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NPJ Vaccines . Defining the root cause of reduced H1N1 live attenuated influenza vaccine effectiveness: low viral fitness leads to inter-strain comp

tetano

Editor, Senior Moderator
NPJ Vaccines


. 2021 Mar 12;6(1):35.
doi: 10.1038/s41541-021-00300-z.
Defining the root cause of reduced H1N1 live attenuated influenza vaccine effectiveness: low viral fitness leads to inter-strain competition


Oliver Dibben[SUP] 1 [/SUP], Jonathan Crowe[SUP] 2 [/SUP], Shaun Cooper[SUP] 2 [/SUP], Laura Hill[SUP] 2 [/SUP], Katarzyna E Schewe[SUP] 2 [/SUP], Helen Bright[SUP] 2 [/SUP]



Affiliations
Free article

Abstract

In the 2013-14 and 2015-16 influenza seasons, reduced vaccine effectiveness (VE) was observed for the H1N1 component of the FluMist quadrivalent live attenuated influenza vaccine (QLAIV) in the USA, leading to loss of Advisory Committee on Immunization Practices recommendation. Here we demonstrate in ferrets that 2015-16A/H1N1pdm09 vaccine strain A/Bolivia/559/2013 (A/BOL13) is outcompeted in trivalent (TLAIV) and QLAIV formulations, leading to reduced protection from wild-type challenge. While monovalent (MLAIV) A/BOL13 provided significant protection from wild-type virus shedding and fever at doses as low as 3.0 log[SUB]10[/SUB] fluorescent focus units (FFU), it failed to provide a similar level of protection in TLAIV or QLAIV formulation, even at a 6.0 log[SUB]10[/SUB] FFU dose. Conversely, clinically effective H1N1 strain A/New Caledonia/20/1999 provided significant protection in MLAIV, TLAIV, and QLAIV formulations. In conclusion, reduced A/BOL13 replicative fitness rendered it susceptible to inter-strain competition in QLAIV, contributing to its reduced VE in the 2015-16 season.
 
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