Category: Flu Vaccine

In October 2023, the US Food and Drug Administration accepted AstraZeneca's supplemental biologic license application (sBLA) for approval of a self- or caregiver-administered option for the company's influenza vaccine live, intranasal (Flumist Quadrivalent). The sBLA was supported by a usability study that confirmed that persons aged 18 years and older could self-administer or administer the vaccine to eligible patients aged 2 to 49 years.

The Prescription Drug User Fee Act (PDUFA) date is expected during the first quarter of 2024, and if approved, the influenza vaccine would be the only one available to be self-administered by eligible patients or given by caregivers.

With the PDUFA date approaching, Patient Care Online sat down with Ravi Jhaveri, MD, division head, Infectious Disease; Virginia H. Rogers professor in infectious diseases, professor of pediatrics, Northwestern University School of Medicine, to discuss the vaccine's potential to help increase vaccination rates, the impact on primary care practices, and more.

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Self-Administered Flu Vaccine May be Powerful Tool in Immunization Efforts, Says Expert - Patient Care Online

SK Bioscience's cell-cultured flu vaccine, SKYCellflu (SK Bioscience)

South Korean pharmaceuticals firm SK Bioscience said Thursday that it exported its cell-cultured flu vaccine, SKYCellflu, to Thailand, marking its first entry into a market with southern hemisphere requirements.

The company shipped out approximately 440,000 doses of SKYCellflu to its Thai partner Biogenetech from its vaccine manufacturing facility in Andong, North Gyeongsang Province.

SKYCellflu, the world's first cell-cultured flu vaccine endorsed by the World Health Organization, aligns with the WHO's 2024 southern hemisphere flu vaccine recommendation and is safe for egg-allergic individuals unlike traditional vaccines.

Thailand holds strategic importance for SKYCellflu due to its elongated geography, necessitating year-round flu vaccination that follows both the northern and southern hemisphere vaccine guidelines despite being entirely in the northern hemisphere.

Furthermore, SK Bioscience has honed its focus on the southern hemisphere market, leveraging potential cost savings and shorter supply delays through continuous production if flu strains are shared between hemispheres.

Starting with Thailand, SK Bioscience aims to extend its reach across southern hemisphere markets and beyond. With marketing authorizations secured in 12 countries and pending approval in ten more, the company is poised for further expansion.

Additionally, it seeks to strengthen its global presence through procurement contracts with organizations like the United Nations Children's Fund and the Pan American Health Organization.

"The export of SKYCellflu to Thailand marks a significant milestone in our expansion into the southern hemisphere and global markets," said Ahn Jae-yong, CEO of SK Bioscience.

"In line with our commitment to diversifying product markets, we are dedicated to developing vaccines with high potential, such as our upcoming pneumococcal conjugate vaccine candidate, slated for phase three clinical trials this year," Ahn added.

By Heo Yu-jeong (yjheo@heraldcorp.com)

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SK Bioscience exports cell-cultured flu vaccines to Thailand - The Korea Herald

Key Takeaways

The COVID-19 pandemic put a fresh eye on infectious diseases, including the consequences that can come from having a virus. While long COVID is now a well-known condition, researchers have discovered that people can develop lingering illness from the flu, too.

A recent study of more than 92,000 people compared the health outcomes of those who were admitted to the hospital with COVID versus people admitted with the flu. The researchers found that both viruses caused people to have lingering health problems that can last for months to years.

Were learning that these respiratory viruses can have long-term effects, William Schaffner, MD,an infectious disease specialist and professor at the Vanderbilt University School of Medicine, told Verywell. It seems like that was always the case. Were just becoming much more aware of it now.

Research into long flu is in its infancy.

Were learning now that a variety of infections result in symptoms after the acute phase as consequences of infection, Thomas Russo, MD, professor and chief of infectious disease at the University at Buffalo in New York, told Verywell. Long flu can cause respiratory symptoms like shortness of breath and a cough with activity, he said.

Its unclear why someone might develop long flu.

Its probably due to a continuing inflammatory response, Schaffner said. This is your bodys way of fighting off the infection. Youve gotten over the acute infection, but its as though the army that is your immune system keeps fighting.

There are a few options to treat long flu at home. Schaffner recommends taking warm showers once or twice a day to get moisture into your lungs and running a humidifier at night.

Clean the humidifier after every use, dry it off, and, when you use it again, put in a new supply of water, he said. If you dont, bacteria can grow, and you can inhale the bacteria, making you sicker.

If youre experiencing pain or body aches, acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help, Schaffner said.

Taking any medication long-term without consulting a doctor first isnt advised, Russo said. If youre considering taking a medication like acetaminophen or NSAIDs long-term or find that youve been taking them consistently for more than a few weeks, Russo said its time to consult a doctor.

For coughs, Schaffner said that consuming a spoonful of honey or mixing it with warm water or tea may temporarily help.

Its not very useful to take an over-the-counter cough suppressantthey dont work very well, he said.

A lingering cough is usually a good indicator to make a doctors appointment, Schaffner said.

If you suspect that you have long flu, Russo said its best to see a healthcare provider for an evaluation to make sure youre not dealing with another health issue. Long flu is a diagnosis of exclusionmeaning doctors want to rule out other health issues firstand its important to be checked for other illnesses as well.

If you have symptoms that last more than a few weeks after flu recovery that affect your daily activities, you should reach out to a healthcare provider to see if there is any sort of systemic treatment that could be beneficial, Russo said.

You should contact your doctor if you find that you feel better after having the flu and then get worse within a week or two.

You could have a secondary infection like bronchitis or pneumonia, Russo said.

More research is needed on how to effectively treat long flu. But Russo said that bronchodilators like albuterol and salmeterol, as well as pulmonary rehabilitation, might work for long flu. These interventions are also recommended for respiratory symptoms of long COVID.

Youre more likely to develop long flu if you have a serious course of influenza, which doctors said makes the case for getting an annual flu vaccine.

We certainly know that vaccination seems to be the most important measure to minimize acute consequences with long COVID, Russo said. We dont have as much data for long flu, but theres no question it would help, too.

Like long COVID, long flu is a real illness. If you have symptoms of long flu, including shortness of breath and a lingering cough, and they last for more than two weeks after you recover from the flu, its time to consult a doctor.

By Korin Miller Korin Miller is a health and lifestyle journalist who has been published in The Washington Post, Prevention, SELF, Women's Health, The Bump, and Yahoo, among other outlets.

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Here's What to Do If You Have Long Flu - Verywell Health

Investigation of an early signal for stroke associated with COVID-19 bivalent vaccines turned into suspicion of high-dose or adjuvanted flu shots instead, based on a large U.S. population-based study.

When researchers inspected a large Medicare database, they found no evidence of a significantly elevated risk for stroke at 1-21 days or 22-42 days after vaccination with either of the mRNA COVID vaccines distributed for the 2022-2023 respiratory season when compared with the 43-90 day control window, reported researchers led by Yun Lu, PhD, a statistician of the FDA in Silver Spring, Maryland.

There was a significant excess of nonhemorrhagic stroke for people with concomitant administration of Pfizer-BioNTech's bivalent vaccine plus a high-dose or adjuvanted influenza vaccine during the 22-42 days risk window (risk difference of 3.13 out of 100,000 doses); and a significant excess of transient ischemic attack for people with concomitant administration of Moderna's bivalent COVID vaccine plus a high-dose or adjuvanted influenza vaccine during the 1-21 days risk window (risk difference of 3.33 out of 100,000 doses).

But the researchers found that people with administration of a high-dose or adjuvanted influenza vaccine alone (without concomitant COVID vaccination) had an elevated risk for the combined outcome of nonhemorrhagic stroke or transient ischemic attack in both the 1-21 days risk window (risk difference of 1.65 per 100,000 doses) and 22-42 days risk window (risk difference of 1.60 per 100,000 doses).

"This finding suggests that the observed association between vaccination and stroke in the concomitant subgroup was likely driven by a high-dose or adjuvanted influenza vaccination," the investigators reported in JAMA.

COVID-19 bivalent vaccines were made to blend protection against the ancestral COVID strain and the Omicron BA.4/5 subvariants. They were not as widely adopted as the original vaccines but still remained on the market until they were replaced in September 2023 with monovalent vaccines targeting the XBB.1.5 Omicron subvariant alone for the 2023-2024 respiratory virus season.

Lu and colleagues conducted their study as a follow-up to the CDC and FDA's January 2023 warning of an early signal of nonhemorrhagic stroke in older adults who had received Pfizer-BioNTech's bivalent COVID-19 vaccine. That preliminary notice had been based on reports to the Vaccine Safety Datalink during the immediate period after vaccination, though later analyses also suggested a connection with concomitant flu vaccination.

Regarding these now-retired bivalent COVID vaccines, the present data are "reassuring" and consistent with reports from France and Israel, according to vaccine researchers Kathryn Edwards, MD, and Marie Griffin, MD, MPH, both of Vanderbilt University in Nashville, Tennessee.

Edwards and Griffin emphasized the small magnitude of the stroke risk associated with high-dose influenza vaccination identified by Lu's team.

"From a population health perspective, a risk of serious outcomes of 1 per 100,000 vaccinated individuals would be more than balanced by the benefits of most recommended vaccines. For example, influenza virus results in thousands of potentially preventable illnesses, medical care visits, hospitalizations, and deaths among persons aged 65 years or older in the U.S. annually and missed days from school and work in younger persons," they commented in an accompanying editorial.

The duo nevertheless cautioned that the risk-benefit calculus of these vaccines may not be so favorable for some relatively healthy older adults who are at an extremely low risk of serious influenza complications.

"It is encouraging that the current U.S. vaccine safety system can identify small vaccine risks on the order of 1 per 100,000. Importantly, public health professionals should be prepared to effectively communicate the level of certainty about potential risks," Edwards and Griffin urged. "The study by Lu et al illustrates the value of a timely, well-designed analysis and has provided reassurance about the COVID-19 boosters. Ongoing monitoring of influenza vaccines marketed for older adults will provide additional data on stroke risk."

For their study, the authors relied on a large representative database that identified over 5.3 million Medicare beneficiaries (median age 74 years, 56% women) who got either mRNA bivalent COVID vaccine starting from Aug. 31, 2022, the emergency use authorization date for these products, to Feb. 4, 2023. Excluded were people with a recent prior stroke, residents of long-term care facilities, and those in hospice care.

There were ultimately 11,001 individuals recorded as having a stroke after getting a COVID-19 bivalent vaccine. Approximately 10-15% of this case population had a COVID-19 diagnosis claim in the months prior to stroke, and 34-45% had had a concomitant high-dose or adjuvanted influenza vaccination.

"Because the framework of the current self-controlled case series study does not compare the populations who were vaccinated vs those who were unvaccinated, it does not account for the reduced rate of severe influenza after vaccination," Lu's group wrote. "More studies are needed to better understand the association between high-dose or adjuvanted influenza vaccination and stroke."

The study authors also acknowledged that they likely did not capture all cases of SARS-CoV-2 infection among participants due to non-reported at-home tests.

Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was funded by the FDA and CMS via a contract with Acumen.

Lu had no relevant disclosures.

Edwards reported receiving grant funding from the NIH and the CDC; being a consultant to Bionet, Dynavax, GSK, and IBM; and being a member of data safety and monitoring committees for Sanofi, X-4 Pharma, Seqirus, Moderna, Pfizer, Merck, Roche, Novavax, and CEPI. Griffin disclosed being a member of the CDC's Advisory Committee on Immunization Practices RSV Vaccines Adult Work Group.

Primary Source

JAMA

Source Reference: Lu Y, et al "Stroke risk after COVID-19 bivalent vaccination among US older adults" JAMA 2024; DOI: 10.1001/jama.2024.1059.

Secondary Source

JAMA

Source Reference: Edward KM, Griffin MR "Postmarketing vaccine safety assessments: important work in progress" JAMA 2024; DOI: 10.1001/jama.2023.26630.

Excerpt from:

Early Stroke Scare With Bivalent COVID Vaccines Unsupported by Large Study - Medpage Today

Silver Spring (Precision Vaccinations News)

In the United States, influenzais a significant health concern each year, affecting millions of people and leading to hospitalization and death for many.

Flu vaccines have been recommended for over five decades and have been proven to lower the risk of flu and its severe complications in those who receive it.

The composition of U.S. flu vaccines is reviewed annually in time for newer flu vaccines to be manufactured each year.

On March 5, 2024, the U.S.FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) met to discuss and recommend the viruses for the nextflu season's vaccines.

The VRBPACrecommended that all 2024-2025 U.S. flu vaccines be three-component (trivalent) vaccines and include an influenza A(H1N1), an A(H3N2), and a B/Victoria-lineage vaccine virus.

This decision was made because influenza B/Yamagata viruses are no longer circulating and have not been detected in global surveillance after March 2020.

Therefore, itsinclusion in next season's flu vaccines is no longer warranted.

Initial news from vaccine producers has been very positive, with the intent to deliver the trivalent flu shots on time in 2024.

These types of vaccine changes have been made for many years.

From 1978-1979 through 2012-2013, flu vaccines were trivalent. But, quadrivalent flu vaccines became available in the U.S.during the 2013-2014 flu season.

The newer vaccines contained a fourth componenta second influenza B virusto protect against both influenza B virus lineages.

As of March2024, about158millionquadrivalent flu vaccineshad beendistributedduring the 2023-2024 season.

Furthermore, government agencies have reviewprocesses to determine if the flu vaccines, egg, cell, or nasal-based vaccines actually deliver virus protection.

Regarding flu shot protection, on February 28, 2024,Aaron M. Frutos, Ph.D., MPH, presented to the U.S. CDC's Advisory Committee on Immunization Practices (ACIP), confirming four networksevaluate vaccine effectiveness (VE) against laboratory-confirmed influenza for children, adolescents, and adults in the outpatient and inpatient settings.

According to the ACIP, the aggregated interim VE for this season's flu vaccines is about 50%. The final data is expected during a later CDC meeting.

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Next Season's Flu Shots Will Be Different Precision Vaccinations News - Precision Vaccinations

Electronic nudges sent to patients failed to increase influenza vaccine uptake in one randomized clinical trial, while another trial found that slight increases in vaccination rates from letters emailed to patients failed to impact clinical outcomes.

Neither portal nor text messages to remind patients to get an influenza vaccination were effective at a population level at improving vaccination uptake, Peter Szilagyi, MD, MPH, of the UCLA Mattel Children's Hospital at the University of California in Los Angeles, and colleagues reported in JAMA Internal Medicine. Among patients who received care from 79 primary care practices in a large healthcare system, flu shot rates remained at approximately 47% whether patients received portal messages, text messages, or no reminders at all.

And in an analysis of the Danish NUDGE-FLU trial, an about 1% boost in influenza vaccination associated with email letters encouraging patients to get vaccinated did not translate into improvements in cardiovascular, respiratory, or other clinical endpoints, Niklas Johansen, MD, of the Copenhagen University Hospital-Harlev and Gentofte in Denmark, and colleagues wrote in the Annals of Internal Medicine.

Potential Advantage to Text Messages

Szilagyi and investigators found that patient portal messages sent monthly or before scheduled visits did not increase influenza vaccination rates.

However, preappointment reminders sent 24 to 48 hours before a scheduled primary care appointment, by either text or patient portal, had a small positive effect on vaccine uptake (adjusted risk ratio [aRR] 1.04, 95% CI 1.01-1.06, P=0.01) in a subgroup of patients who were unvaccinated but had at least one primary care appointment. This effect seemed to be driven by text preappointment reminders, which were associated with an absolute increase in vaccination rates of 1.6-1.8% (aRR 1.07, P=0.002), whereas the portal preappointment reminders had no significant impact.

"We suspect there are several reasons why text, but not portal, preappointment reminders were effective," Szilagyi and colleagues wrote. "Portal messages require patients to open the portal and find and then read the message, whereas text messages appear instantly and might appear more urgent or important."

Given the results of their study, the authors concluded that "text message preappointment reminders can be effective for patients with scheduled appointments," but health systems might opt for more intensive interventions instead, "such as improving access to vaccinations (e.g., Saturday or after-hours clinics) or communication training for clinicians to address vaccine hesitancy."

The trial included patients 6 months of age or older in the UCLA Health System with either one or two visits to a primary care provider within the past year or who were enrolled in managed care within the system. The trial included 262,085 patients, 9% of whom where children. Mean age was 45 years: females accounted for 57% of participants, 53% were white, 12% were Hispanic or Latino, and 10% were Asian. Most (83.5%) had private health insurance, and 14.9% received Medicare. About 65% had received an influenza vaccination within 2 years.

Patients were randomized equally to receive standard of care, influenza vaccine portal reminders, or vaccine text reminders. Those randomized to the portal reminder group were further randomized to receive fixed or responsive monthly portal reminders, with or without preappointment reminders. Those randomized to the text reminder group received fixed monthly reminders and were further randomized to receive preappointment reminders or no preappointment reminders.

The primary outcome was influenza vaccination, including vaccination at pharmacies and other sites.

NUDGE-FLU Analysis

Previously, the Danish NUDGE-FLU trial found that electronic letters that nudged recipients to get vaccinated for influenza and also provided information on its cardiovascular benefits (so-called "gain-framing") were associated with a small increase of about 1% in flu vaccine uptake.

In this prespecified clinical outcome assessment of that trial, no statistically significant differences in clinical outcomes were found among those who received a letter that incorporated cardiovascular gain-framing or in those who received repeated letters, when compared with the usual care group who received no letters, reported Johansen and co-authors.

Hospitalization for pneumonia or influenza was 1% in the usual care group, 1% in the group that received the letters with cardiovascular gain-framing, and 1.1% in the repeated-letter group. Hospitalization for any cause was approximately 13% in all three groups. Mortality during the study occurred in 1.8% of the usual care group, 1.9% in the gain-framing group, and 1.7% in the repeated-letter group.

Given the modest results of the original NUDGE-FLU trial, the findings of the prespecified analysis came as no surprise to Mark Fendrick, MD, of the University of Michigan Medical School in Ann Arbor.

"It's not that the flu shot doesn't work, it's that an intervention that got a very small [number] of additional people to get the flu shot did not produce a positive outcome effect across the entire population," Fendrick told MedPage Today. "I would not expect an additional 1% of a population getting the flu shot to actually show meaningfully clinical outcome differences."

"There's pretty robust evidence to show that a lot of these [vaccine] reminders are not extraordinarily effective," he added.

Johansen told MedPage Today via email that his group wasn't surprised either. "We were well aware that our nudging letters only resulted in modest increases in influenza vaccination, and we therefore suspected that the difference in vaccination rates would not be enough to drive a difference in clinical outcomes."

In the original NUDGE-FLU trial, approximately 965,000 Danish participants were randomized to usual care or to receive one of nine different electronically delivered behavioral nudging letters during the 2022-2023 flu season. The current analysis included 691,820 participants of that trial who were 65 years of age or older. Since the original NUDGE-FLU trial found that repeated standard letters and cardiovascular gain-framing letters resulted in modest but significantly higher rates of influenza vaccination, the current analysis focused on comparison of the groups that received no letters, letters sent at baseline and 14 days later, and cardiovascular gain-framed letters.

Katherine Kahn is a staff writer at MedPage Today, covering the infectious diseases beat. She has been a medical writer for over 15 years.

Disclosures

The study by Szilagyi's group was funded by the National Institute of Allergy and Infectious Diseases.

The study by Johansen's group was funded by Sanofi.

Szilagyi reported no relevant conflicts of interest; other co-authors of the study reported ties to industry.

Johansen reported no relevant conflicts of interest; other co-authors of the study reported ties to industry.

Primary Source

JAMA Internal Medicine

Source Reference: Szilagyi PG, et al "Text vs patient portal messaging to improve influenza vaccination coverage" JAMA Intern Med 2024; DOI: 10.1001/jamainternmed.2024.0001.

Secondary Source

Annals of Internal Medicine

Source Reference: Johansen ND, et al "Clinical outcomes with electronic nudges to increase influenza vaccination" Ann Intern Med 2024; DOI: 10.7326/M23-2638.

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Electronic Nudges to Get the Flu Shot Fall Short for Vax Rates, Outcomes - Medpage Today

This falls flu shot will be designed to protect you from just three strains of the influenza virus, instead of the usual four, according to the U.S. Food and Drug Administration (FDA). Thats because an entire branch of the influenza family tree has died out, and experts say that's likely due, at least in part, to the COVID pandemic and the precautions many people were taking. Heres what to know about the now extinct Yamagata influenza B virus, what happened to it and how its disappearance will affect next years flu vaccines.

In the years leading up to the pandemic, Dr. Arnold Monto, a professor emeritus of epidemiology at the University of Michigan and member of the FDA's vaccine committee, tells Yahoo Life that scientists got a clue that Yamagata might be on the decline because it wasnt diversifying the way that B Victoria did," which is another lineage of influenza B. "Victoria was doing all the weird, wonderful things that flu viruses do," says Monto, "but that wasnt happening with B Yamagata."

Then the COVID pandemic hit, and scientists stopped seeing Yamagata in samples taken from patients with flu altogether. None at all extinction, says Monto.

Its impossible to say for sure what caused the death of the Yamagata strain, according to Monto and Dr. Pedro Piedra, a professor of molecular virology, microbiology and pediatrics at Baylor College of Medicine. But they and most virologists consider the various methods to slow the spread of COVID, like masking and social distancing, a major factor.

One reason that might have led to the extinction of Yamagata is that influenza B almost exclusively infects humans, Piedra tells Yahoo Life, while influenza infects animals. For viruses to stay alive, they need a host, he explains. So imagine for influenza B Yamagata, all of a sudden the ability to transmit is not possible, because the host is now protecting themselves through non-pharmacological interventions, such as avoiding close contact with other people to slow the spread of COVID.

The Victoria B strain was more prevalent than Yamagata before the pandemic and managed to hang on, but the year prior to the pandemic, there was less Yamagata circulating, so that when it took a hit, that hit was more dramatic, Piedra explains. Influenza A, meanwhile, had plenty of animal hosts to sustain it while humans hid out.

Each year, scientists have to guess which subtypes of influenza viruses they think will be most actively circulating in order to formulate the most protective vaccine possible. Thats a serious challenge because viruses are constantly recombining and mutating.

There are four broad types of influenza: A, B, C and D. But types C and D rarely appear and generally cause only mild illnesses. For this reason, the CDC and the World Health Organization dont consider them to be public health threats.

Strains of influenza A and B, on the other hand, circle the globe seasonally. More than 130 subtypes of influenza A have been discovered in nature, according to the CDC, while influenza B has been divided into just two groups, known as lineages: B Victoria and B Yamagata. But vaccine makers cant yet include more than four types of the flu virus in a given vaccine due to technological limitations. Since 2014, therefore, the vaccine has been made to protect against two strains of influenza A H1N1 and H3N2 and two strains of influenza B, Victoria and Yamagata.

But with the disappearance of Yamagata, the U.S. and much of the world will use a shot based on just three strains of flu or a trivalent vaccine instead of a quadrivalent vaccine, which is designed to protect against four strains.

Making a vaccine based on fewer flu strains could improve vaccine-making capacity globally, research suggests. It gives you a little more leeway, Piedra says.

It means that making the vaccine wont take quite as long, so scientists may have a little longer to pick the flu strains the vaccine is designed to block a decision that typically happens in May. Or, as Piedra explains: You will have the vaccine a little earlier, to be sure that everyone who wants to be is vaccinated. If the vaccine comes in late, its much harder to vaccinate everyone and have broad coverage.

Yes, say both Monto and Piedra. Theres no evidence that Yamagata B is still around, so the vaccine will be tailored to the strains that arecirculating. As a matter of principle, you dont want to vaccinate people with something that you dont need, says Monto.

Its also worth noting that it's not impossible for the B Yamagata strain to reemerge, says Piedra. But he adds that theres no reason to vaccinate against it now and no immediate cause for concern that it will come back. Also, according to Monto, there's a good reason to leave it out of the vaccine recipe. In the U.S., flu shots contain an inactivated virology-speak for dead bit of virus thats incapable of causing infection. But the nasal spray form uses whats called a live attenuated influenza vaccine, meaning it contains weakened, live viruses.

This version of the virus is generally too weak to cause illness, but "the concern there was about not wanting to bring back something that was gone by including B Yamagata in these vaccines, Monto says. So come the fall, the flu shot and nasal spray will protect against three subtypes instead.

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COVID helped to kill off a flu strain. Here's how that will affect influenza vaccines in the future. - Yahoo Life

Juliet Morrison, assistant professor in the microbiology and plant pathology department at the University of California, Riverside, said she was excited to hear the news that the Yamagata virus was no longer a threat to public health.

This is a win for all humans because we now have one less influenza virus to fight off, she said.

That the strain disappeared during an extended period of health restrictions also provides strong evidence that public safety measures like masking and isolation work well to prevent the spread of respiratory viruses, Prof Morrison added.

However, its disappearance creates a headache for vaccine manufacturers.

The current generation of flu jabs are quadrivalent they target all four influenza viruses and are updated every six months depending on what sub-strains are in circulation.

Vaccine-makers proffer recommendations for the northern and southern hemispheres each spring and autumn, based on the influenza trends recorded during their respective winters.

But with B/Yamagata now eliminated, there is no longer a need for quadrivalent vaccines. Manufacturers must instead develop trivalent versions to target the three remaining influenza viruses.

Yet altering vaccines is not so simple as a tick of the box, said Prof Subbarao, who sits on the WHO expert panel responsible for recommending biannual changes to the flu jab.

In order to roll out trivalent vaccines for both hemispheres, the immediate challenge for manufacturers is to establish licences, she added, as the new jabs will need fresh regulatory approval.

As of now, with the autumn rollout still a long way off in the northern hemisphere, we have a window of opportunity to reduce the quadrivalent vaccine to a trivalent iteration, said Prof Subbarao.

[But] the big challenge with influenza viruses is that we make decisions six months ahead of what goes into the vaccine, and the virus continues to evolve, she said. By the time notable patterns have been observed, recommendations made and vaccines have been changed accordingly, things might have shifted again.

We dont ever seem to get it quite right, she conceded.

There is also the risk that the B/Yamagata one day makes a resurgence. History shows its a possibility.

During the Nineties, the Victoria B strain of influenza appeared only periodically during testing, but became prevalent again in Asia-Pacific at various points over the following decade.

Following the WHO ruling that B/Yamagata is no longer warranted, the US last week announced that it would update its vaccine in time for its winter rollout, which usually occurs in the autumn months ahead of the sudden drop in temperatures.

There were concerns that the shift from quadrivalent to trivalent could not be made in time though this has moved faster than expected, perhaps due to American manufacturers already having trivalent vaccine approvals.

Other countries may struggle to be as nimble.

There will also be a knock-on effect for vaccines in development, too. Moderna and Pfizer have quadrivalent mRNA vaccines in phase 3 clinical trials that contain B/Yamagata, while a Novavax jab thats currently being trialled also targets the strain.

We have to improve our influenza vaccines, absolutely no doubt about it, said Prof Subbarao.

If the mRNA vaccines currently being developed do work for flu, we will be able to push back the vaccine strain selection decision a little later, said Prof Subbarao, as they are able to be tweaked later on in the development process.

We are always wishing for four more weeks, so that might help, added Prof Subbarao.

Still, the goal that everybody has in mind is having a universal influenza vaccine, where you dont have to change it every year: something that elicits broadly cross-reactive immunity.

Were not there yet, she added. Theres a lot of exciting science, but were not there yet.

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How Covid killed off a deadly strain of flu - The Telegraph

In todays Health Alert, influenza continues to circulate at high levels in Michigan.Given that it's late in the flu season, some may be wondering whether it's still worthwhile to get the flu shot.

I get asked that all the time by my patients, and here's my answer. If there's any flu activity happening, it's definitely not too late to get the flu shot. Here in Michigan, we have not yet plateaued. Cases are still climbing and the CDCs flu activity map shows our state as Very High for influenza. Looking at Michigans weekly influenza report, just over 8,800 outpatient visits in the week ending March 2 were due to influenza-like illness. Most of the flu results reported were H1N1, a type of influenza A virus.

While you may think its a bit late in the flu season to get the shot, there can be significant flu activity well into the month of May. The annual flu shot is your best defense against this virus. Estimates for this season show 41% to 44% effectiveness against hospitalization for adults and 52% to 61% for children.

According to the CDC, roughly 44.9% of adults and 50% of children were vaccinated for the flu this season. Here in Michigan, about 25% of adults and 19% of kids got the vaccine. Thats pretty low. The reluctance to get vaccinated could be due to COVID-19 vaccine fatigue. But also, many people think, Im healthy, so I dont need a flu vaccine. Because the flu has been around so long, people just accept it as part of life. But unfortunately, the flu can cause serious illness and death, even in healthy people.

The CDC estimates weve had 310,000 hospitalizations and about 20,000 people have died. 103 were pediatric deaths, including one here in Michigan. Sadly, almost 90% of the children who died were not fully vaccinated. Its recommended that everyone six months and older get a yearly flu shot. Kids under the age of 8 get two doses if theyve not had the shot before. I get one every year and so do my kids. And thats because the flu vaccine can lessen the severity of your illness and its very effective at preventing severe illness.

So once again, I highly recommend getting vaccinated against the flu if you have not yet done so.

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As the flu circulates in Michigan, is it too late to get your flu shot? - WXYZ 7 Action News Detroit

More than 100 children have died of the flu this season, the Centers for Disease Control and Prevention reported Friday.

The number of pediatric deaths 103 so far is not a seasonal record. While kids with underlying health problems are more at risk for severe outcomes from the flu, the latest CDC numbers provide a stark reminder that flu can indeed be devastating to any child.

This is certainly sobering information, but its not something necessarily unexpected, said Alicia Budd, head of the CDCs domestic influenza surveillance team.

More than half of the children who died (53%) had no medical issues before their influenza infection, Budd said.

Among the 10 new pediatric deaths in the most recent report, most died within the last few weeks, Budd said.

Although cases seem to be peaking across the country, flu season is not over. The CDC estimates that the nation has logged at least 28 million flu illnesses, resulting in 310,000 hospitalizations so far this year. In addition to the 103 pediatric deaths, about 20,000 others have died of flu.

There is a popular misconception among families that flu is just another cold virus, and that its no big deal, said Dr. Kristina Bryant, a pediatric infectious disease physician at Norton Healthcare in Louisville, Kentucky.

I have taken care of kids who are critically ill in the intensive care unit with flu, Bryant said. Ive taken care of kids who have ultimately died from flu. And almost universally, their parents tell me, I had no idea that flu could do this to my child.

The vast majority of children infected with flu every year recover. One of the virus biggest mysteries is how it can quickly and swiftly kill otherwise healthy and robust children without warning.

Kids have smaller airways, so breathing becomes compromised once a virus infects and inflames those airways, said Dr. Alexandra Yonts, a pediatric infectious diseases physician at Childrens National Hospital in Washington, D.C.

Childrens immune systems are superprimed to attack any new germ that comes their way, said Yonts. Sometimes those immune responses go too far.

As with a lot of viral illnesses, more than anything its the bodys immune response that determines the severity of the symptoms.

Theres something about influenza that is particularly immunogenic to our bodies and can create these massive cytokine storms and fevers that end up landing kids in the ICU with a sepsis-like picture, Yonts said.

The CDCs Budd said that nearly 90% of the children who died of flu this year were not fully vaccinated. For most kids, this means just one shot per year. But kids younger than age 8 need two doses if theyve never received the flu shot before.

Just over 50% of kids got the flu shot this season, slightly lower than 53.3% last year. Preliminary CDC data shows the vaccine is up to 61% effective in keeping kids with flu out of the hospital.

The vaccine can reduce the risk of a child needing to have a medical visit by about two-thirds, Budd said. And it can reduce their risk of hospitalization by about half.

Experts cant predict which flu virus strains might be more virulent in any given year. About half of the pediatric deaths in the 2023-24 season were due to an influenza A strain, the CDC reported, while 47 were attributed to an influenza B strain. One child had both A and B strains.

The 2014-15 flu season was a particularly severe one that took the lives of 141 children. Gianna Wehrkamp, a perfectly healthy and energetic 2-year-old, was one of them.

It was Jan. 8, 2015, when Gianna came home from day care with a slight fever not even 100 degrees. Her mother, Angie Wehrkamp, said Gianna was playing normally and did not act like anything was wrong. She was just as bossy as always, she said.

The next morning, the normally smiley, spunky little girl was not herself.

She just looked like she didnt feel good, Wehrkamp, 46, of Sioux Falls, South Dakota, said. You could see it on her face.

A trip to the doctor revealed that Gianna had influenza A. The doctor assured Wehrkamp that Gianna would soon be on the mend.

Gianna spent the day resting at home with her beloved teddy bear named Dog and watched cartoons; Mickey Mouse Clubhouse and Frozen were favorites. Gianna perked up a bit at dinner, eating black olives one by one off of the tips of her fingers. Her fever never rose above 101 degrees.

At bedtime, Wehrkamp said that Giannas lungs sounded a little rattly, so she brought the little girl into her bed to keep an eye on her overnight.

Around 2 a.m., I woke up and she was not breathing, Wehrkamp said. It took paramedics nearly an hour to get Giannas heart beating again.

By then, it was too late.

Less than 48 hours after she started showing symptoms, Gianna died of influenza.

It all just happened so fast, Wehrkamp said. We did not know that healthy children could lose their lives to the flu.

The little girl hadnt received the flu shot the year she died.

We had every intention of getting Gianna vaccinated, her mother said. But it just kind of fell off the radar as busy parents, and unfortunately we paid the ultimate price for that. Failing to make that a priority will forever be my greatest regret.

Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY."

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Over 100 kids have died of flu this season. More than half were previously healthy - NBC News