1. INFLUENZA VACCINE Group 1 Zainab Ashfaq Bushra Abbas Ahtasham Danish

2. Introduction Influenza virus Type A and B viruses (seasonal flu outbreak) Type C flu virus (more stable and causes milder respiratory symptom) Inhale infected droplets or by touching virus gets absorbed According to CDC, 3,000 to 49,000 deaths and more than 200,000 hospitalizations per year in the U.S.

3. In winter Humidity of indoor air is very low Humans tend to be indoors Virus stay suspended in the air for prolonged periods

4. History 1918-19 30 million to 50 million died worldwide 1931 Egg culture viruses can be grown in eggs 1935 First egg Culture Vaccination (smallpox) 1935-41 First human influenza vaccines tested 1942-43 Extensive case studies at army posts 1946-47 Influenza strains change annually 1958 Cell Culture Madin-Darby Canine Kidney (MDCK) cell line developed for harvesting viruses 1960-present Cell cultures used for many vaccines, e.g, polio

5. 1979 Pandemic swine flu outbreak & 25% in U.S were vaccinated suffered a serious neurological condition 2005 U.S approved clinical development of cell culture–based influenza vaccines 2007 First licensed, Commercially distributed, cell culture–based influenza vaccine in Europe 2011 US government announced Novartis facility first to be pandemic ready 2012 FDA approves the first cell culture influenza vaccine

7. 2014-2015 Influenza Vaccine Composition Trivalent vaccines ( flu shot ) an A/California/7/2009 (H1N1)pdm09-like virus; an A/Texas/50/2012 (H3N2)-like virus; a B/Massachusetts/2/2012-like virus. Quadri-valent vaccines (nasal spray vaccine & flu shot) a B/Brisbane/60/2008-like virus.

8. IIV (inactivated influenza vaccine) i.IIV3 (egg-based and cell-culture-based trivalent inactivated influenza vaccines ) ii.IIV4 represents egg-based quadrivalent inactivated influenza vaccine. LAIV4 live attenuated influenza virus as quadrivalent RIV is recombinant hemagglutinin influenza vaccine available as a trivalent form (RIV3).

10. Side effects Most people have no side effects. If reported these are: Severe shoulder pain Abdominal pain Last for few hours, if happens Soreness, redness, swelling Fever (low grade) Nausea Wheezing

11. For nasal vaccine in particular the observed side effects are : Runny nose Headache Sore throat Cough

12. Vaccines in clinical trials  Novavax NCT01960686- RSV F  Novavax NCT00519389- H5N1  Fluarix Quadrivalent ( Glaxosmith)  FluLaval Quadrivalent(Glaxosmith)  Fluzone Quadrivalent (Sanofi Pasteur)  Fluzone Intradermal (Sanofi Pasteur)  Afluria ( BioCSL)  Fluvirin (Novartis)

13. Mode of delivery FLU SHOTFLU NASAL SPRAY Inactive viruses 6 months or older, higher dose for people above 65 years Injected into the muscle or just below the skin Trivalent vaccines Live weakened flu viruses Healthy people,2 years to 49 years Not recommended for pregnant women, children under 5 with regular wheezing problem, asthma patients Quadrivalent vaccines, trivalent vaccines with a recombinant viral strain RIV

14. Flu shotNasal vaccine

15. Dosage Every person should get a flu vaccine, people at higher risk should get once every year 9 year and older need one shot per year Children aged 6 months to 8 years need 2 shots a year, at least one month apart [if getting for a first time] For children first time vaccine should be in September-October

16. Who should not get the vaccine? Have a fever or illness that is more than "just a cold" Had a moderate to severe reaction after a previous flu vaccine Developed Guillain-Barre syndrome within 6 weeks after receiving a flu vaccineGuillain-Barre syndrome Allergies to chicken or egg proteins

17. Efficacy and Effectiveness Depends on Age and immunocompetence of the vaccine recipient Similarity between virus in vaccination and those in circulation

18. Duration of immunity 6 to 8 months particularly in non elderly population Longer if the circulating viral strains are antigenically similar to the vaccine strains Adults aged >65 years show diminished response to flu vaccine

19. Improvement recommendation 2013–14 U.S. trivalent influenza vaccines will contain an A/California/7/2009 (H1N1)–like virus, an H3N2 virus antigenically like the cell- propagated prototype virus A/Victoria/361/2011, and a B/Massachusetts/2/2012–like virus.

20. Quadrivalent vaccines will include an additional vaccine virus strain, B/Brisbane/60/2008–like virus. Vaccines will also contain the RIV recombinant strain

21. References http://www.cdc.gov/flu/about/season/vaccine-selection.htm http://www.cdc.gov/flu/about/qa/nasalspray.htm http://www.emedicinehealth.com/flu_vaccine/page2_em.htm http://www.webmd.com/cold-and-flu/flu-guide/what-causes-flu- viruseshttp://www.webmd.com/cold-and-flu/flu-guide/what-causes-flu- viruses http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6207a1.htm?s_c id=rr6207a1_w#InfluenzaVaccineEffectivenesshttp://www.cdc.gov/mmwr/preview/mmwrhtml/rr6207a1.htm?s_c id=rr6207a1_w#InfluenzaVaccineEffectiveness www.mayoclinic.org/drugs.../influenza-virus-vaccine.../drg- 20071452www.mayoclinic.org/drugs.../influenza-virus-vaccine.../drg- 20071452 http://www.patient.co.uk/doctor/influenza-vaccination

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