tetano
Editor, Senior Moderator
Clin Infect Dis. 2019 May 17. pii: ciz411. doi: 10.1093/cid/ciz411. [Epub ahead of print]
[h=1]Influenza Vaccine Effectiveness: Defining the H3N2 Problem.[/h] Belongia EA[SUP]1[/SUP], McLean HQ[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] Observational studies have consistently shown that influenza vaccine effectiveness is lower for H3N2 relative to H1N1pdm09 and type B, and this is not entirely explained by antigenic match. The triad of virus, vaccine, and host immunity provides a framework to examine contributing factors. Antigenic evolution facilitates H3N2 immune escape, and increasing glycosylation of the hemagglutinin shields antigenic sites from antibody binding. Egg passage adaptation of vaccine viruses generates mutations that alter glycosylation, impair the neutralizing antibody response, and reduce vaccine effectiveness. Complex host immune factors may also influence H3N2 vaccine effectiveness, including early childhood imprinting and repeated vaccination, but their role is uncertain. Of the triad of contributing factors, only changes to the vaccine are readily achievable, but it is unclear whether current licensed non-egg-based vaccines generate superior protection against H3N2. The optimal strategy remains to be defined, but newer vaccine technology platforms offer great potential.
? The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
PMID: 31102401 DOI: 10.1093/cid/ciz411
[h=1]Influenza Vaccine Effectiveness: Defining the H3N2 Problem.[/h] Belongia EA[SUP]1[/SUP], McLean HQ[SUP]1[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] Observational studies have consistently shown that influenza vaccine effectiveness is lower for H3N2 relative to H1N1pdm09 and type B, and this is not entirely explained by antigenic match. The triad of virus, vaccine, and host immunity provides a framework to examine contributing factors. Antigenic evolution facilitates H3N2 immune escape, and increasing glycosylation of the hemagglutinin shields antigenic sites from antibody binding. Egg passage adaptation of vaccine viruses generates mutations that alter glycosylation, impair the neutralizing antibody response, and reduce vaccine effectiveness. Complex host immune factors may also influence H3N2 vaccine effectiveness, including early childhood imprinting and repeated vaccination, but their role is uncertain. Of the triad of contributing factors, only changes to the vaccine are readily achievable, but it is unclear whether current licensed non-egg-based vaccines generate superior protection against H3N2. The optimal strategy remains to be defined, but newer vaccine technology platforms offer great potential.
? The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
PMID: 31102401 DOI: 10.1093/cid/ciz411