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Flu vaccine effectiveness called 㽶Ƶֱdecent㽶Ƶֱ

Researchers find current vaccine 42 per cent effective against dominant H3N2 strain
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A nurse prepares prepares a syringe with influenza vaccine. (Black Press files)

TORONTO 㽶Ƶֱ This season㽶Ƶֱs influenza vaccine is estimated to have been more than 40 per cent effective in preventing illness with the dominant H3N2 viral strain in Canadians who got their shots, a national network of infectious diseases experts says.

The Canadian Sentinel Practitioner Surveillance Network determines vaccine effectiveness by analyzing how many inoculated people tested positive for the flu virus compared to those who were unvaccinated.

㽶ƵֱA vaccine effectiveness of 40 per cent against the H3N2 virus is decent,㽶Ƶֱ lead researcher Dr. Danuta Skowronski of the B.C. Centre for Disease Control said Thursday from Vancouver.

㽶ƵֱIt㽶Ƶֱs lower than we would like to see, particularly because H3N2 epidemics tend to be associated with more hospitalizations and deaths. But reducing the risk by 40 per cent is really important, not only at the individual level, but also at the population level when we tally the serious outcomes at the end of the season.㽶Ƶֱ

Young children, the elderly and people with underlying health conditions like heart disease are vulnerable to complications from flu; H3N2 flu is particularly hard on the elderly.

An effectiveness level of about 40 per cent means the risk of getting sick enough to require medical attention is almost cut in half, and Skowronski said that㽶Ƶֱs important for those at risk of complications.

This season㽶Ƶֱs vaccine, which contained components aimed at preventing illness from two A strains 㽶Ƶֱ H3N2 and H1N1 㽶Ƶֱ and a B strain, has been much better at protecting people than the 2014-15 shot, which was mismatched to the H3N2 genetic variant that ended up circulating that season.

The decision on which influenza strains 㽶Ƶֱ and which particular genetic variations of those strains 㽶Ƶֱ to target in an upcoming flu season is decided by the World Health Organization (WHO) each February, giving pharmaceutical companies time to produce the vaccine.

But in the intervening months, the viruses can genetically mutate, sometimes leading to such a mismatch as occurred in 2014-15.

Skowronski said vaccine effectiveness levels from Canada and other countries, as well as what genetic mutations might have occurred as the flu bug was passed from person to person over the season, help the WHO decide what strains next season㽶Ƶֱs vaccine should contain.

㽶ƵֱThere㽶Ƶֱs a lot of complexity to the influenza virus. We like to think of it as just a uniform beast, but it㽶Ƶֱs not. It㽶Ƶֱs constantly changing shape, it㽶Ƶֱs constantly evolving.㽶Ƶֱ

And from what the surveillance network is seeing, next season㽶Ƶֱs vaccine could very well be altered.

㽶ƵֱThere are quite a few emerging variants of H3N2 virus, by province,㽶Ƶֱ she said, noting that genetic decoding of virus samples in Alberta showed a lot of consistency, but B.C.㽶Ƶֱs cases presented a 㽶Ƶֱrainbow㽶Ƶֱ on a coloured bar graph. 㽶ƵֱOntario and Quebec are also showing a smorgasbord of viruses, compared to what Alberta was showing.

㽶ƵֱThis virus is dynamically evolving, real time, during the epidemic. So there㽶Ƶֱs variation 㽶Ƶֱ that㽶Ƶֱs showing up in this virus as it㽶Ƶֱs trying to evade the immunity in the population.㽶Ƶֱ

That variation was reflected in vaccine effectiveness in different regions of the country. In Alberta, where influenza activity started earliest and where there was a single dominant H3N2 variant, the shot㽶Ƶֱs effectiveness was estimate at about 60 per cent. In B.C., Ontario and Quebec, where flu activity was delayed and a greater mix of H3N2 genetic variants was detected, the estimate was about 30 per cent.

As of Jan. 28, 12,694 laboratory-confirmed influenza cases had been reported to the Public Health Agency of Canada, according to the most recent figures from its FluWatch report. However, that number represents the 㽶Ƶֱtip of the iceberg㽶Ƶֱ as most people who get a flu-like illness don㽶Ƶֱt seek medical attention, experts say.

There had also been 2,964 hospitalizations and more than 105 deaths, most of them among adults aged 65 or older.

Skowronski said H3N2 has been responsible for 95 per cent of flu cases this season, but the number of new infections with that viral strain has now begun to wane.

㽶ƵֱIt does look like generally we㽶Ƶֱve turned the corner on this H3N2 wave, we㽶Ƶֱre likely on the down slope of the epidemic curve 㽶Ƶֱ just,㽶Ƶֱ she said.

㽶ƵֱAnd now 㽶Ƶֱ we㽶Ƶֱre starting to pick up some influenza B activity 㽶Ƶֱ not much, but it㽶Ƶֱs starting 㽶Ƶֱ and we do often see a tail-end wave of influenza B, so now we㽶Ƶֱre waiting to ride that wave out to the end of the season.㽶Ƶֱ

The research was published online Thursday in the journal Eurosurveillance (http://eurosurveillance.org/).

㽶Ƶֱ Sheryl Ubelacker, The Canadian Press





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