Evaluation of Southern Hemisphere influenza vaccine recommendations

In 1999, the World Health Organization switched from annual to semi-annual recommendations for influenza vaccine composition. We compared the antigenic match between recommendations and circulating viruses before and after 1999, in the Northern and Southern Hemispheres. Vaccine match proportion for A/H3N2 viruses increased from 31% to 59% in the Southern Hemisphere (P<0.05), and is now comparable to that in the Northern Hemisphere. Vaccine match for influenza B decreased from approximately 100% to 33-54% in both hemispheres (P<0.05), following the unexpected resurgence of influenza B/Victoria in 1997. No estimate was available for influenza A/H1N1. We conclude that semi-annual vaccine recommendations are useful overall and discuss potential ways forward, including a recommendation for the improvement of vaccination policy and influenza surveillance in tropical areas.