{"id":1470,"date":"2015-05-21T15:00:46","date_gmt":"2015-05-21T19:00:46","guid":{"rendered":"http:\/\/allphasepharma.com\/dir\/?p=1470"},"modified":"2015-06-27T14:51:08","modified_gmt":"2015-06-27T18:51:08","slug":"vaccine-mismatch-the-influenza-season-2014-2015","status":"publish","type":"post","link":"https:\/\/allphasepharma.com\/dir\/2015\/05\/21\/1470\/vaccine-mismatch-the-influenza-season-2014-2015\/","title":{"rendered":"Vaccine Mismatch \u2013 The Influenza Season 2014 \/ 2015"},"content":{"rendered":"

PLEASE SHARE YOUR OPINION AND VOTE\u00a0BELOW<\/span><\/strong><\/h1>\n
\n

 <\/p>\n

It has\u00a0always been a bit of a gamble: Predicting the main circulating flu types and subtypes for the next season based on information from the previous season is an educated guess. \u00a0It works well most of the time but fails when there is no obvious selection candidate or the virus change its antigenic profile\u00a0just before the new\u00a0season.<\/p>\n

As\u00a0selection of\u00a0vaccine candidates has to be made way ahead of the next flu season to allow for sufficient production time, this creates\u00a0an approx. 6 month ‘escape’ window for viral mutations.

The 2014-2015 influenza vaccine is made to protect against the following three viruses[1]<\/a>:
\n<\/span>1. an A\/California\/7\/2009 (H1N1)pdm09-like virus
\n2. an A\/Texas\/50\/2012 (H3N2)-like virus<\/span>
\n3. a B\/Massachusetts\/2\/2012-like virus<\/span><\/p>\n<\/div><\/p>\n

It is\u00a0no secret that vaccine efficacy is and will\u00a0never be even close to 100%.\u00a0 A 50-60% level of protection is the norm. Every year CDC and health organizations admonish us\u00a0to get vaccinated because available data show that disease caused by influenza A and B strains\u00a0is mitigated and mortality reduced in vaccine recipients. \u00a0Some but not all experts feel that even with vaccines providing mismatched, hence\u00a0‘suboptimal’ coverage there is still a benefit [2]. \u00a0“Suboptimal’\u00a0is a euphemism: ‘mediocre’ seems\u00a0a more appropriate term.<\/p>\n

So far, so good.<\/p>\n

\"2003<\/a>
Table 1: Vaccine Effectiveness 2003 (MMWR 2004; 53: 707)<\/figcaption><\/figure>\n

Mismatches between vaccine strains and the circulating pool of influenza virus are inevitable.\u00a0 With vaccines usually containing at least 2 strains for influenza A (with 80-90% of circulating virus, this is the predominant type), not all is lost.\u00a0 For instance, in 2003 we had a mismatch and protection was conferred in only 36% of vaccinated non-high risk persons (see Table 1).<\/p>\n

However, protective efficacy has\u00a0never been as low as in this 2014 \/ 2015 flu season. Due to a major H3N2 mismatch, efficacy\u00a0levels as low as 23% (first estimate), then 18% (a later estimate), and eventually 15% (for children age 2-8 years) were reported.<\/p>\n

In light of such low coverage, why do\u00a0CDC and Health Authorities\u00a0still recommend in unison that we adhere to existing vaccination recommendations as in the past, why is hospital personnel still required (under threat of dismissal) to prove vaccination status?<\/p>\n

We are told that vaccine efficacy is not to be equated with vaccine strains and that coverage is broader as long as\u00a0the mismatch is less than a complete viral shift. \u00a0However, not everyone agreed with CDC\u2019s assertion that such partial coverage still\u00a0reduce disease severity\u00a0and mortality.[3]<\/a><\/p>\n

This is a complex issue\u00a0but here is the rub:\u00a0 There must be a level of protection at which point the benefits no longer outweigh the risks (and costs) of the effort.\u00a0 If this break point is less than 18%, as current\u00a0CDC endorsement\u00a0indicates, is it at 15%, 10% or as low as 5%?\u00a0 Trying to get this question answered proved more difficult than expected.<\/p>\n

I was hoping to find some literature, an analysis that would provide the answer. Unfortunately, this was not the case.\u00a0\u00a0Before\u00a0calling the experts at the CDC, I would like to hear from you. \u00a0Please vote below and\/or\u00a0leave a comment below – thank you!<\/p>\n

[poll id=”3″]<\/p>\n

References:<\/strong>
\n[1] http:\/\/www.cidrap.umn.edu\/news-perspective\/2014\/12\/cdcs-flu-warning-raises-questions-about-vaccine-match
\n[2]<\/a>\u00a0A Tricco \u00a0Tricco et al. BMC Medicine 2013, 11:153
\n[3]<\/a> http:\/\/www.cdc.gov\/flu\/professionals\/vaccination\/virusqa.htm<\/p>\n","protected":false},"excerpt":{"rendered":"

PLEASE SHARE YOUR OPINION AND VOTE\u00a0BELOW   It has\u00a0always been a bit of a gamble: Predicting the main circulating flu types and subtypes for the next season based on information from the previous season is an educated guess. \u00a0It works well most of the time but fails when there is Continue reading Vaccine Mismatch \u2013 The Influenza Season 2014 \/ 2015<\/span>→<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":1480,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[227,3],"tags":[403,991,988,989,986,987,990,992],"class_list":["post-1470","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-recent_literature","category-the_news","tag-antibiotic-blog","tag-cdc-recommendations","tag-effectiveness","tag-h3n2-drift","tag-influenza-vaccine","tag-mismatch","tag-vaccine-composition","tag-vaccine-effectiveness"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2015\/05\/Flu-Vaccine-Slider.jpg?fit=640%2C180&ssl=1","jetpack_shortlink":"https:\/\/wp.me\/p4KWFr-nI","jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":2596,"url":"https:\/\/allphasepharma.com\/dir\/2016\/07\/07\/2596\/is-laiv-dead-or-just-on-laiv-support\/","url_meta":{"origin":1470,"position":0},"title":"Is LAIV Dead or Just on LAIV-Support?","author":"Harald","date":"July 7, 2016","format":false,"excerpt":"Very recently we came across several studies in which small differences in design\u00a0had a major\u00a0impact on outcomes. A blog\u00a0is not a good\u00a0place\u00a0to dig deeply into the minutiae of study design as the discussion\u00a0becomes quickly very dry and quite\u00a0technical. However, readers and clinicians are often unaware how a seemingly small change\u2026","rel":"","context":"In "Recent Literature"","block_context":{"text":"Recent Literature","link":"https:\/\/allphasepharma.com\/dir\/category\/recent_literature\/"},"img":{"alt_text":"VE slider","src":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2016\/07\/VE-slider.jpg?resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2016\/07\/VE-slider.jpg?resize=350%2C200 1x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2016\/07\/VE-slider.jpg?resize=525%2C300 1.5x"},"classes":[]},{"id":5948,"url":"https:\/\/allphasepharma.com\/dir\/2025\/12\/15\/5948\/influenza-vaccination-in-the-elderly\/","url_meta":{"origin":1470,"position":1},"title":"INFLUENZA VACCINATION IN THE ELDERLY","author":"Harald","date":"December 15, 2025","format":false,"excerpt":"In 2024, the ECDC published a detailed review of flu vaccine studies [1].\u00a0 In particular, the report examined published trials of newer flu vaccines.\u00a0 As is well known, the older vaccines provide significant protection, but efficacy is diminished in certain populations.\u00a0 Especially the elderly are at an increased risk of\u2026","rel":"","context":"In "Recent Literature"","block_context":{"text":"Recent Literature","link":"https:\/\/allphasepharma.com\/dir\/category\/recent_literature\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/12\/image.png?resize=350%2C200&ssl=1","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/12\/image.png?resize=350%2C200&ssl=1 1x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/12\/image.png?resize=525%2C300&ssl=1 1.5x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/12\/image.png?resize=700%2C400&ssl=1 2x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/12\/image.png?resize=1050%2C600&ssl=1 3x, https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2025\/12\/image.png?resize=1400%2C800&ssl=1 4x"},"classes":[]},{"id":577,"url":"https:\/\/allphasepharma.com\/dir\/2014\/07\/11\/577\/bacterial-vaccine-targets\/","url_meta":{"origin":1470,"position":2},"title":"Bacterial Vaccine Targets","author":"Harald","date":"July 11, 2014","format":false,"excerpt":"A recent publication [1] from the team which brought us the Meningococcal B vaccine is of interest from the perspective of vaccine development strategy and feasibility.\u00a0 Appropriately, tuberculosis (TB) leads the list of important bacterial targets for vaccine research. Despite numerous attempts, all the vaccines candidate tested so far had\u2026","rel":"","context":"In "Recent Literature"","block_context":{"text":"Recent Literature","link":"https:\/\/allphasepharma.com\/dir\/category\/recent_literature\/"},"img":{"alt_text":"Bacterial Targets","src":"https:\/\/i0.wp.com\/allphasepharma.com\/dir\/wp-content\/uploads\/2014\/07\/Bacterial-Targets-Rappuoli.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":671,"url":"https:\/\/allphasepharma.com\/dir\/2014\/08\/02\/671\/learning-from-set-backs-the-frustrating-search-for-a-staphylococcal-vaccine\/","url_meta":{"origin":1470,"position":3},"title":"Learning from Set-Backs: The Frustrating Search for a Staphylococcal Vaccine","author":"Harald","date":"August 2, 2014","format":false,"excerpt":"Several reasons have been proposed as explanations why so many\u00a0S. aureus vaccines\u00a0have failed in clinical trials.\u00a0 Clearly, the organism has a battery of virulence factors which may require a multipronged approach and\u00a0neutralizing just a single mechanism with a specific mAb may not suffice. However, passive immunization with polyclonal antibodies did\u2026","rel":"","context":"In "Recent Literature"","block_context":{"text":"Recent Literature","link":"https:\/\/allphasepharma.com\/dir\/category\/recent_literature\/"},"img":{"alt_text":"IgG antibody","src":"http:\/\/allphasepharma.com\/dir\/wp-content\/uploads\/2014\/08\/antibody.jpe","width":350,"height":200},"classes":[]},{"id":3550,"url":"https:\/\/allphasepharma.com\/dir\/2020\/02\/09\/3550\/some-thoughts-about-the-new-coronavirus-syndrome-and-its-transmission\/","url_meta":{"origin":1470,"position":4},"title":"Some Thoughts about the New Coronavirus Syndrome and its Transmission","author":"Harald","date":"February 9, 2020","format":false,"excerpt":"First and upfront, let\u2019s call this virus WARS*, which stands for Wuhan Associated Respiratory Syndrome.\u00a0 President Xi Jingping called for a war against the new virus, and a war it is.\u00a0 Therefore our acronym makes intuitive sense.\u00a0 The naming of new viruses is getting politized and silly: yes, we need\u2026","rel":"","context":"In "The News"","block_context":{"text":"The News","link":"https:\/\/allphasepharma.com\/dir\/category\/the_news\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":608,"url":"https:\/\/allphasepharma.com\/dir\/2014\/07\/15\/608\/surprise-hanta-virus-right-in-your-back-yard\/","url_meta":{"origin":1470,"position":5},"title":"Surprise: Hanta Virus Right in Your Back Yard","author":"Harald","date":"July 15, 2014","format":false,"excerpt":"Hanta Virus Epidemics in Germany? When I learned that a friend of mine came down with Hanta virus infection in Germany, I thought I had heard wrong. Mice and voles shed hanta viruses in their excreta which - when aerosolized and inhaled - can cause significant disease.\u00a0 In some parts\u2026","rel":"","context":"In "Did you know...?"","block_context":{"text":"Did you know...?","link":"https:\/\/allphasepharma.com\/dir\/category\/interesting_facts\/"},"img":{"alt_text":"No, it's not a camel this time...","src":"http:\/\/allphasepharma.com\/dir\/wp-content\/uploads\/2014\/07\/bank-vole.jpe","width":350,"height":200},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/posts\/1470","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/comments?post=1470"}],"version-history":[{"count":20,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/posts\/1470\/revisions"}],"predecessor-version":[{"id":1628,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/posts\/1470\/revisions\/1628"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/media\/1480"}],"wp:attachment":[{"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/media?parent=1470"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/categories?post=1470"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/allphasepharma.com\/dir\/wp-json\/wp\/v2\/tags?post=1470"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}