Improving influenza prevention: Why universal influenza vaccines are needed

Eva van Doorn

Research output: ThesisThesis fully internal (DIV)

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Vaccination is the most effective way to prevent flu. Currently, the flu vaccine has to be updated annually due to antigenic drift of the virus. Despite the yearly update, the vaccine effectiveness varies per season, per country, and even per influenza (sub)type/lineage. Efforts are being made to develop flu vaccines that give the population broad protection against multiple influenza virus strains (a ‘universal’ flu vaccine).
In this thesis the flu vaccine effectiveness is estimated over 11 seasons in the Netherlands. The effectiveness was particularly low when the vaccine did not match with the circulating viruses and when influenza A(H3N2) was the dominant virus subtype. The incorporation of an adjuvant can increase the efficacy of a flu vaccine. However, there should be an acceptable balance between the beneficial effects on the immune response and the risk adverse events. The safety and tolerability of adjuvants that are currently being tested in pre-registration clinical trials for (universal) influenza vaccines was evaluated. We advise caution especially when using Montanide ISA 51. In addition, we have investigated the differences in the approval procedure for a vaccine trial in five European countries. A more harmonized procedure is desirable, especially for multinational trials, since the differences in e.g. the documents that should be submitted and the submission procedure.
Finally, a clinical trial has been conducted to evaluate the immunogenicity and safety of a universal influenza vaccine (Multimeric-001, M-001). The vaccine was proven to be safe and able to increase CD4+ cells. Such an elevation is associated with less severe illness. Future studies are needed to assess the ability of M-001 to reduce the incidence of influenza infections.
Translated title of the contributionVerbeteren van influenza preventie: Waarom universele influenza vaccins nodig zijn
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • University of Groningen
  • Hak, Eelko, Supervisor
  • Huckriede, Anke, Supervisor
Award date26-Jan-2018
Place of Publication[Groningen]
Print ISBNs978-94-034-0303-8
Electronic ISBNs978-94-034-0302-1
Publication statusPublished - 2018

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