich J, Nachbagauer R, Rudin D. Seasonal influenza vaccine performance and the potential benefits of mRNA vaccines. Hum Vaccin Immunother 2024; 20:2336357. [PMID: 38619079 PMCID: PMC11020595 DOI: 10.1080/21645515.2024.2336357] [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: 11/13/2023] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
Influenza remains a public health threat, partly due to suboptimal effectiveness of vaccines. One factor impacting vaccine effectiveness is strain mismatch, occurring when vaccines no longer match circulating strains due to antigenic drift or the incorporation of inadvertent (eg, egg-adaptive) mutations during vaccine manufacturing. In this review, we summarize the evidence for antigenic drift of circulating viruses and/or egg-adaptive mutations occurring in vaccine strains during the 2011-2020 influenza seasons. Evidence suggests that antigenic drift led to vaccine mismatch during four seasons and that egg-adaptive mutations caused vaccine mismatch during six seasons. These findings highlight the need for alternative vaccine development platforms. Recently, vaccines based on mRNA technology have demonstrated efficacy against SARS-CoV-2 and respiratory syncytial virus and are under clinical evaluation for seasonal influenza. We discuss the potential for mRNA vaccines to address strain mismatch, as well as new multi-component strategies using the mRNA platform to improve vaccine effectiveness.
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Affiliation(s)
- Colin A. Russell
- Department of Medical Microbiology & Infection Prevention, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Ron A. M. Fouchier
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
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3
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Hamel L, Tardif R, Poirier‐Gravel F, Rasoolizadeh A, Brosseau C, Giroux G, Lucier J, Goulet M, Barrada A, Paré M, Roussel É, Comeau M, Lavoie P, Moffett P, Michaud D, D'Aoust M. Molecular responses of agroinfiltrated Nicotiana benthamiana leaves expressing suppressor of silencing P19 and influenza virus-like particles. PLANT BIOTECHNOLOGY JOURNAL 2024; 22:1078-1100. [PMID: 38041470 PMCID: PMC11022802 DOI: 10.1111/pbi.14247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 12/03/2023]
Abstract
The production of influenza vaccines in plants is achieved through transient expression of viral hemagglutinins (HAs), a process mediated by the bacterial vector Agrobacterium tumefaciens. HA proteins are then produced and matured through the secretory pathway of plant cells, before being trafficked to the plasma membrane where they induce formation of virus-like particles (VLPs). Production of VLPs unavoidably impacts plant cells, as do viral suppressors of RNA silencing (VSRs) that are co-expressed to increase recombinant protein yields. However, little information is available on host molecular responses to foreign protein expression. This work provides a comprehensive overview of molecular changes occurring in Nicotiana benthamiana leaf cells transiently expressing the VSR P19, or co-expressing P19 and an influenza HA. Our data identifies general responses to Agrobacterium-mediated expression of foreign proteins, including shutdown of chloroplast gene expression, activation of oxidative stress responses and reinforcement of the plant cell wall through lignification. Our results also indicate that P19 expression promotes salicylic acid (SA) signalling, a process dampened by co-expression of the HA protein. While reducing P19 level, HA expression also induces specific signatures, with effects on lipid metabolism, lipid distribution within membranes and oxylipin-related signalling. When producing VLPs, dampening of P19 responses thus likely results from lower expression of the VSR, crosstalk between SA and oxylipin pathways, or a combination of both outcomes. Consistent with the upregulation of oxidative stress responses, we finally show that reduction of oxidative stress damage through exogenous application of ascorbic acid improves plant biomass quality during production of VLPs.
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Affiliation(s)
| | | | | | - Asieh Rasoolizadeh
- Centre SÈVE, Faculté des Sciences, Département de BiologieUniversité de SherbrookeSherbrookeQuébecCanada
| | - Chantal Brosseau
- Centre SÈVE, Faculté des Sciences, Département de BiologieUniversité de SherbrookeSherbrookeQuébecCanada
| | - Geneviève Giroux
- Centre SÈVE, Faculté des Sciences, Département de BiologieUniversité de SherbrookeSherbrookeQuébecCanada
| | - Jean‐François Lucier
- Centre SÈVE, Faculté des Sciences, Département de BiologieUniversité de SherbrookeSherbrookeQuébecCanada
| | - Marie‐Claire Goulet
- Centre de Recherche et d'innovation sur les Végétaux, Département de PhytologieUniversité LavalQuébecQuébecCanada
| | - Adam Barrada
- Centre de Recherche et d'innovation sur les Végétaux, Département de PhytologieUniversité LavalQuébecQuébecCanada
| | | | | | | | | | - Peter Moffett
- Centre SÈVE, Faculté des Sciences, Département de BiologieUniversité de SherbrookeSherbrookeQuébecCanada
| | - Dominique Michaud
- Centre de Recherche et d'innovation sur les Végétaux, Département de PhytologieUniversité LavalQuébecQuébecCanada
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4
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Stein AN, Mills CW, McGovern I, McDermott KW, Dean A, Bogdanov AN, Sullivan SG, Haag MDM. Relative Vaccine Effectiveness of Cell- vs Egg-Based Quadrivalent Influenza Vaccine Against Test-Confirmed Influenza Over 3 Seasons Between 2017 and 2020 in the United States. Open Forum Infect Dis 2024; 11:ofae175. [PMID: 38698895 PMCID: PMC11064727 DOI: 10.1093/ofid/ofae175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/20/2024] [Indexed: 05/05/2024] Open
Abstract
Background Influenza vaccine viruses grown in eggs may acquire egg-adaptive mutations that may reduce antigenic similarity between vaccine and circulating influenza viruses and decrease vaccine effectiveness. We compared cell- and egg-based quadrivalent influenza vaccines (QIVc and QIVe, respectively) for preventing test-confirmed influenza over 3 US influenza seasons (2017-2020). Methods Using a retrospective test-negative design, we estimated the relative vaccine effectiveness (rVE) of QIVc vs QIVe among individuals aged 4 to 64 years who had an acute respiratory or febrile illness and were tested for influenza in routine outpatient care. Exposure, outcome, and covariate data were obtained from electronic health records linked to pharmacy and medical claims. Season-specific rVE was estimated by comparing the odds of testing positive for influenza among QIVc vs QIVe recipients. Models were adjusted for age, sex, geographic region, influenza test date, and additional unbalanced covariates. A doubly robust approach was used combining inverse probability of treatment weights with multivariable regression. Results The study included 31 824, 33 388, and 34 398 patients in the 2017-2018, 2018-2019, and 2019-2020 seasons, respectively; ∼10% received QIVc and ∼90% received QIVe. QIVc demonstrated superior effectiveness vs QIVe in prevention of test-confirmed influenza: rVEs were 14.8% (95% CI, 7.0%-22.0%) in 2017-2018, 12.5% (95% CI, 4.7%-19.6%) in 2018-2019, and 10.0% (95% CI, 2.7%-16.7%) in 2019-2020. Conclusions This study demonstrated consistently superior effectiveness of QIVc vs QIVe in preventing test-confirmed influenza over 3 seasons characterized by different circulating viruses and degrees of egg adaptation.
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Affiliation(s)
- Alicia N Stein
- Centre for Outcomes Research and Epidemiology, CSL Seqirus, Melbourne, Australia
| | | | - Ian McGovern
- Centre for Outcomes Research and Epidemiology, CSL Seqirus, Waltham, Massachusetts, USA
| | | | - Alex Dean
- Real World Evidence, Veradigm, Chicago, Illinois, USA
| | | | - Sheena G Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, and Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute of Infection and Immunity, Melbourne, Australia
- Department of Epidemiology, University of California, Los Angeles, California, USA
| | - Mendel D M Haag
- Centre for Outcomes Research and Epidemiology, CSL Seqirus, Amsterdam, Netherlands
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5
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Hamamoto I. Developments and current challenges in the process of cell culture-based seasonal influenza vaccine manufacture in Japan. Glob Health Med 2024; 6:93-100. [PMID: 38690131 PMCID: PMC11043132 DOI: 10.35772/ghm.2023.01070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/25/2023] [Accepted: 12/22/2023] [Indexed: 05/02/2024]
Abstract
Seasonal influenza is an acute respiratory infection primarily caused by influenza A and B viruses, which circulate annually and cause substantial morbidity and mortality worldwide. Annual influenza vaccination is currently the most effective measure for preventing influenza and greatly reduces the risk of disease severity and the incidence of complications and death. Annual seasonal influenza vaccines are traditionally produced in Japan and many other countries using viruses propagated in embryonated chicken eggs. However, at present, the effectiveness of the seasonal influenza vaccines has some significant limitations, partly because of egg-adaptive mutations in the antigenic sites of the influenza virus haemagglutinin, which are caused by the continued evolution of seasonal influenza viruses. To overcome the limitations of egg-based influenza vaccine production, a mammalian cell culture-based influenza vaccine production system has been developed in Japan in the past decade as an alternative to the current production method. In this review, I have summarised the progress in the development of cell-based seasonal influenza vaccines and discussed the technological challenges encountered in the development of influenza vaccines.
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Affiliation(s)
- Itsuki Hamamoto
- Laboratory of Cell-based Vaccine Development, Research Center for Influenza and Respiratory Viruses, National Institute of Infectious Diseases, Tokyo, Japan
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6
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Chi CY, Cheng MF, Ko K, Mould JF, Chen CJ, Huang YC, Lee PI. Cost-effectiveness analysis of cell-based versus egg-based quadrivalent influenza vaccines in the pediatric population in Taiwan. J Med Virol 2024; 96:e29279. [PMID: 38196182 DOI: 10.1002/jmv.29279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 11/03/2023] [Accepted: 11/19/2023] [Indexed: 01/11/2024]
Abstract
Cell-based influenza vaccines avoid egg-adaptive mutations, potentially improving vaccine effectiveness. We assessed the one-season cost-effectiveness of cell-based quadrivalent influenza vaccine (QIVc) against that of egg-derived quadrivalent influenza vaccines (QIVe) in children (6 months to 17 years of age) from payer and societal perspectives in Taiwan using an age-stratified static model. Base case and high egg adaptation scenarios were assessed. Deterministic and probabilistic sensitivity analyses were performed. The incremental cost-effectiveness ratio (ICER) threshold in Taiwan was assumed to be USD 99 177/quality-adjusted life year (QALY). Compared to QIVe, QIVc would prevent 15 665 influenza cases, 2244 complicated cases, and 259 hospitalizations per year. The base case ICER was USD 68 298/QALY and USD 40 085/QALY from the payer and societal perspective, respectively. In the high egg adaptation scenario, the ICER was USD 45 782/QALY from the payer's perspective and USD 17 489/QALY from the societal perspective. Deterministic sensitivity analyses indicated that infection incidence rate, vaccination coverage, and prevalence of the A/H3N2 strain were the main drivers of ICER. In conclusion, switching the immunization strategy from QIVe to QIVc is predicted to reduce the influenza-associated disease burden and be cost-effective for the pediatric population in Taiwan. The potential benefits of QIVc would be even higher during influenza seasons with high levels of egg adaptation.
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Affiliation(s)
- Chia-Yu Chi
- National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan
| | - Ming-Fang Cheng
- Department of Paediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Karam Ko
- Medical Affairs, Seqirus Korea Ltd., Seoul, Korea
| | - Joaquin F Mould
- Global Medical Affairs, CSL Seqirus USA Inc., Summit, New Jersey, USA
| | - Chih-Jung Chen
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yhu-Chering Huang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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7
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Shi H, Ross TM. Inactivated recombinant influenza vaccine: the promising direction for the next generation of influenza vaccine. Expert Rev Vaccines 2024; 23:409-418. [PMID: 38509022 PMCID: PMC11056089 DOI: 10.1080/14760584.2024.2333338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/18/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Vaccination is the most effective method to control the prevalence of seasonal influenza and the most widely used influenza vaccine is the inactivated influenza vaccine (IIV). Each season, the influenza vaccine must be updated to be most effective against current circulating variants. Therefore, developing a universal influenza vaccine (UIV) that can elicit both broad and durable protection is of the utmost importance. AREA COVERED This review summarizes and compares the available influenza vaccines in the market and inactivation methods used for manufacturing IIVs. Then, we discuss the latest progress of the UIV development in the IIV format and the challenges to address for moving these vaccine candidates to clinical trials and commercialization. The literature search was based on the Centers for Disease Control and Prevention (CDC) and the PubMed databases. EXPERT OPINION The unmet need for UIV is the primary aim of developing the next generation of influenza vaccines. The IIV has high antigenicity and a refined manufacturing process compared to most other formats. Developing the UIV in IIV format is a promising direction with advanced biomolecular technologies and next-generation adjuvant. It also inspires the development of universal vaccines for other infectious diseases.
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Affiliation(s)
- Hua Shi
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA
| | - Ted M. Ross
- Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA
- Department of Infectious Diseases, University of Georgia, Athens, GA, USA
- Florida Research and Innovation Center, Cleveland Clinic, Port Saint Lucie, FL, USA
- Department of Infection Biology, Lehner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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8
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Nguyen VH, Ashraf M, Mould-Quevedo JF. Estimating the impact of influenza vaccination of low-risk 50-64-year-olds on acute and ICU hospital bed usage in an influenza season under endemic COVID-19 in the UK. Hum Vaccin Immunother 2023; 19:2187592. [PMID: 36912725 PMCID: PMC10054290 DOI: 10.1080/21645515.2023.2187592] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
Co-circulation of influenza and SARS-CoV-2 has the potential to place considerable strain on health-care services. We estimate the cost-effectiveness and health-care resource utilization impacts of influenza vaccination of low-risk 50-64-y-olds in the United Kingdom (UK) against a background SARS-CoV-2 circulation. A dynamic susceptible-exposed-infected-recovered model was used to simulate influenza transmission, with varying rates of vaccine coverage in the low-risk 50-64 y age-group. Four scenarios were evaluated: no vaccination (baseline), 40%, 50%, and 60% coverage. For the 50% and 60% coverage, this rate was also applied to high-risk 50-64-y-olds, whereas 48.6% was used for the baseline and 40% coverage scenarios. Cost-effectiveness was estimated in terms of humanistic outcomes and incremental cost-effectiveness ratio (ICER), with discounting applied at 3%. Overall, influenza vaccination of 50-64-y-olds resulted in reductions in GP visits, hospitalizations, and deaths, with a reduction in influenza-related mortality of 34%, 41%, and 52% for 40%, 50%, and 60% coverage, respectively. All four scenarios resulted in acute and intensive care unit (ICU) bed occupancy levels above available capacity, although vaccination of low-risk 50-64-y-olds resulted in a 35-54% and 16-25% decrease in excess acute and ICU bed requirements, respectively. Vaccination of this group against influenza was highly cost-effective from the payer perspective, with ICERs of £2,200-£2,343/quality-adjusted life year across the coverage rates evaluated. In conclusion, in the UK, vaccination of low-risk 50-64-y-olds against influenza is cost-effective and can aid in alleviating bed shortages in a situation where influenza and SARS-CoV-2 are co-circulating.
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Kikuchi C, Antonopoulos A, Wang S, Maemura T, Karamanska R, Lee C, Thompson AJ, Dell A, Kawaoka Y, Haslam SM, Paulson JC. Glyco-engineered MDCK cells display preferred receptors of H3N2 influenza absent in eggs used for vaccines. Nat Commun 2023; 14:6178. [PMID: 37794004 PMCID: PMC10551000 DOI: 10.1038/s41467-023-41908-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/15/2023] [Indexed: 10/06/2023] Open
Abstract
Evolution of human H3N2 influenza viruses driven by immune selection has narrowed the receptor specificity of the hemagglutinin (HA) to a restricted subset of human-type (Neu5Acα2-6 Gal) glycan receptors that have extended poly-LacNAc (Galβ1-4GlcNAc) repeats. This altered specificity has presented challenges for hemagglutination assays, growth in laboratory hosts, and vaccine production in eggs. To assess the impact of extended glycan receptors on virus binding, infection, and growth, we have engineered N-glycan extended (NExt) cell lines by overexpressing β3-Ν-acetylglucosaminyltransferase 2 in MDCK, SIAT, and hCK cell lines. Of these, SIAT-NExt cells exhibit markedly increased binding of H3 HAs and susceptibility to infection by recent H3N2 virus strains, but without impacting final virus titers. Glycome analysis of these cell lines and allantoic and amniotic egg membranes provide insights into the importance of extended glycan receptors for growth of recent H3N2 viruses and relevance to their production for cell- and egg-based vaccines.
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Affiliation(s)
- Chika Kikuchi
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | | | - Shengyang Wang
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Tadashi Maemura
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Rositsa Karamanska
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK
| | - Chiara Lee
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK
| | - Andrew J Thompson
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA
| | - Anne Dell
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK
| | - Yoshihiro Kawaoka
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
- The Research Center for Global Viral Diseases, National Center for Global Health and Medicine Research Institute, Tokyo, Japan
- Pandemic Preparedness, Infection and Advanced Research Center, The University of Tokyo, Tokyo, Japan
| | - Stuart M Haslam
- Department of Life Sciences, Imperial College London, London, SW7 2AZ, UK.
| | - James C Paulson
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA.
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA.
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10
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Tripp RA. Understanding immunity to influenza: implications for future vaccine development. Expert Rev Vaccines 2023; 22:871-875. [PMID: 37794732 DOI: 10.1080/14760584.2023.2266033] [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: 07/01/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION Influenza virus changes its genotype through antigenic drift or shift making it difficult to develop immunity to infection or vaccination. Zoonotic influenza A virus (IAV) strains can become established in humans. Several impediments to human infection and transmission include sialic acid expression, host anti-viral factors (including interferons), and other elements that govern viral replication. Controlling influenza infection, replication, and transmission is important because IAVs cause annual epidemics and occasional pandemics. Effective seasonal influenza vaccines exist, but these vaccines do not fully protect against novel or pandemic strains. AREAS COVERED With new vaccine production technology, vaccines can be produced rapidly. Universal IAV vaccines are being developed to protect against seasonal, novel, and zoonotic IAVs. These efforts are being enhanced and accelerated by a better understanding the host immune response to influenza viruses. EXPERT OPINION This review discusses several implications for future influenza vaccine development. Host immune responses to influenza virus infection or vaccination can guide vaccine development as anti-influenza immunity is affected by responses influenced by the previous immune history including first and subsequent exposures to influenza virus infections and vaccinations.
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Affiliation(s)
- Ralph A Tripp
- College of Veterinary Medicine, Department of Infectious Diseases, University of Georgia, Athens, GA, USA
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11
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Zhang J, Nian X, Li X, Huang S, Duan K, Li X, Yang X. The Epidemiology of Influenza and the Associated Vaccines Development in China: A Review. Vaccines (Basel) 2022; 10:1873. [PMID: 36366381 PMCID: PMC9692979 DOI: 10.3390/vaccines10111873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 12/28/2023] Open
Abstract
Influenza prevention and control has been one of the biggest challenges encountered in the public health domain. The vaccination against influenza plays a pivotal role in the prevention of influenza, particularly for the elderly and small children. According to the epidemiology of influenza in China, the nation is under a heavy burden of this disease. Therefore, as a contribution to the prevention and control of influenza in China through the provision of relevant information, the present report discusses the production and batch issuance of the influenza vaccine, analysis of the vaccination status and vaccination rate of the influenza vaccine, and the development trend of the influenza vaccine in China.
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Affiliation(s)
- Jiayou Zhang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan 430207, China
- Wuhan Institute of Biological Products Co., Ltd., Wuhan 430207, China
| | - Xuanxuan Nian
- National Engineering Technology Research Center for Combined Vaccines, Wuhan 430207, China
- Wuhan Institute of Biological Products Co., Ltd., Wuhan 430207, China
| | - Xuedan Li
- National Engineering Technology Research Center for Combined Vaccines, Wuhan 430207, China
- Wuhan Institute of Biological Products Co., Ltd., Wuhan 430207, China
| | - Shihe Huang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan 430207, China
- Wuhan Institute of Biological Products Co., Ltd., Wuhan 430207, China
| | - Kai Duan
- National Engineering Technology Research Center for Combined Vaccines, Wuhan 430207, China
- Wuhan Institute of Biological Products Co., Ltd., Wuhan 430207, China
| | - Xinguo Li
- National Engineering Technology Research Center for Combined Vaccines, Wuhan 430207, China
- Wuhan Institute of Biological Products Co., Ltd., Wuhan 430207, China
| | - Xiaoming Yang
- National Engineering Technology Research Center for Combined Vaccines, Wuhan 430207, China
- Wuhan Institute of Biological Products Co., Ltd., Wuhan 430207, China
- China National Biotech Group Company Ltd., Beijing 100029, China
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12
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Shi R, Zeng J, Xu L, Wang F, Duan X, Wang Y, Wu Z, Yu D, Huang Q, Yao YG, Yan J. A combination vaccine against SARS-CoV-2 and H1N1 influenza based on receptor binding domain trimerized by six-helix bundle fusion core. EBioMedicine 2022; 85:104297. [PMID: 36206623 PMCID: PMC9530591 DOI: 10.1016/j.ebiom.2022.104297] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 11/07/2022] Open
Abstract
Background Increasing severe morbidity and mortality by simultaneous or sequential infections with SARS-CoV-2 and influenza A viruses (IAV), especially in the elderly and obese patients, highlight the urgency of developing a combination vaccine against COVID-19 and influenza. Methods Self-assembling SARS-CoV-2 RBD-trimer and Influenza H1N1 HA1-trimer antigens were constructed, upon the stable fusion core in post-fusion conformation. Immunogenicity of SARS-CoV-2 RBD-trimer vaccine and H1N1 HA1-trimer antigens candidates were evaluated in mice. Protection efficacy of a combination vaccine candidate against SARS-CoV-2 and IAV challenge was identified using the K18-hACE2 mouse model. Findings Both the resultant RBD-trimer for SARS-CoV-2 and HA1-trimer for H1N1 influenza fully exposed receptor-binding motifs (RBM) or receptor-binding site (RBS). Two-dose RBD-trimer induced significantly higher binding and neutralizing antibody titers, and also a strong Th1/Th2 balanced cellular immune response in mice. Similarly, the HA1-trimer vaccine was confirmed to exhibit potent immunogenicity in mice. A combination vaccine candidate, composed of RBD-trimer and HA1-trimer, afforded high protection efficacy in mouse models against stringent lethal SARS-CoV-2 and homogenous H1N1 influenza co-infection, characterized by 100% survival rate. Interpretation Our results represent a proof of concept for a combined vaccine candidate based on trimerized receptor binding domain against co-epidemics of COVID-19 and influenza. Funding This project was funded by the Strategic Priority Research Program of CAS (XDB29040201), the National Natural Science Foundation of China (81830050, 81901680, and 32070569) and China Postdoctoral Science Foundation (2021M703450).
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Affiliation(s)
- Rui Shi
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China
| | - Jiawei Zeng
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Ling Xu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, and KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650201, China,Kunming National High-level Biosafety Research Center for Non-Human Primates, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650107, China
| | - Fengze Wang
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiaomin Duan
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yue Wang
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China,University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zheng Wu
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China,Institute of Physical Science and Information, Anhui University, Hefei, 230039, China
| | - Dandan Yu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, and KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650201, China,Kunming National High-level Biosafety Research Center for Non-Human Primates, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650107, China
| | - Qingrui Huang
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China,Corresponding authors.
| | - Yong-Gang Yao
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, and KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650201, China,Kunming National High-level Biosafety Research Center for Non-Human Primates, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650107, China,National Resource Center for Non-Human Primates, National Research Facility for Phenotypic & Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan 650107, China,Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan 650204, China,Corresponding authors.
| | - Jinghua Yan
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China,University of Chinese Academy of Sciences, Beijing 100049, China,Corresponding authors.
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13
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Outcomes in Pregnant Persons Immunized with a Cell-Based Quadrivalent Inactivated Influenza Vaccine: A Prospective Observational Cohort Study. Vaccines (Basel) 2022; 10:vaccines10101600. [PMID: 36298465 PMCID: PMC9612226 DOI: 10.3390/vaccines10101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: To evaluate pregnancy and infant outcomes among persons immunized with a cell-based quadrivalent inactivated influenza vaccine (IIV4c) during routine pregnancy care. Design: Prospective observational cohort. Setting: US-based obstetrics/gynecology clinics. Population: Pregnant persons. This US-based, prospective observational cohort study evaluated the safety of quadrivalent inactivated influenza vaccine (IIV4c; Flucelvax® Quad) in pregnant persons immunized over 3 influenza seasons between 2017 and 2020. Pregnant persons were immunized with IIV4c as part of routine care, after which their health care provides HCPs with all observational data to a single coordinating center. Follow-up data were collected at the end of the second trimester and/or at the time of pregnancy outcome. A scientific advisory committee reviewed the data. Prevalence point estimates were reported with 95% confidence intervals (CIs). Pregnancy outcomes included: live birth, stillbirth, spontaneous abortion, elective termination, and maternal death. Infant outcomes included: preterm birth (<37 weeks gestational age), low birth weight (<2500 g), or major congenital malformations (MCMs). Of the 665 evaluable participants, 659 (99.1%) had a live birth. No stillbirths (0% [95% CI 0.0−0.6]), 4 spontaneous abortions (1.9% [0.5−4.8]), and 1 elective termination (0.5% [0.0−2.6]) were reported. Among 673 infants, 9.2% (upper 95% CI 11.5%) were born prematurely, 5.8% (upper 95% CI 7.6%) had low birth weight, and 1.9% (upper 95% CI 3.1%) were reported to have an MCM. No maternal deaths were reported. Of the 2 infants who died shortly after birth, one was adjudicated as not related to the vaccine; the other’s cause could not be determined due to maternal loss to follow-up. The prevalence of adverse pregnancy outcomes or preterm birth, low birth weight, or MCMs in newborns was similar in persons vaccinated with IIV4c compared to the rates observed in US surveillance systems. The safety profile of IIV4c in pregnant persons is consistent with previously studied influenza vaccines.
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14
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Imran M, Ortiz JR, McLean HQ, Fisher L, O’Brien D, Bonafede M, Mansi JA, Boikos C. Relative Effectiveness of Cell-based Versus Egg-based Quadrivalent Influenza Vaccines in Children and Adolescents in the United States During the 2019-2020 Influenza Season. Pediatr Infect Dis J 2022; 41:769-774. [PMID: 35797705 PMCID: PMC9359763 DOI: 10.1097/inf.0000000000003620] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Egg-based influenza vaccine production can lead to the accumulation of mutations that affect antigenicity. The mammalian cell-based inactivated quadrivalent influenza vaccine (IIV4c) may improve effectiveness compared with egg-based vaccines. This study estimated the relative vaccine effectiveness (rVE) of IIV4c versus egg-based inactivated quadrivalent influenza vaccine (IIV4e) in preventing influenza-related medical encounters (IRME) among children and adolescents during the 2019-2020 US influenza season. METHODS This retrospective cohort study used a dataset linking primary and specialty care electronic medical records with medical and pharmacy claims data from US residents 4 through 17 years of age vaccinated with IIV4c or IIV4e during the 2019-2020 influenza season. Odds ratios (ORs) were derived from a doubly robust inverse probability of treatment-weighted approach adjusting for age, sex, race, ethnicity, region, index week, health status and two proxy variables for healthcare accessibility and use. Adjusted rVE was estimated by (1-OR adjusted )*100, and an exploratory analysis evaluated IRMEs separately for outpatient and inpatient settings. RESULTS The final study cohort included 60,480 (IIV4c) and 1,240,990 (IIV4e) vaccine recipients. Fewer IRMEs were reported in subjects vaccinated with IIV4c than IIV4e. The rVE for IIV4c versus IIV4e was 12.2% [95% confidence interval (CI): 7.5-16.6] for any IRME and 14.3% (9.3-19.0) for outpatient IRMEs. Inpatient IRMEs were much less frequent, and effectiveness estimates were around the null. CONCLUSIONS Fewer IRMEs occurred in pediatric subjects vaccinated with IIV4c versus IIV4e. These results support the greater effectiveness of IIV4c over IIV4e in this population during the 2019-2020 US influenza season.
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Affiliation(s)
| | - Justin R. Ortiz
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Huong Q McLean
- Marshfield Clinic Research Institute, Marshfield, Wisconsin
| | | | | | | | - James A. Mansi
- Seqirus Inc., Kirkland, Quebec, Canada, During Study Conduct
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15
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Review of Analyses Estimating Relative Vaccine Effectiveness of Cell-Based Quadrivalent Influenza Vaccine in Three Consecutive US Influenza Seasons. Vaccines (Basel) 2022; 10:vaccines10060896. [PMID: 35746504 PMCID: PMC9228909 DOI: 10.3390/vaccines10060896] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/13/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022] Open
Abstract
The adaptation of influenza seed viruses in egg culture can result in a variable antigenic vaccine match each season. The cell-based quadrivalent inactivated influenza vaccine (IIV4c) contains viruses grown in mammalian cell lines rather than eggs. IIV4c is not subject to egg-adaptive changes and therefore may offer improved protection relative to egg-based vaccines, depending on the degree of match with circulating influenza viruses. We summarize the relative vaccine effectiveness (rVE) of IIV4c versus egg-based quadrivalent influenza vaccines (IIV4e) to prevent influenza-related medical encounters (IRMEs) from three retrospective observational cohort studies conducted during the 2017–2018, 2018–2019, and 2019–2020 US influenza seasons using the same underlying electronic medical record dataset for all three seasons—with the addition of linked medical claims for the latter two seasons. We identified IRMEs using diagnostic codes specific to influenza disease (ICD J09*-J11*) from the records of over 10 million people. We estimated rVE using propensity score methods adjusting for age, sex, race, ethnicity, geographic location, week of vaccination, and health status. Subgroup analyses included specific age groups. IIV4c consistently had higher relative effectiveness than IIV4e across all seasons assessed, which were characterized by different dominant circulating strains and variable antigenic drift or egg adaptation.
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16
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Jordan K, Murchu EO, Comber L, Hawkshaw S, Marshall L, O'Neill M, Teljeur C, Harrington P, Carnahan A, Pérez-Martín JJ, Robertson AH, Johansen K, Jonge JD, Krause T, Nicolay N, Nohynek H, Pavlopoulou I, Pebody R, Penttinen P, Soler-Soneira M, Wichmann O, Ryan M. Systematic review of the efficacy, effectiveness and safety of cell-based seasonal influenza vaccines for the prevention of laboratory-confirmed influenza in individuals ≥18 years of age. Rev Med Virol 2022; 33:e2332. [PMID: 35137512 DOI: 10.1002/rmv.2332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/06/2022]
Abstract
The most effective means of preventing seasonal influenza is through strain-specific vaccination. In this study, we investigated the efficacy, effectiveness and safety of cell-based trivalent and quadrivalent influenza vaccines. A systematic literature search was conducted in electronic databases and grey literature sources up to 7 February 2020. Randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) were eligible for inclusion. Two reviewers independently screened, extracted data and assessed the risk of bias of included studies. Certainty of evidence for key outcomes was assessed using the GRADE methodology. The search returned 28,846 records, of which 868 full-text articles were assessed for relevance. Of these, 19 studies met the inclusion criteria. No relative efficacy data were identified for the direct comparison of cell-based vaccines compared with traditional vaccines (egg-based). Efficacy data were available comparing cell-based trivalent influenza vaccines with placebo in adults (aged 18-49 years). Overall vaccine efficacy was 70% against any influenza subtype (95% CI 61%-77%, two RCTS), 82% against influenza A(H1N1) (95% CI 71%-89%, 2 RCTs), 72% against influenza A(H3N2) (95% CI 39%-87%, 2 RCTs) and 52% against influenza B (95% CI 30%-68%, 2 RCTs). Limited and heterogeneous data were presented for effectiveness when compared with no vaccination. One NRSI compared cell-based trivalent and quadrivalent vaccination with traditional trivalent and quadrivalent vaccination, finding a small but significant difference in favour of cell-based vaccines for influenza-related hospitalisation, hospital encounters and physician office visits. The safety profile of cell-based trivalent vaccines was comparable to traditional trivalent influenza vaccines. Compared with placebo, cell-based trivalent influenza vaccines have demonstrated greater efficacy in adults aged 18-49 years. Overall cell-based vaccines are well-tolerated in adults, however, evidence regarding the effectiveness of these vaccines compared with traditional seasonal influenza vaccines is limited.
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Affiliation(s)
- Karen Jordan
- Health Technology Assessment, Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Eamon O Murchu
- Health Technology Assessment, Health Information and Quality Authority (HIQA), Dublin, Ireland.,Department of Health Policy & Management, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Laura Comber
- Health Technology Assessment, Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Sarah Hawkshaw
- Health Technology Assessment, Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Liam Marshall
- Health Technology Assessment, Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Michelle O'Neill
- Health Technology Assessment, Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Conor Teljeur
- Health Technology Assessment, Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Patricia Harrington
- Health Technology Assessment, Health Information and Quality Authority (HIQA), Dublin, Ireland
| | - Annasara Carnahan
- Public Health Agency of Sweden, Solna, Sweden.,European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden
| | - Jaime Jesús Pérez-Martín
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,General Directorate of Public Health and Addictions, IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Anna Hayman Robertson
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kari Johansen
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Jorgen de Jonge
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Tyra Krause
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,Statens Serum Institut, Copenhagen, Denmark
| | - Nathalie Nicolay
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Hanna Nohynek
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ioanna Pavlopoulou
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,School of Health Sciences, Faculty of Nursing, Pediatric Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece.,National Advisory Committee on Immunisation, Hellenic Ministry of Health, Athens, Greece
| | - Richard Pebody
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,Institute of Epidemiology & Health, University College London, London, UK
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Marta Soler-Soneira
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,Vigilancia de Enfermedades Prevenibles por Vacunación, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, Madrid, Spain
| | - Ole Wichmann
- European Centre for Disease Prevention and Control, EU/EEA National Immunisation Technical Advisory Group (NITAG) collaboration on newer and enhanced inactivated seasonal influenza vaccines, Stockholm, Sweden.,Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Máirín Ryan
- Health Technology Assessment, Health Information and Quality Authority (HIQA), Dublin, Ireland.,Department of Pharmacology & Therapeutics, Trinity College Dublin, Trinity. Health Sciences, Dublin, Ireland
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17
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Divino V, Ruthwik Anupindi V, DeKoven M, Mould-Quevedo J, Pelton SI, Postma MJ, Levin MJ. A Real-World Clinical and Economic Analysis of Cell-Derived Quadrivalent Influenza Vaccine Compared to Standard Egg-Derived Quadrivalent Influenza Vaccines During the 2019-2020 Influenza Season in the United States. Open Forum Infect Dis 2022; 9:ofab604. [PMID: 35028334 PMCID: PMC8753033 DOI: 10.1093/ofid/ofab604] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 12/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background Cell-derived influenza vaccines are not subject to egg-adaptive mutations that have potential to decrease vaccine effectiveness. This retrospective analysis estimated the relative vaccine effectiveness (rVE) of cell-derived quadrivalent influenza vaccine (IIV4c) compared to standard egg-derived quadrivalent influenza vaccines (IIV4e) among recipients aged 4-64 years in the United States during the 2019-2020 influenza season. Methods The IQVIA PharMetrics Plus administrative claims database was utilized. Study outcomes were assessed postvaccination through the end of the study period (7 March 2020). Inverse probability of treatment weighting (IPTW) was implemented to adjust for covariate imbalance. Adjusted rVE against influenza-related hospitalizations/emergency room (ER) visits and other clinical outcomes was estimated through IPTW-weighted Poisson regression models for the IIV4c and IIV4e cohorts and for the subgroup with ≥1 high-risk condition. Sensitivity analyses modifying the outcome assessment period as well as a doubly-robust analysis were also conducted. IPTW-weighted generalized linear models were used to estimate predicted annualized all-cause costs. Results The final sample comprised 1 150 134 IIV4c and 3 924 819 IIV4e recipients following IPTW adjustment. IIV4c was more effective in preventing influenza-related hospitalizations/ER visits as well as respiratory-related hospitalizations/ER visits compared to IIV4e. IIV4c was also more effective for the high-risk subgroup and across the sensitivity analyses. IIV4c was also associated with significantly lower annualized all-cause total costs compared to IIV4e (-$467), driven by lower costs for outpatient medical services and inpatient hospitalizations. Conclusions IIV4c was significantly more effective in preventing influenza-related hospitalizations/ER visits compared to IIV4e and was associated with significantly lower all-cause costs.
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Affiliation(s)
| | | | - Mitch DeKoven
- Real World Solutions, IQVIA, Falls Church, Virginia, USA
| | | | - Stephen I Pelton
- Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA.,Division of Pediatric Infectious Diseases, Maxwell Finland Laboratory, Boston Medical Center, Boston, Massachusetts, USA
| | - Maarten J Postma
- Department of PharmacoTherapy, Epidemiology and Economics (PTE2), Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands.,Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.,Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Myron J Levin
- Departments of Pediatrics and Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado, USA
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18
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Clinical Development of mRNA Vaccines: Challenges and Opportunities. Curr Top Microbiol Immunol 2022; 440:167-186. [PMID: 35906319 DOI: 10.1007/82_2022_259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The emergence of safe and effective mRNA platform-based COVID-19 vaccines from the recent pandemic has changed the face of vaccine development. Compared with conventional technologies used historically, mRNA-based vaccines offer a rapid flexible and robust approach to preventing disease caused by transient viral strains such as SAR2-CoV-2 variants of concern and seasonal influenza. Adaptations in the formulation of the mRNA delivery systems such as with lipid nanoparticle delivery (LNP) used in mRNA-1273 and BNT16b2b have enabled this technology to flourish under the urgent collective response and collaborative regulatory understanding derived from COVID-19 vaccine development. The application of mRNA-based therapeutics in other areas holds potential promise including combination vaccines that might deliver protections against multiple infectious diseases. Future studies and further advances in mRNA-based technologies will provide insight into the clinical efficacy and real-world effectiveness of vaccines as well as provisions with respect to the impact of reactogenicity profiles. Overall, the success of mRNA-based COVID-19 vaccines has helped unlock a platform likely to result in many more candidate vaccines entering clinical evaluation to address the unmet medical needs of other diseases including viral respiratory diseases, herpesviruses, and historically challenging vaccine targets such as HIV.
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19
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Influenza Vaccine: An Engineering Vision from Virological Importance to Production. BIOTECHNOL BIOPROC E 2022; 27:714-738. [PMID: 36313971 PMCID: PMC9589582 DOI: 10.1007/s12257-022-0115-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/06/2022] [Accepted: 06/12/2022] [Indexed: 01/26/2023]
Abstract
According to data from the World Health Organization (WHO) every year, millions of people are affected by flu. Flu is a disease caused by influenza viruses. For preventing this, seasonal influenza vaccinations are widely considered the most efficient way to protect against the negative effects of the flu. To date, there is no "one-size-fits-all" vaccine that can be effective all over the world to protect against all seasonal or pandemic influenza virus types. Because influenza virus transforms its genetic structure and it can emerges as immunogenically new (antigenic drift) which causes epidemics or new virus subtype (antigenic shift) which causes pandemics. As a result, annual revaccination or new subtype viral vaccine development is required. Currently, three types of vaccines (inactivated, live attenuated, and recombinant) are approved in different countries. These can be named "conventional influenza vaccines" and their production are based on eggs or cell culture. Although, there is good effort to develop new influenza vaccines for broader and longer period of time protection. In this sense these candidate vaccines are called "universal influenza vaccines". In this article, after we mentioned the short history of flu then virus morphology and infection, we explained the diseases caused by the influenza virus in humans. Afterward, we explained in detail the production methods of available influenza vaccines, types of bioreactors used in cell culture based production, conventional and new vaccine types, and development strategies for better vaccines.
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20
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Chung YH, Church D, Koellhoffer EC, Osota E, Shukla S, Rybicki EP, Pokorski JK, Steinmetz NF. Integrating plant molecular farming and materials research for next-generation vaccines. NATURE REVIEWS. MATERIALS 2021; 7:372-388. [PMID: 34900343 DOI: 10.1038/s41578-021-00399-395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 05/28/2023]
Abstract
Biologics - medications derived from a biological source - are increasingly used as pharmaceuticals, for example, as vaccines. Biologics are usually produced in bacterial, mammalian or insect cells. Alternatively, plant molecular farming, that is, the manufacture of biologics in plant cells, transgenic plants and algae, offers a cheaper and easily adaptable strategy for the production of biologics, in particular, in low-resource settings. In this Review, we discuss current vaccination challenges, such as cold chain requirements, and highlight how plant molecular farming in combination with advanced materials can be applied to address these challenges. The production of plant viruses and virus-based nanotechnologies in plants enables low-cost and regional fabrication of thermostable vaccines. We also highlight key new vaccine delivery technologies, including microneedle patches and material platforms for intranasal and oral delivery. Finally, we provide an outlook of future possibilities for plant molecular farming of next-generation vaccines and biologics.
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Affiliation(s)
- Young Hun Chung
- Department of Bioengineering, University of California, San Diego, La Jolla, CA USA
| | - Derek Church
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
| | - Edward C Koellhoffer
- Department of Radiology, University of California, San Diego Health, La Jolla, CA USA
| | - Elizabeth Osota
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
- Biomedical Science Program, University of California, San Diego, La Jolla, CA USA
| | - Sourabh Shukla
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
| | - Edward P Rybicki
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Jonathan K Pokorski
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
- Institute for Materials Discovery and Design, University of California, San Diego, La Jolla, CA USA
- Center for Nano-Immuno Engineering, University of California, San Diego, La Jolla, CA USA
| | - Nicole F Steinmetz
- Department of Bioengineering, University of California, San Diego, La Jolla, CA USA
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
- Department of Radiology, University of California, San Diego Health, La Jolla, CA USA
- Institute for Materials Discovery and Design, University of California, San Diego, La Jolla, CA USA
- Center for Nano-Immuno Engineering, University of California, San Diego, La Jolla, CA USA
- Moores Cancer Center, University of California, San Diego, La Jolla, CA USA
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21
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Chung YH, Church D, Koellhoffer EC, Osota E, Shukla S, Rybicki EP, Pokorski JK, Steinmetz NF. Integrating plant molecular farming and materials research for next-generation vaccines. NATURE REVIEWS. MATERIALS 2021; 7:372-388. [PMID: 34900343 PMCID: PMC8647509 DOI: 10.1038/s41578-021-00399-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2021] [Indexed: 05/04/2023]
Abstract
Biologics - medications derived from a biological source - are increasingly used as pharmaceuticals, for example, as vaccines. Biologics are usually produced in bacterial, mammalian or insect cells. Alternatively, plant molecular farming, that is, the manufacture of biologics in plant cells, transgenic plants and algae, offers a cheaper and easily adaptable strategy for the production of biologics, in particular, in low-resource settings. In this Review, we discuss current vaccination challenges, such as cold chain requirements, and highlight how plant molecular farming in combination with advanced materials can be applied to address these challenges. The production of plant viruses and virus-based nanotechnologies in plants enables low-cost and regional fabrication of thermostable vaccines. We also highlight key new vaccine delivery technologies, including microneedle patches and material platforms for intranasal and oral delivery. Finally, we provide an outlook of future possibilities for plant molecular farming of next-generation vaccines and biologics.
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Affiliation(s)
- Young Hun Chung
- Department of Bioengineering, University of California, San Diego, La Jolla, CA USA
| | - Derek Church
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
| | - Edward C. Koellhoffer
- Department of Radiology, University of California, San Diego Health, La Jolla, CA USA
| | - Elizabeth Osota
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
- Biomedical Science Program, University of California, San Diego, La Jolla, CA USA
| | - Sourabh Shukla
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
| | - Edward P. Rybicki
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Jonathan K. Pokorski
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
- Institute for Materials Discovery and Design, University of California, San Diego, La Jolla, CA USA
- Center for Nano-Immuno Engineering, University of California, San Diego, La Jolla, CA USA
| | - Nicole F. Steinmetz
- Department of Bioengineering, University of California, San Diego, La Jolla, CA USA
- Department of Nanoengineering, University of California, San Diego, La Jolla, CA USA
- Department of Radiology, University of California, San Diego Health, La Jolla, CA USA
- Institute for Materials Discovery and Design, University of California, San Diego, La Jolla, CA USA
- Center for Nano-Immuno Engineering, University of California, San Diego, La Jolla, CA USA
- Moores Cancer Center, University of California, San Diego, La Jolla, CA USA
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22
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Ortiz de Lejarazu-Leonardo R, Montomoli E, Wojcik R, Christopher S, Mosnier A, Pariani E, Trilla Garcia A, Fickenscher H, Gärtner BC, Jandhyala R, Zambon M, Moore C. Estimation of Reduction in Influenza Vaccine Effectiveness Due to Egg-Adaptation Changes-Systematic Literature Review and Expert Consensus. Vaccines (Basel) 2021; 9:1255. [PMID: 34835186 PMCID: PMC8621612 DOI: 10.3390/vaccines9111255] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Influenza vaccines are the main tool to prevent morbidity and mortality of the disease; however, egg adaptations associated with the choice of the manufacturing process may reduce their effectiveness. This study aimed to estimate the impact of egg adaptations and antigenic drift on the effectiveness of trivalent (TIV) and quadrivalent (QIV) influenza vaccines. METHODS Nine experts in influenza virology were recruited into a Delphi-style exercise. In the first round, the experts were asked to answer questions on the impact of antigenic drift and egg adaptations on vaccine match (VM) and influenza vaccine effectiveness (IVE). In the second round, the experts were presented with the data from a systematic literature review on the same subject and aggregated experts' responses to round one questions. The experts were asked to review and confirm or amend their responses before the final summary statistics were calculated. RESULTS The experts estimated that, across Europe, the egg adaptations reduce, on average, VM to circulating viruses by 7-21% and reduce IVE by 4-16%. According to the experts, antigenic drift results in a similar impact on VM (8-24%) and IVE (5-20%). The highest reduction in IVE was estimated for the influenza virus A(H3N2) subtype for the under 65 age group. When asked about the frequency of the phenomena, the experts indicated that, on average, between the 2014 and 19 seasons, egg adaptation and antigenic drift were significant enough to impact IVE that occurred in two and three out of five seasons, respectively. They also agreed that this pattern is likely to reoccur in future seasons. CONCLUSIONS Expert estimates suggest there is a potential for 9% on average (weighted average of "All strains" over three age groups adjusted by population size) and up to a 16% increase in IVE (against A(H3N2), the <65 age group) if egg adaptations that arise when employing the traditional egg-based manufacturing process are avoided.
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Affiliation(s)
| | - Emanuele Montomoli
- Department of Molecular Medicine, University of Siena, 53100 Siena, Italy;
| | - Radek Wojcik
- Medialis Ltd., Banbury OX16 0AH, UK; (S.C.); (R.J.)
| | | | | | - Elena Pariani
- Department of Biomedical Science for Health, University of Milan, 20122 Milan, Italy;
| | - Antoni Trilla Garcia
- Preventive Medicine and Epidemiology, Hospital Clínic, University of Barcelona, 08007 Barcelona, Spain;
| | - Helmut Fickenscher
- Institute for Infection Medicine, Kiel University, 24118 Kiel, Germany;
- University Medical Center Schleswig-Holstein, 24105 Kiel, Germany
| | - Barbara C. Gärtner
- Institute for Microbiology and Hygiene, Saarland University, Faculty of Medicine and Medical Center, Building 43, 66421 Homburg/Saar, Germany;
| | | | | | - Catherine Moore
- Wales Specialist Virology Centre, Public Health Wales, Cardiff CF14 4XW, UK;
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23
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Elkashif A, Alhashimi M, Sayedahmed EE, Sambhara S, Mittal SK. Adenoviral vector-based platforms for developing effective vaccines to combat respiratory viral infections. Clin Transl Immunology 2021; 10:e1345. [PMID: 34667600 PMCID: PMC8510854 DOI: 10.1002/cti2.1345] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/10/2021] [Accepted: 09/15/2021] [Indexed: 02/06/2023] Open
Abstract
Since the development of the first vaccine against smallpox over two centuries ago, vaccination strategies have been at the forefront of significantly impacting the incidences of infectious diseases globally. However, the increase in the human population, deforestation and climate change, and the rise in worldwide travel have favored the emergence of new viruses with the potential to cause pandemics. The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is a cruel reminder of the impact of novel pathogens and the suboptimal capabilities of conventional vaccines. Therefore, there is an urgent need to develop new vaccine strategies that allow the production of billions of doses in a short duration and are broadly protective against emerging and re-emerging infectious diseases. Extensive knowledge of the molecular biology and immunology of adenoviruses (Ad) has favored Ad vectors as platforms for vaccine design. The Ad-based vaccine platform represents an attractive strategy as it induces robust humoral and cell-mediated immune responses and can meet the global demand in a pandemic situation. This review describes the status of Ad vector-based vaccines in preclinical and clinical studies for current and emerging respiratory viruses, particularly coronaviruses, influenza viruses and respiratory syncytial viruses.
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Affiliation(s)
- Ahmed Elkashif
- Department of Comparative PathobiologyPurdue Institute for Inflammation, Immunology and Infectious Disease, and Purdue University Center for Cancer ResearchCollege of Veterinary MedicinePurdue UniversityWest LafayetteINUSA
| | - Marwa Alhashimi
- Department of Comparative PathobiologyPurdue Institute for Inflammation, Immunology and Infectious Disease, and Purdue University Center for Cancer ResearchCollege of Veterinary MedicinePurdue UniversityWest LafayetteINUSA
| | - Ekramy E Sayedahmed
- Department of Comparative PathobiologyPurdue Institute for Inflammation, Immunology and Infectious Disease, and Purdue University Center for Cancer ResearchCollege of Veterinary MedicinePurdue UniversityWest LafayetteINUSA
| | | | - Suresh K Mittal
- Department of Comparative PathobiologyPurdue Institute for Inflammation, Immunology and Infectious Disease, and Purdue University Center for Cancer ResearchCollege of Veterinary MedicinePurdue UniversityWest LafayetteINUSA
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Cell-Adapted Mutations and Antigenic Diversity of Influenza B Viruses in Missouri, 2019-2020 Season. Viruses 2021; 13:v13101896. [PMID: 34696325 PMCID: PMC8538563 DOI: 10.3390/v13101896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/12/2021] [Accepted: 09/16/2021] [Indexed: 01/31/2023] Open
Abstract
Influenza B viruses (IBVs) are causing an increasing burden of morbidity and mortality, yet the prevalence of culture-adapted mutations in human seasonal IBVs are unclear. We collected 368 clinical samples from patients with influenza-like illness in Missouri during the 2019–2020 influenza season and recovered 146 influenza isolates including 38 IBV isolates. Of MDCK-CCL34, MDCK-Siat1, and humanized MDCK (hCK), hCK showed the highest virus recovery efficiency. All Missourian IBVs belonged to the Victoria V1A.3 lineage, all of which contained a three-amino acid deletion on the HA protein and were antigenically distant from the Victoria lineage IBV vaccine strain used during that season. By comparing genomic sequences of these IBVs in 31 paired samples, eight cell-adapted nonsynonymous mutations were identified, with the majority in the RNA polymerase. Analyses of IBV clinical sample–isolate pairs from public databases further showed that cell- and egg-adapted mutations occurred more widely in viral proteins, including the receptor and antibody binding sites on HA. Our study suggests that hCK is an effective platform for IBV isolation and that culture-adapted mutations may occur during IBV isolation. As culture-adapted mutations may affect subsequent virus studies and vaccine development, the knowledge from this study may help optimize strategies for influenza surveillance, vaccine strain selection, and vaccine development.
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25
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Boikos C, Fischer L, O'Brien D, Vasey J, Sylvester GC, Mansi JA. Relative Effectiveness of the Cell-derived Inactivated Quadrivalent Influenza Vaccine Versus Egg-derived Inactivated Quadrivalent Influenza Vaccines in Preventing Influenza-related Medical Encounters During the 2018-2019 Influenza Season in the United States. Clin Infect Dis 2021; 73:e692-e698. [PMID: 33400775 PMCID: PMC8326580 DOI: 10.1093/cid/ciaa1944] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/01/2021] [Indexed: 12/13/2022] Open
Abstract
Background The cell-propagated inactivated quadrivalent influenza vaccine (ccIIV4) may offer improved protection in seasons where egg-derived influenza viruses undergo mutations that affect antigenicity. This study estimated the relative vaccine effectiveness (rVE) of ccIIV4 versus egg-derived inactivated quadrivalent influenza vaccine (eIIV4) in preventing influenza-related medical encounters in the 2018–2019 US season. Methods A dataset linking primary care electronic medical records with medical claims data was used to conduct a retrospective cohort study among individuals ≥ 4 years old vaccinated with ccIIV4 or eIIV4 during the 2018–2019 season. Adjusted odds ratios (ORs) were derived from a doubly robust inverse probability of treatment-weighted approach adjusting for age, sex, race, ethnicity, geographic region, vaccination week, and health status. rVE was estimated by (1 – OR) × 100 and presented with 95% confidence intervals (CI). Results Following the application of inclusion/exclusion criteria, the study cohort included 2 125 430 ccIIV4 and 8 000 903 eIIV4 recipients. Adjusted analyses demonstrated a greater reduction in influenza-related medical encounters with ccIIV4 versus eIIV4, with the following rVE: overall, 7.6% (95% CI, 6.5–8.6); age 4–17 years, 3.9% (95% CI, .9–7.0); 18–64 years, 6.5% (95% CI, 5.2–7.9); 18–49 years, 7.5% (95% CI, 5.7–9.3); 50–64 years, 5.6% (95% CI, 3.6–7.6); and ≥65 years, –2.2% (95% CI, –5.4 to .9). Conclusions Adjusted analyses demonstrated statistically significantly greater reduction in influenza-related medical encounters in individuals vaccinated with ccIIV4 versus eIIV4 in the 2018–2019 US influenza season. These results support ccIIV4 as a potentially more effective public health measure against influenza than an egg-based equivalent.
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Affiliation(s)
| | | | | | - Joe Vasey
- Veradigm, San Francisco, California, USA
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26
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Park SH, Ji KY, Kim HM, Ma SH, Park SY, Do JH, Oh DB, Kang HS, Shim JS, Joung YH. Optimization of the human colorectal carcinoma antigen GA733-2 production in tobacco plants. PLANT BIOTECHNOLOGY REPORTS 2021; 15:55-67. [PMID: 33520002 PMCID: PMC7825390 DOI: 10.1007/s11816-020-00657-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/03/2020] [Accepted: 12/08/2020] [Indexed: 05/02/2023]
Abstract
The colorectal carcinoma-associated protein GA733-2 is one of the representative candidate protein for the development of plant-derived colorectal cancer vaccine. Despite of its significant importance for colorectal vaccine development, low efficiency of GA733-2 production limits its wide applications. To improve productivity of GA733-2 in plants, we here tested multiple factors that affect expression of recombinant GA733-2 (rGA733-2) and rGA733 fused to fragment crystallizable (Fc) domain (rGA733-Fc) protein. The rGA733-2 and rGA733-Fc proteins were highly expressed when the pBINPLUS vector system was used for transient expression in tobacco plants. In addition, the length of interval between rGA733-2 and left border of T-DNA affected the expression of rGA733 protein. Transient expression analysis using various combinations of Agrobacterium tumefaciens strains (C58C1, LBA4404, and GV3101) and tobacco species (Nicotiana tabacum cv. Xanthi nc and Nicotiana benthamiana) revealed that higher accumulation of rGA733-2 and rGA733-Fc proteins were obtained by combination of A. tumefaciens LBA4404 and Nicotiana benthamiana. Transgenic plants generated by introduction of the rGA733-2 and rGA733-Fc expression cassettes also significantly accumulated corresponding recombinant proteins. Bioactivity and stability of the plant-derived rGA733 and rGA733-Fc were evaluated by further in vitro assay, western blot and N-glycosylation analysis. Collectively, we here suggest the optimal condition for efficient production of functional rGA733-2 protein in tobacco system.
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Affiliation(s)
- Se Hee Park
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186 Korea
| | - Kon-Young Ji
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054 Korea
| | - Hyun Min Kim
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186 Korea
| | - Sang Hoon Ma
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186 Korea
| | - Seo Young Park
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186 Korea
| | - Ju Hui Do
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186 Korea
| | - Doo-Byoung Oh
- Synthetic Biology and Bioengineering Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, 34141 Korea
- Department of Biosystems and Bioengineering, University of Science and Technology (UST), Daejeon, 34113 Korea
| | - Hyung Sik Kang
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186 Korea
| | - Jae Sung Shim
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186 Korea
| | - Young Hee Joung
- School of Biological Sciences and Technology, Chonnam National University, Gwangju, 61186 Korea
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27
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Cai R, Gerlier L, Eichner M, Schwehm M, Rajaram S, Mould-Quevedo J, Lamotte M. Cost-effectiveness of the cell-based quadrivalent versus the standard egg-based quadrivalent influenza vaccine in Germany. J Med Econ 2021; 24:490-501. [PMID: 33761803 DOI: 10.1080/13696998.2021.1908000] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Standard influenza vaccines are produced using egg-based manufacturing methods. Through the process, the resulting egg-adapted viral strains may differ from the selected vaccine strain. Cell-derived influenza vaccine manufacturing prevents egg-adaptation of the antigen which can improve vaccine effectiveness. We evaluated the cost-effectiveness of quadrivalent cell-derived influenza vaccine (QIVc) versus an egg-based quadrivalent influenza vaccine (QIVe) in preventing seasonal influenza from German societal and payer perspectives. METHODS Adapted version of the individual-based dynamic 4Flu transmission model was combined with a decision-tree to calculate the impact of QIVc versus QIVe on influenza over 20 seasons in Germany. Egg-adaptation, resulting in lower effectiveness of QIVe versus QIVc towards the H3N2 influenza strain, is sourced from a US retrospective study and assumed in 100% (base case) or 55% (conservative scenario) of years. Influenza-related probabilities of outpatient visits, hospitalizations, productivity loss, and mortality, with associated (dis)utilities/costs, were extracted from literature. Costs and outcomes were discounted 3.0%/year. RESULTS Replacing QIVe with QIVc in subjects aged ≥ 9 years can annually prevent 167,265 symptomatic cases, 51,114 outpatient visits, 2,091 hospitalizations, and 103 deaths in Germany. The annual number of quality-adjusted life-years (QALYs) increased by 1,628 and healthcare costs decreased by €178 M from societal perspective. From payer perspective, the incremental cost-effectiveness ratio was €2,285 per QALY. Scenario analyses confirmed results robustness. CONCLUSIONS The use of QIVc compared to QIVe, in the German Immunization Program, could significantly prevent outpatient visits and hospitalizations and would enable substantial savings from a societal perspective.
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Affiliation(s)
- Rui Cai
- IQVIA Real World Solutions, Amsterdam, The Netherlands
| | | | - Martin Eichner
- Epimos GmbH, Dusslingen, Germany
- Institute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany
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28
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Antiviral Plants in View of Avicenna’s The Canon of Medicine and Modern Medicine Against Common Cold. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1328:99-121. [DOI: 10.1007/978-3-030-73234-9_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Thompson AJ, Paulson JC. Adaptation of influenza viruses to human airway receptors. J Biol Chem 2020; 296:100017. [PMID: 33144323 PMCID: PMC7948470 DOI: 10.1074/jbc.rev120.013309] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 12/19/2022] Open
Abstract
Through annual epidemics and global pandemics, influenza A viruses (IAVs) remain a significant threat to human health as the leading cause of severe respiratory disease. Within the last century, four global pandemics have resulted from the introduction of novel IAVs into humans, with components of each originating from avian viruses. IAVs infect many avian species wherein they maintain a diverse natural reservoir, posing a risk to humans through the occasional emergence of novel strains with enhanced zoonotic potential. One natural barrier for transmission of avian IAVs into humans is the specificity of the receptor-binding protein, hemagglutinin (HA), which recognizes sialic-acid-containing glycans on host cells. HAs from human IAVs exhibit “human-type” receptor specificity, binding exclusively to glycans on cells lining the human airway where terminal sialic acids are attached in the α2-6 configuration (NeuAcα2-6Gal). In contrast, HAs from avian viruses exhibit specificity for “avian-type” α2-3-linked (NeuAcα2-3Gal) receptors and thus require adaptive mutations to bind human-type receptors. Since all human IAV pandemics can be traced to avian origins, there remains ever-present concern over emerging IAVs with human-adaptive potential that might lead to the next pandemic. This concern has been brought into focus through emergence of SARS-CoV-2, aligning both scientific and public attention to the threat of novel respiratory viruses from animal sources. In this review, we summarize receptor-binding adaptations underlying the emergence of all prior IAV pandemics in humans, maintenance and evolution of human-type receptor specificity in subsequent seasonal IAVs, and potential for future human-type receptor adaptation in novel avian HAs.
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Affiliation(s)
- Andrew J Thompson
- Department of Molecular Medicine, Scripps Research, La Jolla, California, USA.
| | - James C Paulson
- Department of Molecular Medicine, Scripps Research, La Jolla, California, USA; Department of Immunology & Microbiology, Scripps Research, La Jolla, California, USA.
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Stambas J, Lu C, Tripp RA. Innate and adaptive immune responses in respiratory virus infection: implications for the clinic. Expert Rev Respir Med 2020; 14:1141-1147. [PMID: 32762572 DOI: 10.1080/17476348.2020.1807945] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The innate immune response is the first line of defense and consists of physical, chemical and cellular defenses. The adaptive immune response is the second line of defense and is pathogen-specific. Innate immunity occurs immediately while adaptive immunity develops upon pathogen exposure, and is long-lasting, highly specific, and sustained by memory T cells. Respiratory virus infection typically induces effective immunity but over-exuberant responses are associated with pathophysiology. Cytokines expressed in response to viral infection can enhance biological responses, activate, and trigger signaling pathways leading to adaptive immunity Vaccines induce immunity, specifically B and T cell responses. Vaccination is generally efficacious, but for many viruses, our understanding of vaccination strategies and immunity is incomplete or in its infancy. Studies that examine innate and adaptive immune responses to respiratory virus infection will aid vaccine development and may reduce the burden of respiratory viral disease. AREAS COVERED A literature search was performed using PubMed. The search covered: innate, adaptive, respiratory virus, vaccine development, B cell, and T cell. EXPERT OPINION Immunity rests on two pillars, i.e. the innate and adaptive immune system, which function together on different tasks to maintain homeostasis. a better understanding of immunity is necessary for disease prevention and intervention.
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Affiliation(s)
- John Stambas
- School of Medicine, Deakin University , Melbourne, Australia
| | - Chunni Lu
- School of Medicine, Deakin University , Melbourne, Australia
| | - Ralph A Tripp
- Department of Infectious Diseases, University of Georgia , Athens, GA, USA
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