Abstract
ObjectiveTo assess the current and future development of influenza vaccines. Data SourcesPubMed searches were performed cross-referencing the keywords influenza, influenza vaccine, host immune response, correlates of protection, vaccine development, vaccine efficacy. Articles were reviewed for additional citations. Study SelectionsArticles were reviewed and selected on the basis of relevance to subject matter. ResultsIn this review, we first introduce the influenza virus, its nomenclature, and the concepts of antigenic drift and shift. Second, we discuss the status of currently licensed influenza virus vaccines. We briefly focus on influenza vaccine responses beyond hemagglutination inhibition that may correlate with protection against influenza viruses of different subtypes. Third, we explain how studying host responses to influenza infection and vaccination with advanced serologic methods, B-cell receptor sequencing, and transcriptomic profiling can guide the development of improved influenza virus vaccines. Fourth, we provide 2 suggestions on how current influenza vaccines can be optimized by redirecting immune responses toward conserved viral antigens and the use of adjuvants. ConclusionInfluenza vaccine design can benefit from novel insights obtained from the study of host responses to influenza virus infection and vaccination. Integration of the large amount of available clinical and preclinical data requires systems approaches that can elucidate novel correlates of protection and will guide further development of influenza vaccine.
Highlights
Influenza is a respiratory illness caused by influenza viruses
Influenza vaccine design can benefit from novel insights obtained from the study of host responses to influenza virus infection and vaccination
We are on the road toward a true universal influenza vaccine to be available in the pharmacy, currently licensed vaccines are the best option to protect against influenza virus infection
Summary
We are on the road toward a true universal influenza vaccine to be available in the pharmacy, currently licensed vaccines are the best option to protect against influenza virus infection. Not discussed in detail in this review, development of new vaccine production platforms has helped with increasing immune responses that target influenza virus. Influenza vaccine development is hampered to some extent by the fact that only a limited number of correlates or surrogates of protection are used to predict vaccine efficacy.[71] The preclinical and clinical data gathered from animal models and human cohort studies performed with currently licensed influenza vaccines or after influenza infection are crucial for gaining a better understanding of immune correlates of protection. Development of a more targeted influenza vaccine can be established and will be guided by novel immune correlates of protection that we are starting to understand better. The challenge is to put all available data at work to optimize current and future influenza vaccine approaches that can lead to the development of an influenza vaccine that can protect the human population from the burden influenza viruses still cause
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