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We developed an influenza hemagglutinin (HA) pseudotype library encompassing Influenza A subtypes HA1-18 and Influenza B subtypes (both lineages) to be employed in influenza pseudotype microneutralization (pMN) assays. The pMN is highly sensitive and specific for detecting virus-specific neutralizing antibodies against influenza viruses and can be used to assess antibody functionality in vitro. Here we show the production of these viral HA pseudotypes and their employment as substitutes for wildtype viruses in influenza neutralization assays. We demonstrate their utility in detecting serum responses to vaccination with the ability to evaluate cross-subtype neutralizing responses elicited by specific vaccinating antigens. Our findings may inform further preclinical studies involving immunization dosing regimens in mice and may help in the creation and selection of better antigens for vaccine design. These HA pseudotypes can be harnessed to meet strategic objectives that contribute to the strengthening of global influenza surveillance, expansion of seasonal influenza prevention and control policies, and strengthening pandemic preparedness and response. ; Bill and Melinda Gates Foundation: Grand Challenges Universal Influenza Vaccines Award; UK Research and Innovation (UKRI); EC FETopen (Virofight, Grant 899619); Department of Science and Technology of South Africa; UK Department for the Environment, Food and Rural Affairs (Defra); Scottish and Welsh governments. ; http://www.mdpi.com/journal/vaccines ; pm2022 ; Veterinary Tropical Diseases

AbstractRates of COVID-19 and influenza vaccine coverage among Hispanic young children continue to be low in comparison to other racial and ethnic groups in the United States. This study utilized a person-centered approach to understand COVID-19 and influenza vaccination hesitancy for young children under the age of five among 309 economically marginalized Hispanic mothers. Drawing on the cultural health belief model, in 2022, following FDA approval of the COVID-19 vaccine for young children, a latent profile analysis was conducted from which three profiles emerged. The Low Acculturation group (Profile 1), was notable for lower acculturation, moderate cultural medical mistrust, lower access to vaccines, and higher financial security. Compared to Profile 1, the two remaining profiles had higher acculturation and lower levels of financial security, but differed in that the High Acculturation group (Profile 2) had higher vaccine accessibility and the Moderate Acculturation group (Profile 3) had higher cultural medical mistrust. Relative to other profiles, Low Acculturation mothers were more likely to plan to vaccinate their child against current and seasonal COVID-19 and seasonal influenza, report that their child's health provider recommended the COVID-19 shot and reported lower COVID-19 and influenza vaccine mistrust. However, they also reported lower vaccine accessibility and moderate levels of cultural medical mistrust. The study highlights the importance of developing person-centered public health strategies that draw on Hispanic cultural values and consider diversity within lower income Hispanic populations to increase future pediatric COVID-19 and flu vaccination coverage among young Hispanic children.

In the first five I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe) influenza seasons vaccine effectiveness (VE) results were relatively homogenous among participating study sites. In 2013-2014, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in six European Union (EU) countries to measure 2013-2014 influenza VE against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. Influenza A(H3N2) and A(H1N1)pdm09 viruses co-circulated during the season. Practitioners systematically selected ILI patients to swab within eight days of symptom onset. We compared cases (ILI positive to influenza A(H3N2) or A(H1N1)pdm09) to influenza negative patients. We calculated VE for the two influenza A subtypes and adjusted for potential confounders. We calculated heterogeneity between sites using the I(2) index and Cochrane's Q test. If the I(2) was 49% we used a two-stage random effects model. We included in the A(H1N1)pdm09 analysis 531 cases and 1712 controls and in the A(H3N2) analysis 623 cases and 1920 controls. For A(H1N1)pdm09, the Q test (p=0.695) and the I(2) index (0%) suggested no heterogeneity of adjusted VE between study sites. Using a one-stage model, the overall pooled adjusted VE against influenza A(H1N1)pdm2009 was 47.5% (95% CI: 16.4-67.0). For A(H3N2), the I(2) was 51.5% (p=0.067). Using a two-stage model for the pooled analysis, the adjusted VE against A(H3N2) was 29.7 (95% CI: -34.4-63.2). The results suggest a moderate 2013-2014 influenza VE against A(H1N1)pdm09 and a low VE against A(H3N2). The A(H3N2) estimates were heterogeneous among study sites. Larger sample sizes by study site are needed to prevent statistical heterogeneity, decrease variability and allow for two-stage pooled VE for all subgroup analyses. ; Sí

Influenza in the tropics occurs year round with peaks that correspond variably to temperate regions. However, data on influenza vaccine effectiveness (VE) in the tropics is sparse. We report on the effectiveness of influenza vaccine to prevent medically attended laboratory confirmed influenza from sentinel surveillance conducted at a Thai military medical facility in Bangkok, Thailand from August 2009 to January 2013. Patients ≥6 months old presenting with influenza-like illness underwent combined nasal/throat swabs which were tested by influenza RT-PCR. A case test-negative study design was used to evaluate VE. Of 2999 samples available for analysis,1059 (35.3%) were PCR-positive (cases) and 1940 (64.6%) were PCR-negative (test-negative controls). Five hundred and seven (16.9%) of these patients reported being vaccinated within the previous 12 months. Periods of high and low influenza activity were defined based on publicly available Thai Ministry of Public Health data. Overall VE adjusted for age and epiweek was found to be 50.1% (95%CI: 35.0, 61.9%). The May to April adjusted VE for year 2010, 2011 and 2012 was 57.7% (95%CI: 33.7, 73.8%), 57.1% (95% CI: 35.2, 68.3%) and 37.6% (95% CI: 3.5, 62.9%).During high influenza activity in years with the same vaccine formulation, the adjusted VE was 54.9% (95%CI: 38.9, 66.9%). VE appeared to be much higher during high versus low influenza activity periods. The adjusted point estimate for VE was highest in the 18–49 year age group (76.6%) followed by 6–23 months (58.1%) and 2–17 years (52.5%). Adjusted estimates were not done for those ≥50 years of age due to small numbers. VE in patients with underlying disease was 75.5% compared to 48.0% in those without. Our findings demonstrate moderate protection by influenza vaccination and support the utility of influenza vaccination in the tropics including in very young children and those with underlying disease.

AbstractWhen deciding whether to vaccinate, people often seek information through consequential processes that are not currently well understood. A survey of a nationally representative sample of U.S. adults (N = 2,091) explored the factors associated with intentions to seek influenza vaccine information in the 2018–2019 influenza season. This survey shed light on what motivates intentions to seek information about the influenza vaccine through the lens of the risk information seeking and processing (RISP) model. The model explained information‐seeking intentions well among both unvaccinated and vaccinated respondents. Key findings show that informational subjective norms, information insufficiency, and different types of affect are strong predictors of information‐seeking intentions. Theoretical insights on extending the RISP model and practical guidance on designing interventions are provided.

INTRODUCTION: An effective vaccine may help us to exit the COVID-19 pandemic. General Practitioners/Family Doctors (GPs/FDs) play a vital role in public vaccination in most countries and they also serve as role models. However, they may not always follow national vaccination policies. This study was carried out in order to ascertain the degree of vaccine hesitancy of GPs and GP trainees in Malta vis-à-vis influenza vaccination and a putative novel COVID-19 vaccine. ; METHODS: A short, anonymous questionnaire was emailed via the Malta College of Family Doctors. ; RESULTS: There were 123 responses from 288 GPs (33.3%) and 62 trainees (43.5%). Significantly more will take the influenza vaccine, at all ages. Almost two thirds of GPs are likely to take the COVID-19 vaccine but significantly less (a third) of trainees will. Older doctors were likelier to take this vaccine. The likelihood of taking influenza vaccination was significantly associated with that of taking COVID-19 vaccine. The majority of COVID-19 concerns pertained to insufficient knowledge and concern regarding potential long-term side effects. ; DISCUSSION: The vaccination rates for COVID-19 vaccination are less than those for influenza uptake. Vaccine hesitancy in younger doctors is a seemingly global youth phenomenon, an unwise insouchance when the possibility of long-term viral complications is considered. An information drive should be mounted with regard to COVID-19 vaccination as well as campaign to promote annual influenza vaccination. ; peer-reviewed

Letter in which the author questions the efficacy of influenza vaccination programs and the accuracy of the Centers for Disease Control and Prevention's flu-associated mortality statistics. ; http://www.bmj.com/content/333/7576/1020.3 ; Click here for the free full-text article on publisher's website

The Global Influenza Initiative (GII)is a global expert group that aims to raise acceptance and uptake of influenza vaccines globally and provides recommendations and strategies to address challenges at local, national, regional, and global levels. This article provides a consolidated estimation of disease burden in Latin America, currently lacking in published literature, and delivers the GII recommendations specific to Latin America that provide guidance to combat existing vaccination challenges. While many countries worldwide, especially in the tropics and subtropics, do not have a seasonal influenza policy, 90% of Latin American countries have a seasonal influenza policy in place. Local governments in the Latin American countries and The Pan American Health Organization's Technical Advisory Group on Vaccine-preventable Diseases play a major role in improving the vaccination coverage and reducing the overall disease burden. Influenza seasonality poses the biggest challenge in deciding on optimal timing for vaccination in Latin America, as in temperate climates seasonal influenza activity peaks during the winter months (November–February and May–October)in the northern and southern hemispheres, respectively, while in the tropics and subtropical regions it usually occurs throughout the year, but especially during the rainy season. Besides this, vaccine mismatch with circulating strains, misconception concerning influenza vaccine effectiveness, and poor disease and vaccine awareness among the public are also key challenges that need to be overcome. Standardization of clinical case definitions is important across all Latin American countries. Surveillance (mostly passive)has improved substantially in the Latin American countries over the past decade, but more is still required to better understand the disease burden and help inform policies.

Testimony issued by the Government Accountability Office with an abstract that begins "Shortages of influenza vaccine in the 2004-05 and previous influenza seasons and mounting concern about recent avian influenza activity in Asia have raised concern about the nation's preparedness to deal with a worldwide influenza epidemic, or influenza pandemic. Although the extent of such a pandemic cannot be predicted, according to the Centers for Disease Control and Prevention (CDC), an agency within the Department of Health and Human Services (HHS), it has been estimated that in the absence of any control measures such as vaccination or antiviral drugs, a "medium-level" influenza pandemic could kill up to 207,000 people in the United States, affect from 15 to 35 percent of the U.S. population, and generate associated costs ranging from $71 billion to $167 billion in the United States. GAO was asked to discuss the challenges the nation faces in responding to the threat of an influenza pandemic, including the lessons learned from previous annual influenza seasons that can be applied to its preparedness and overall ability to respond to a pandemic. This testimony is based on GAO reports and testimony issued since 2000 on influenza vaccine supply, pandemic planning, emergency preparedness, and emerging infectious diseases and on current work examining the influenza vaccine shortage in the United States for the 2004-05 influenza season."

EVA Hospital Group: Irina Kislaya, Ana Paula Rodrigues, Liliana Dias, Paula Branquinho, Cláudia Mihon, Ana Rita Estriga, Ana Brito, Luís Vale, Helena Pacheco, André Almeida, Helena Amorim, Paula Lopes, Vitor Augusto, Rosa Ribeiro, Regina Viseu, Raquel Guiomar, Pedro Pechirra, Paula Cristovão, Patrícia Conde. ; Erratum in: Acta Med Port. 2021 Jan 4;34(1):70-73. doi:10.20344/amp.15515. Epub 2021 Jan 4. ; Introduction: The project 'Integrated Monitoring of Vaccines in Europe' aimed to measure seasonal influenza vaccine effectiveness against hospitalised adults, aged 65 years and over, with influenza. We describe the protocol implementation in Portugal. Material and Methods: We implemented a test-negative design, targeting community-dwelling patients aged 65 years old and over hospitalised with severe acute respiratory illness. Patients were reverse transverse-polymerase chain reaction tested for influenza. Cases were those positive for influenza while others were controls. Most variables were collected using hospital medical records. Selection bias was evaluated by comparison with the laboratory influenza test requests database according to demographic characteristics. Crude, season-adjusted influenza vaccine effectiveness was estimated as = 1 – odds ratio, and 95% confidence intervals were obtained by conditional logistical regression, matched with the disease onset month. Results: The recruitment rate was 37.8%. Most participants (n = 368) were female (55.8%) and aged 80 years old and over (55.8%). This was similar to values for potentially eligible severe acute respiratory illness patients (80 years old and over: 56.8%, female: 56.2%). The proportion of missing values was below 2.5% for 20 variables and above 5% (maximum 11.6%) for six variables. Influenza vaccine effectiveness estimates were 62.1% against AH1pdm09 (95% confidence intervals: -28.1 to 88.8), 14.9% against A(H3N2) (95% confidence intervals: -69.6 to 57.3), 43.6% against B/Yam (95% confidence intervals: -66.2 to 80.8). Discussion: Given the non-existence of a coded admission database in either participating hospital the selection of severe acute respiratory illness due to clinical features was the feasible one. These results are only valid for the older adult population residing in the catchment area of the two participating hospitals who were admitted to a public hospital with severe influenza or SARI symptoms. Conclusion: Despite the low participation rate, we observed comparable characteristics of participants and eligible severe acute respiratory illness patients. Data quality was high, and influenza vaccine effectiveness results were in accordance with the results of meta-analyses and European season-specific estimates. The final sample size was low, which inhibited obtaining estimates with good precision. ; Introdução: O projeto "Integrated Monitoring of Vaccines in Europe" pretende medir a efetividade da vacina antigripal nas hospitalizações por gripe nos adultos com mais de 65 anos. Este estudo pretende descrever a implementação do protocolo em Portugal. Material e Métodos: Implementou-se um estudo com desenho caso-controlo teste negativo. A população-alvo foram indivíduos com idade superior a 65 anos, hospitalizados com doença respiratória aguda grave. Os doentes foram testados para gripe por reverse transverse-polimerase chain reaction. Foram considerados casos aqueles com resultado positivo; os restantes foram controlos. Os dados foram obtidos através de registo clinicos. O potencial viés de seleção foi avaliado por comparação de características demográficas e enfermarias com dados das requisições laboratoriais. A efetividade da vacina, foi estimada em 1 – odds ratio por regressão logística condicional, emparelhada para o mês de início da doença. Resultados: A taxa de recrutamento foi de 37,8%. A maioria dos participantes (n = 368) era do sexo feminino (55,8%) e tinha idade superior a 80 anos (55,8%). Padrão similar foi verificado nos doentes elegíveis (idade superior a 80 anos: 56,8%; feminino: 56,2%). Os valores omissos foram inferiores a 2,5% em 20 variáveis e acima de 5% (máximo 11,6%) em seis variáveis. As estimativas da efetividade foram 62,1% contra AH1pdm09 (intervalo de confiança IC 95%: -28,1, 88,8); 14,9% contra A (H3) (intervalo de confiança 95%: -69,6; 57,3) e 43,6% contra B/yamagata (intervalo de confiança 95%: -66,2; 80,8). ; Abstract in English, Portuguese ; This work is part of I-MOVE+ (Integrated Monitoring of Vaccines in Europe) project that received funding from the European Union's Horizon 2020 research and innovation programme [grant agreement number 634446]. ; info:eu-repo/semantics/publishedVersion

Background: The Accelerated Development of VAccine beNefit-risk Collaboration in Europe (ADVANCE) is a public-private collaboration aiming to develop and test a system for rapid benefit-risk monitoring of vaccines using existing healthcare databases in Europe. We estimated vaccine coverage from electronic healthcare databases as part of a fit-for-purpose assessment for vaccine benefit-risk studies. Methods: A retrospective dynamic cohort study was conducted through a distributed network approach. Coverage with measles-vaccine for birth year 2006, human papillomavirus (HPV)-vaccine for birth years 1990-2000 and influenza-vaccine for birth years 1920-1950 was estimated using period-prevalence and inverse probability weighting methods. Seven databases from four countries participated: Italy (Pedianet, Val Padana), Spain (BIFAP, SIDIAP), UK (RCGP-RSC, THIN), Denmark (SSI/AUH). Database access providers extracted the data, transformed it into a common structure and ran an R-script locally. The created output tables were shared and pooled at a central server. Results: The total study population comprised 274,616 persons for measles-vaccine, 2,011,666 persons for HPV-vaccine and 14,904,033 persons for influenza-vaccine. Measles-vaccine coverage varied from 84.3% (Denmark) to 96.5% (Italy, Val Padana) for the first dose and from 82.8% (Italy, Val Padana) to 90.9% (UK) for the second dose at the age of 7 years. The HPV-vaccine coverage, aggregated over birth years 1997-2000, ranged from 60% (UK) to 88.3% (Denmark) at the age of 15 years. The influenza-vaccine coverage for the influenza seasons from 2009 to 2015 for persons aged 65 years and more was roughly stable around 43% in Denmark and around 68% in the UK while a decrease from 58 to 50% was observed in Catalonia (Spain). Conclusions: We obtained detailed, age-specific coverage estimates though a common procedure. We discussed between database comparability and comparability to published national estimates. ; The Innovative Medicines Initiative Joint Undertaking funded this project under ADVANCE grant agreement no 115557, resources of which were composed of a financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and in kind contributions from EFPIA member companies. ; Braeye, T (reprint author), Sciensano, Rue Juliette Wytsman 14, B-1050 Brussels, Belgium. toon.braeye@sciensano.be

The Public Health Agency of Canada has a mandate to prepare and respond to public health events, including influenza pandemics. Pandemic preparedness requires a multifaceted approach with collaboration from all levels of government. The Canadian Pandemic Influenza Preparedness: Planning Guidance for the Health Sector (CPIP) is a guidance document that outlines key health sector preparedness activities designed to ensure Canada is ready to respond to the next influenza pandemic. This article, the first in a series, outlines Canada's pandemic influenza vaccine strategy as described in the CPIP annex on vaccines. The strategy encompasses all elements of a vaccine program including prioritization of the initial vaccine distribution, securing a pandemic vaccine supply, regulatory approval of a pandemic vaccine, vaccine safety, distribution and storage of the vaccine, allocation and vaccine uptake.

10.3201/eid0703.017320 ; Emerging infectious diseases ; 7 ; 3 ; 463-465