FLU NEWS SCAN: Flu vaccination settings, universal flu vaccine trial, H1N1 on planes, Tamiflu benefits, H9N2 analysis

Jun 16, 2011

Nonmedical settings show gains as flu vaccination sites
A survey of where adults received seasonal flu vaccine during the 2010-11 flu season found that while most were vaccinated in a medical setting, an increasing number of immunizations took place elsewhere, such as the workplace and pharmacies. Researchers from the US Centers for Disease Control and Prevention (CDC) detailed their findings today in the latest issue of Morbidity and Mortality Weekly Report (MMWR). The information was collected during January through March from 46 states and the District of Columbia through the Behavioral Risk Factor Surveillance System. The survey includes responses from 36,581 adults. A doctor's office was the most common flu vaccination site (39.8%), followed by a store (18.4%), and the workplace (17.4%). Older adults and those with chronic medical conditions were more likely to be vaccinated at a doctor's office. The authors said the findings show how important the role of doctors is in flu vaccination and that changes in state laws allowing pharmacists to administer vaccine are playing an important role, especially among people who are less likely to be seen regularly by health providers.
Jun 17 MMWR report

Universal flu vaccine shows promise in phase 2 trial
BiondVax, a pharmaceutical company based in Israel, today announced positive results from a phase 2a trial of its universal influenza vaccine. The company's vaccine candidate includes a proprietary combination of conserved epitopes from influenza virus proteins, designed to protect against seasonal and pandemic flu strains. According to a BiondVax press release, the trial included 200 healthy volunteers who received the vaccine at one of two clinical research centers. Researchers reported that the vaccine, called Multimeric-011, was safe and effective. No severe adverse events were seen, and no safety differences were seen between treatment and control groups. The vaccine induced antibody as well as cell-mediated immune responses, confirming findings from previous trials. Participants who received two doses of the vaccine in an adjuvanted formulation showed a statistically significant rise in immunoglobulin G antibodies. The group also linked vaccination to a statistically significant elevation in Interferon-gamma, a cytokine that plays a critical role in fighting viral and bacterial infections. Also, administration of the vaccine with a 50% dose of commercially available trivalent inactivated vaccine (TIV) for seasonal flu induced higher rates of hemagglutination inhibition antibody responses compared with the TIV alone. BiondVax said the vaccine had the potential, when administered before flu outbreaks, to boost protection against a range of different flu strains.
Sitting near ill passengers may raise flu risk on international flights
Sitting within two rows of a passenger with influenza-like illness (ILI) on an international flight raises the risk of contracting pandemic 2009 flu slightly, while sitting within two seats raises it a bit more, according to Australian health officials writing in Emerging Infectious Diseases. They conducted a retrospective cohort study of two long-distance flights entering Australia during May 2009. One, from Los Angeles, contained six passengers who later tested positive for pandemic H1N1 flu. The second flight was from Singapore, where 2009 H1N1 was not yet circulating, but one passenger later tested positive for pandemic H1N1. Data analysis from 319 (43%) of 738 passengers showed that 13 (2%) had an ILI in flight and 32 (5%) had one within a week of arrival. The researchers found that passengers were at a 3.6% increased risk of contracting 2009 H1N1 flu if they sat within two rows of someone who was symptomatic before boarding. Sitting within two seats (in front, behind, or to the side) increased the risk to 7.7%. While stating that further studies are needed, the authors conclude, "The findings of this investigation suggest that efforts to prevent importation of respiratory diseases into a community and protection of individuals from in-flight exposure to ILI may require changes in international policies of both exit screening of symptomatic passengers preflight and contact tracing of those exposed to an ILI in-flight."
Jun 15 Emerg Infect Dis study

Meta-analysis: Oseltamivir reduces risk of flu complications by 37%
Harvard University researchers say their meta-analysis of 11 randomized clinical trials shows that in patients with confirmed influenza infections, oseltamivir (Tamiflu) reduces the risk of lower respiratory complications requiring antibiotic treatment by 37%. In Clinical Infectious Diseases (CID), the researchers say their analysis shows that the antiviral drug reduces the risk of such complications by 28% in patients with flu-like illness. They observed no reduction of such complications in patients who did not have influenza. In addition, they confirmed previous reports citing an increased risk of nausea and vomiting with the drug but found no increased risk of neuropsychiatric disorders, except for headache, among those taking oseltamivir.
Jun 15 CID report

Researchers detail world's largest H9N2 analysis
In the largest analysis of H9N2 avian influenza viruses so far, an international group of researchers found that viruses isolated in Central Asia and the Middle East between 1998 and 2010 fall into four distinct and cocirculating groups and have undergone frequent reassortment events. H9N2 is considered a possible pandemic strain, due to its detection in pigs and humans and extensive cocirculation with other avian flu viruses, researchers said in the Journal of Virology. They found that genetic variability was linked to amino acid mutations that play a role in H9N2 transmissibility to mammals and antiviral resistance, both of which could pose a threat to humans. Their study involved phylogenetic and molecular characterization of samples of H9N2 viruses from nine countries: Iran, Iraq, Israel, Jordan, the United Arab Emirates (UAE), Pakistan, Afghanistan, Saudi Arabia and Qatar. The group noted that the Arabian peninsula has seen a rapid increase in live poultry imports over the past decade and could serve as an ecological sink, as well as a regional source for the viruses. They wrote that the amino acid analysis suggests H9N2 virus could vary in antigenicity, and that poultry vaccination in many of the countries could be an important factor in the evolution of the viruses.
Jun 15 J Virol abstract

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