Abstract
Vaccination is the most cost-effective way to reduce the considerable disease burden of seasonal influenza. Although seasonal influenza vaccines are effective, their performance in the elderly and immunocompromised individuals would benefit from improvement. Major problems related to the development and production of pandemic influenza vaccines are response time and production capacity as well as vaccine efficacy and safety. Several improvements can be envisaged. Vaccine production technologies based on embryonated chicken eggs may be replaced by cell culture techniques. Reverse genetics techniques can speed up the generation of seed viruses and new mathematical modelling methods improve vaccine strain selection. Better understanding of the correlates of immune-mediated protection may lead to new vaccine targets besides the viral haemagglutinin, like the neuraminidase and M2 proteins. In addition, the role of cell-mediated immunity could be better exploited. New adjuvants have recently been shown to increase the breadth and the duration of influenza vaccine-induced protection. Other studies have shown that influenza vaccines based on different viral vector systems may also induce broad protection. It is to be expected that these developments may lead to more universal influenza vaccines that elicit broader and longer protection, and can be produced more efficiently.
Highlights
Seasonal, avian and pandemic influenza are three manifestations of human influenza which all have a different aetiology
Seasonal influenza viruses manage to persist in the human population by a process called ‘antigenic drift’, which is based on the high mutation rate that allows these viruses to escape continuously from the antibodies that are generated after each influenza virus infection
Special recommendations and guidelines are in place for the vaccination of individuals in the socalled high-risk groups for influenza. These individuals may suffer from more serious disease and are more prone to develop severe complications when infected with seasonal influenza viruses
Summary
Avian and pandemic influenza are three manifestations of human influenza which all have a different aetiology. Seasonal influenza viruses manage to persist in the human population by a process called ‘antigenic drift’, which is based on the high mutation rate that allows these viruses to escape continuously from the antibodies that are generated after each influenza virus infection. Like the implementation of hygienic measures and the closure of schools and social events, may reduce the spread of influenza, medical interventions to combat disease largely rely on surveillance, rapid diagnostics, dedicated clinical care and the use of vaccines and antivirals. There is an urgent need for the development of new generation influenza vaccines that offer broader protection, to emerging drift variants of seasonal influenza viruses, but preferably to influenza A virus of different influenza A virus subtypes that regularly infect birds and mammals and may be the basis of future influenza pandemics. More ‘universal vaccines’ that offer broader and long-lived protection should be considered the major challenge for the development of new generation influenza vaccines
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