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Measuring Influenza Neutralizing Antibody Responses to AH3N2 Viruses in Human Sera by Microneutralization Assays Using MDCK-SIAT1 Cells
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Influenza Vaccine Effectiveness: Defining the H3N2 Problem.

Edward A Belongia1, Huong Q McLean1

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Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 19, 2019
PubMed
Summary

Influenza vaccine effectiveness is lower for H3N2 strains compared to others. Factors like virus evolution, vaccine adaptation, and host immunity contribute to this reduced protection, necessitating improved vaccine strategies.

Keywords:
influenzaH3N2vaccine effectiveness

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Area of Science:

  • Virology
  • Immunology
  • Vaccinology

Background:

  • Observational studies consistently report lower influenza vaccine effectiveness (VE) for H3N2 strains compared to H1N1pdm09 and influenza B.
  • This reduced VE is not fully explained by antigenic mismatch alone, suggesting other factors are involved.

Purpose of the Study:

  • To examine the contributing factors to lower H3N2 influenza vaccine effectiveness within the virus-vaccine-host immunity framework.
  • To explore potential strategies for improving H3N2 vaccine protection.

Main Methods:

  • Review of existing literature on influenza virus evolution, vaccine manufacturing processes, and host immune responses.
  • Analysis of the impact of hemagglutinin glycosylation and egg passage adaptation on vaccine virus immunogenicity.
  • Consideration of host immune factors such as imprinting and prior vaccination history.

Main Results:

  • Antigenic evolution and increased glycosylation of H3N2 hemagglutinin contribute to immune escape.
  • Egg passage adaptation of vaccine viruses introduces mutations that reduce neutralizing antibody response and VE.
  • The role of host immune factors like imprinting and repeated vaccination in H3N2 VE remains uncertain.

Conclusions:

  • Improving H3N2 vaccine effectiveness requires addressing virus evolution, vaccine adaptation, and host immunity.
  • Modifications to vaccine manufacturing, particularly avoiding egg passage adaptation, may enhance protection.
  • Novel vaccine technology platforms hold promise for developing superior H3N2 vaccines, though optimal strategies require further definition.