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FDA panel recommends strains for 2013-2014 flu vaccine
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The FDA's Vaccines and Related Biological Products Advisory Committee accepted the recommendations of WHO for the components of the 2013-2014 seasonal influenza vaccine, which replaces the influenza A (H3N2) and influenza B strains used this past season.
The committee members voted unanimously to retain the influenza A/California/7/2009 (H1N1)pdm09-like virus. Also, in a pair of 16-0 votes, both with one abstention, the committee decided to replace the influenza A/Victoria/361/2011 (H3N2)-like virus with a virus that is antigenically like the cell-propagated prototype virus A/Victoria/361/2011, and to replace the influenza B/Wisconsin/1/2010-like virus with an influenza B/Massachusetts/2/2012-like virus.
Both of the influenza B viruses are part of the B/Yamagata lineage, but the B/Wisconsin strain is in clade 3, whereas the B/Massachusetts strain is in clade 2. Clade 2 virus represents most of the influenza B viruses circulating now in Europe and North America.
The change in the A (H3N2) was made because of antigenic changes to the current vaccine virus that resulted from the adaptation to propagation in eggs. The recommended virus for the 2013-2014 vaccine is A/Texas/50/2012, which is antigenically like the cell-propagated prototype virus used this season.
For quadrivalent vaccines, which are expected to be available for the upcoming season, the committee recommended that the virus contain a second influenza B virus, B/Brisbane/60/2008-like virus, which is part of the B/Victoria lineage.
Perspective
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Sandra A. Fryhofer, MD
Much thought and study goes in to deciding which influenza strains to include in the influenza vaccine for the next season. Next season, more quadrivalent vaccine will be available which offers opportunity for greater protection against flu. One question is, now that the vaccine is available earlier (due to new methodologies, and production and manufacturing technologies-) when is the ideal time to administer the vaccine? In addition, we still need to figure out why seniors had such poor immunogenicity to some components of the 2012-2103 vaccine.
This is not entirely clear. Immunosenescence has a role. As we age, our immune system also ages and does not work as well. This phenomenon was the impetus for the high dose flu shot for seniors, a way to boost immune response. This season’s nonsignificant vaccine effectiveness against influenza A (H3N2) for seniors also demonstrates the need for better and more effective vaccines (especially for this older age group) and the importance of antiviral medications in symptomatic individuals, regardless of vaccination status.
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