Seasonal influenza vaccine

2 October 2009

Here at Columbia University Medical Center, all employees and students may receive, at no charge, influenza vaccine every year. I just went to the lobby of the Milstein Hospital, showed my ID, and received the seasonal influenza vaccine. Here is the proof:

seasonal-flu-shot

As I’ve written before, vaccine records provide interesting information. The medical center administration has clearly printed many of these slips to accommodate those who will be receiving the pandemic H1N1 vaccine in a few weeks. Below ‘Seasonal Influenza Vaccine’, which is checked, is ‘H1N1 Vaccine #1 DOSE’. They have left open the possibility that more than one dose will be required, despite a published study – using CSL vaccine -  that one dose induces protective immunity.

The nurse who administered the vaccine placed a small sticker on the record, which indicates that the preparation that I received, Afluria®, was manufactured by CSL Biotherapies, an Australian company and a recent (2007) entrant into the US influenza vaccine market. Using a sticker obviously allows the medical center to purchase vaccine from different suppliers. I’ll be interested to know the supplier of the pandemic H1N1 vaccine.

The vaccine that I received is trivalent. It contains three different seasonal influenza virus strains: A/Brisbane/59/2007 (H1N1); A/Brisbane/10/2007 (H3N2); B/Brisbane/60/2008. The viral strains were propagated in embryonated hen eggs, inactivated with formalin, and disrupted with detergent.

The nurse who administered the vaccine asked me the following questions: “Do you have allergies to eggs or latex; are you taking coumadin; do you have a history of Guillain-Barré (which she mispronounced), do you have a fever”?  She also told me to put ice on the inoculation site if it became sore, that “all the antibodies I was going to develop would appear in 2-3 weeks”, and that any flu-like symptoms that result will last for a day or two.

While I waited, three other employees lined up for their immunizations. And they were giving out lollipops or tootsie rolls.

  • Margaret

    I've already gotten my seasonal flu shot, and am ready and willing for the swine flu shot as soon as I can get my hands on it! I have a question for the expert.
    Have there been any influenza vaccines in any year since they've been given, other than the 1976 swine flu vaccine of course, that contained any swine or avian flu parts? Since I understand this 2009 novel H1N1 is made up of a mix of elements of swine and avian influenza , and not just human influenza parts, I'd like to know, does this fact in itself make the vaccine any riskier than the usual seasonal flu vaccines? Does it make the effects less predictable?

  • http://www.virology.ws profvrr

    In answering your very interesting question, we'll just consider the
    HA and NA genes, which are typically the only ones present in the
    reassortants used to produce vaccine. The other RNAs are derived from
    a virus that produces high yields in eggs. The seasonal H1N1 vaccine
    that we have had since 1977 has HA and NA genes that originated in the
    1918 pandemic strain which came from birds. The HA and NA of the H2N2
    and H3N2 vaccines were also avian. The 1976 swine flu vaccine, and the
    2009 H1N1 vaccine, are the only vaccines to have swine-origin HA and
    NA genes. Indeed, the HA genes of the two vaccines are very similar -
    in fact if you received the 1976 vaccine you likely are protected
    against 2009 H1N1 influenza. Does this make the 2009 vaccine any
    riskier? If risk is based on scientific evidence, the answer is no. I
    know of no evidence that swine HA and/or NA genes predispose to
    Guillain-Barré, and I can't think of a reasonable mechanism to explain
    the association. I'm not worried.

  • gsgs

    I had tried to figure out, how much NA is in the vax.
    Emailed several producers, searched the web … invain.
    Invain.
    But I assume it is tiny, if any. It also degrades presumably.
    This had come up wrt. H5N1-protection : there had been a report
    by Webster et.al. that seasonal vax gave some protection against
    H5N1 (because of the N1, they thought)

  • David

    Vincent, any concerns that the seasonal shot you just got may actually increase your risk of being infected with 2009-H1N1? The Canadians think so and have even delayed their seasonal vaccination program based on this infamous yet-to-be-published study: http://www.cbc.ca/health/story/2009/09/23/flu-s

    David

  • albatross

    A related question is whether the swine flu vaccine is being rushed through the safety testing. I've seen this issue raised a few places, but I don't know enough to evaluate whether it's a concern.

  • http://djtechnocrat.blogspot.com/ Technocrat

    What happen to B/Florida/4/2006?

    According to the CDC – http://www.cdc.gov/flu/weekly/weeklyarchives200

    WHO and FDA have recommended that the 2008-09 trivalent influenza vaccine for the Northern Hemisphere contain A/Brisbane/59/2007-like (H1N1), A/Brisbane/10/2007-like (H3N2), and B/Florida/4/2006-like viruses.

  • http://djtechnocrat.blogspot.com/ Technocrat

    Sorry…wrong year. lol

  • http://djtechnocrat.blogspot.com/ Technocrat

    B/Florida/4/2006 replaced B/Malaysia 2506/2004 in 2008-09.

  • http://www.virology.ws profvrr

    The swine flu vaccine has not been rushed through safety testing. It has been given to thousands of volunteers before being licensed by the Food and Drug Administration. The technology used to produce the vaccine has been used to make influenza vaccines for 60 years and the safety record is excellent.

  • http://www.virology.ws profvrr

    I have zero concerns that the seasonal influenza vaccine would increase the severity of 2009-H1N1. There is no precedent for such an observation and no biological basis for it. Nevertheless, I haven't seen the data referred to in the Canadian study. Since it has been leaked during peer review it's not likely to originate from some of the more respected scientific journals. When it emerges I'll write about it on virology blog.

  • http://www.virology.ws profvrr

    NA is not standardized in the inactivated vaccine because the glycoprotein is labile during purification and storage. However there is an immune response to NA (albeit weak) so some must be present. You can probably find some information on NA in the vaccine on PubMed but it will take a good amount of searching.

  • pam goldman

    Hi. Just discovered your site and have a question. The current Novartis vaccine for seasonal flu contains, according to the informational insert in the box containing the vial of vaccine, 15 micrograms of influenza virus hemagglutin (HA) from each of the following 3 viruses: A/Brisbane/59/2007, IVR-148 (H1N1); A/Uruguay/716/2007, NYMC X-175C (H3N2); and B/Brisbane/60/2008.

    Is IVR-148 different from the current H1N1? If so, how?

    Also, what will the viral makeup of the current H1N1 vaccine be–will it, like the seasonal flu vaccine, contain several strains or only the H1N1?

    Thanks,
    Pam

  • http://www.virology.ws profvrr

    IVR-148 is a descendant of last season's seasonal influenza virus; it
    is significantly different from the 2009 H1N1 pandemic strain.
    Immunizing with IVR-148 will not confer protection against the 2009
    H1N1 strain. The IVR-148 H1 protein has been evolving in humans since
    1918 (with a gap between 1957-1977), while the 2009 H1 protein has
    been evolving in pigs from 1918 to 2009. There are two vaccines this
    year: a trivalent seasonal vaccine (your Novartis example), and a
    monovalent vaccine against the 2009 H1N1 pandemic strain.

  • perry

    I saw in a tv show a young lady who get sick with a danger daises after 10 days from taking the seasonal flu vaccine and i want to take the vaccine but scared because i have asma and im 32 year old female?

  • perry

    I saw in a tv show a young lady who get sick with a danger daises after 10 days from taking the seasonal flu vaccine and i want to take the vaccine but scared because i have asma and im 32 year old female?

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