The good news is that platforms for more rapid vaccination turnarounds are on the horizon.
My friend, a busy mom of three, texted me frantically a few nights ago that her young son, ailing with an unexpected and unusual eye infection, had now developed a high fever. The doctor who had prescribed oral antibiotics that morning, told her that if this occurred she should go immediately to the emergency room for intravenous antibiotics… Yikes.
It was clear my friend felt caught between a bacteria and a virus—or a bird in the hand versus two in a bush in, a Dr. Mom quandary. Though understandably worried about her son’s eye infection, she feared more the news reports of ERs being flooded with flu victims. Would dealing with a “bug” in the hand be better than the hundreds of potential “bugs” in “the bush” of the unknown ER?
She opted for the ER, and happily her son improved after receiving those crucial medications.
Yes, deadly flu hype is always out there, driven by statements like: “This is the worse flu season in a decade!!!”
But guess what? 2017-2018 actually IS one of the worst flu seasons in a decade. Our medical infrastructure is being swamped this year for good reasons, including the prevalence of the always morphing, more severe H3N2 influenza A strain. During the week ending Jan. 27th, 80.2% of the 1,597 influenza-positive tests reported to the US Centers for Disease Control and Prevention (CDC) by public health laboratories were influenza A viruses and 19.8% were influenza B viruses. Of the 1,206 influenza A viruses that were subtyped, a whopping 1,017 (84.3%) were H3N2 while only 189 (15.7%) were (H1N1).
Research published in The Lancet Infectious Diseases last year details how these vaccines, created before the prevalent strains are even known, offer much reduced protection against the H3N2 strains, which mutate much faster compared to the more common H1N1pdm09, H1N1 (pre-2009), and type B strains. The time it takes to generate vaccines, formulate an informed prediction of strains, and then manufacture the vaccines in eggs with subsequent purification and packaging is substantial. The good news is that there are researchers and companies working to generate platforms for more rapid vaccination turnarounds in the very near future.
The new recommendations from the Advisory Committee on Immunization Practices (ACIP) for 2017-2018 describes an increased set of options to battle the flu season. These recommendations include approval of quadravalent, instead of trivalent, vaccines and new formulations and delivery systems. For example, the Flublok Quadrivalent (Protein Sciences) derives from an egg-free system where four influenza virus recombinant hemagglutinin proteins are produced in cell culture. The baculovirus-based vector (Autographa californica nuclear polyhedrosis virus) is utilized to infect Sf9 insect cell line (expresSF+®) derived from cells of the fall armyworm, Spodoptera frugiperda. This continuous cell culture in serum-free media allows for scalable vaccine production, also with the hope of potential use of the system for future unknown pandemic situations.
Another important improvement in the works, detailed in the new ACIP recommendations, includes more protective measures for children ages 6 months and older, including the approval of Afluria Quadrivalent (Seqirus), an influenza vaccine that relies on a NEEDLE-FREE injection system; it shoots a high-pressure jet of fluid into the body without any needles.
As a mom of teens, my memory is still fresh of anxious children receiving their earliest vaccinations by injection. The unfortunate discontinuation of the earlier nasal delivery system meant yet another shot last year, and even though the shots are effective and quick, it is difficult to convince pre-teens that it is worth the pain! At least when they were smaller the promised lollypop was a worthy treat—now the requested incentive is a pricey video game.
Yes, I still remember those days of restraining kids from running from the room, so I am grateful to share the good news with my still anxious 13 year old (now grown up and towering over me) that there is hope for him and for all people with all the new improvements in flu vaccinations.
Now that is worth the hype!