A major bump in the road to building broader, more durable vaccines may not be as much of a hurdle as scientists once thought, new research suggests.
In a study published Dec. 21 in PLOS Biology, a research team led by scientists from the University of Pittsburgh announced they had discovered that when some people receive a trivalent flu vaccine, they produce a type of antibody that overcomes a major viral hurdle to stave off both of the two dominant subtypes of the seasonal bug. By reverse engineering their immune responses, the researchers hope to develop broader, more durable flu vaccines.
Our immune system actually evolved to combat viruses, study lead Kevin McCarthy, Ph.D. told Fierce Biotech Research in an interview. If we understand how it evolved in those individuals who had very strong responses, then maybe we can help guide the evolution of everybodys immune system to make similar responses.
Flu vaccines currently target four subtypes of influenzatwo different flu A viruses known as H1 and H3. and two flu B viruses, which include a Yamagata lineage virus and a Victoria lineage virus. The specific strains from each type that the vaccine will protect against are selected based on predictions made with surveillance data from influenza centers around the world. While some years vaccines may carry over protection from the prior year, they generally need to be reformulated annually.
The vaccines work by prompting immune cells called B cells to generate antibodies against the selected strains. These antibodies bind to a protein on the surface of the virus called hemagglutinin, which normally helps the virus infect cells. Blocking hemagglutinin prevents the virus from getting inside. Hemagglutinin evolves over time, resulting in new flu strains. Researchers have been trying for years to figure out how to target multiple strainsspecifically, strains of both subtypes H1 and H3with a single antibody. While some antibodies with the H3 mutation can indeed target H1, theres a major caveat: If the H1 antibodies have a mutation in their hemagglutinin called the 133a insertion, the H3 antibodies wont recognize them.
But as it turns out, humans can produce antibodies that circumvent the 133a insertion and protect against H3 and H1 strains, as McCarthys lab found in their new study. Using blood taken from donors before and after they received a flu vaccine, the researchers collaborated with scientists from Johns Hopkins University to examine individual B cells and the antibodies they produced, then profile the antibodies in a high-throughput fashion, McCarthy explained.
The results contained an exciting discovery: Two of the donors produced antibodies to H3 and H1 with or without the 133a insertion. Intriguingly, they were also around the same age, with similar histories of exposure to the flu: Both were children in the early 1990s, and both had antibodies that bound strongly to H3 strains from the decade. Their antibodies also contained an adaptation that allows the flu virus to grow better in chicken eggs, one of the flu vaccine manufacturing processes.
Their history may have led to a "jackpot event," as McCarthy described it.
Its really tempting to speculate that these people were infected as kids before childhood vaccination with the flu was really a thing, and then the vaccines came in with this adaptation and elicited a very strong response, McCarthy explained. I think what it shows is that the proper series of events are capable of eliciting similar antibodies quite strongly, and so that gives us a clue for how one can figure out ways to improve vaccines.
Notably, the finding is not a step toward a universal flu vaccine, a goal of many researchers and biotechs. In fact, it may be evidence that targeting hemagglutinin alone is unlikely to be enough to create a vaccine against all strains of the flu, McCarthy said.
An important point of this is that probably no single antibody or one single site on the flu hemagglutinin protein is going to be sufficient to have a universal vaccine, he said. So what we found here expands the repertoire of possibilities of antibodies that can engage different subtypes of influenza.
Next, the researchers plan to take what theyve learned from the donors and use it trace the events that resulted in the development of these antibodies.
Were trying to also characterize broad antibody responseswhich we can then use to rationally design vaccines that will elicit very strong responses simultaneously to multiple sites across the molecule, McCarthy said.
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With the influenza season in full swing, public health officials are still urging anyone who is eligible to get the vaccine.
Greene County Public Health Director Becky Wolf says the flu vaccine is available at several locations, including pharmacies, primary care physicians and at public health. She tells Raccoon Valley Radio about the flu vaccine and what it is designed to protect against.
Your vaccine for flu, its called quadrivalent. So its two Type A (Influenza) and two Type B (Influenza). Your Type B are more milder symptoms of influenza (and) Type A is pretty nasty.
Wolf talks about why it is important for eligible individuals to get a flu vaccine.
Were trying to create a community blanket of protection because we know there are certain people that cannot get the flu vaccine. So we want to create herd immunity and that means that we get as many people vaccinated as possible to blanket the people that cant get it.
Wolf reminds everyone it takes two weeks for the vaccine to take full effect. Call Greene County Public Health at 515-386-3228 to schedule an appointment to get a flu vaccine.
A COVID-19 and influenza vaccine on Thursday, Sept. 28, 2023 in Everett, Washington. (Olivia Vanni / The Herald)
EVERETT Flu season is about to hit its peak, health officials say. But its not too late to get vaccinated.
Earlier this month, local hospitals and clinics tightened mask policies to prevent spread of the big three respiratory viruses: COVID, influenza and respiratory syncytial virus, or RSV. Snohomish County saw a rate of 27 new COVID cases last week, continuing a trend of low-to-medium transmission in the county. But rates for flu and RSV the leading cause of infant hospitalization are rising.
Flu is just getting started, county Health Officer James Lewis said. It will likely peak in the next few weeks.
Just over 15% of people in Washington have been vaccinated with the latest COVID shot. About 16% of seniors have been vaccinated against RSV. And the flu vaccination rate was 27%, as of Friday.
Snohomish Countys vaccination rates are comparable to those statewide. In general, fewer people have been vaccinated this flu season lasting from about October to March than the previous three. Nationwide, adult flu vaccinations are around 8 million doses behind last seasons rate, insurance claim data show. Flu shots in children are down around 5% from last season.
The Centers for Disease Control and Prevention issued a health advisory last week regarding low vaccination rates and a strain on hospitals across the United States. Hospital stays for respiratory virus infections increased nationwide over the past month: 200% for flu, 51% for COVID and 60% for RSV.
In Snohomish County, people with COVID were visiting the emergency department at a rate of 1.7%, below a transmission alert threshold of 3%. Flu and RSV emergency visits were above the thresholds for those viruses. The latest flu rates were recorded at 2.2%, compared to an alert threshold of 1%. RSV rates were at 0.9%, with a threshold of 0.3%. These visit rates resemble statewide trends.
Providence Regional Medical Center Everett saw flu and RSV cases double over the past two months, hospital records show.
Providence Swedish recommends that everyone remain vigilant in protecting themselves and their loved ones from respiratory viruses through vaccination, spokesperson Erika Hermanson said.
Hospitals in the county have worked at high capacity for years, Lewis said, but it gets worse during flu season. People can reduce hospital strain by getting vaccinated, masking in crowded indoor spaces and limiting emergency visits when possible. Nurse call lines can help people determine if they need to visit the emergency room. The Everett Clinic, Providence and most health insurance companies have nurse lines.
Though COVID case rates in the county have remained lower than last year, the virus remains more deadly than flu or RSV. Since October, 297 people have died from COVID in Washington. Fewer than 10 people in the state have died from the flu or RSV.
Folks want to say the pandemic is over, Lewis said. Whatever terminology you use, the pathogen is still around. Its a strain on our health care system, and its causing mortality.
Have you gotten vaccinated this year against COVID and the flu?
The fastest-growing COVID variant in the United States is JN.1, a descendant of the BA.2.86 variant, known as Pirola. JN.1 made up 29% of infections nationwide in the past two weeks, up from 8.8% in November, according to the CDC. This years COVID vaccine, designed to protect against variants EG.5 and BA.2.86, is also said to be effective against JN.1.
People may avoid a vaccine because they think it can cause illness, Lewis said. Thats a myth.
Its impossible, he said. The vaccine does not contain the whole virus and cant cause disease. But someone may get sick with another virus around the same time they get their vaccine.
The risk of severe illness and death is much higher for those who are unvaccinated, said Yuan-Po Tu, medical director for disease and outbreak response at Optum Pacific Northwest. In addition, vaccines are better at protecting against severe illness than immunity from a natural infection, he said.
This year marks the first available RSV child immunizations and vaccines recommended for pregnant people and seniors. The United States has seen a shortage of child immunizations due to underestimated demand and supply chain issues, Lewis said, but more are on the way.
The flu and COVID vaccines, recommended for everyone 6 and older, are safe to get at the same time. The latest COVID vaccine can cost over $100, but most insurance companies cover it. Free vaccines for adults can be found through the federal Bridge Access Program. Vaccines for Children providers vaccinate under- or uninsured children.
Lewis said testing and treatment resources for COVID at the county and state level have all but dried up.
Theyre really going away unfortunately, he said. I recommend people check costs with providers ahead of time.
People can still apply for free tests from the federal government. Under- or uninsured people can apply for free Paxlovid treatment.
Tu, who worked on the original COVID nasal swabs for testing, said he trusts the accuracy of home tests. The federal Food and Drug Administration has found home tests consistently detect COVID regardless of the variant. Since home tests are less sensitive to the virus than more expensive tests, Tu said, they may show a false negative at the very onset of an infection. If someone thinks they may have COVID but test negative, they should test again.
Amid a recent spread of respiratory illness in dogs, some may be concerned about infecting their pets with COVID. While this can happen, Tu said its uncommon.
We dont typically test Snoopy, Tu said. But Charlie Brown would say, If youre sick, dont kiss your dog.
Flu season resources:
State vaccine locator;
Federal vaccine search by zip code. Text zip code to GETVAX (438829);
Personal vaccination records;
Bridge Access Program for adult vaccines;
Vaccines for Children providers;
Free tests from the federal government;
Paxlovid for the under- or uninsured;
State testing and treatment resources; and
County reports on flu, COVID and RSV.
Sydney Jackson: 425-339-3430; sydney.jackson@heraldnet.com; Twitter: @_sydneyajackson.
Flu cases have been increasing in Texas since mid-October. Health officials encourage people to get vaccinated against the flu, along with other respiratory viruses like RSV and COVID-19, to prevent the spread during the holidays.
Lets spread joy, love, happiness, said Willie Underwood, the board chair of the American Medical Association. Lets have opportunities with our friends and families. Lets travel, and not be on a plane or a train and giving multiple people the flu at the same time. Best way to do that is to get vaccinated.
Like the COVID-19 vaccine, it takes about two weeks after getting a flu shot to develop immunity to the virus.
The flu is especially harmful to infants, people 65 years and older, and people who are pregnant. Since October, more than 1,300 Texans have died from the flu and pneumonia, according to data from the Texas Department of State Health Services. That includes 1,000 people 65 and older.
The flu can kill you, and it can lead to you being hospitalized, Underwood said. It can lead to you missing out on family events, missing work, missing opportunities. So, the goal is to prevent that.
The number of flu vaccinations given this year is lower nationally now than in both 2021 and 2022. The U.S. Centers for Disease Control and Prevention (CDC) reports 152 million flu vaccine doses have been distributed since Dec. 2.
Chris Parker, associate director for field services with the CDCs National Center for Immunization and Respiratory Diseases, said flu season peaks between December and February. The CDC recommends everyone be vaccinated by late October, but its not too late to get the vaccine now.
As we approach the peak season, its important that everyone who hasnt done so, get their flu shot to protect themselves, their family members and also our communities, Parker said.
Texans can find more information about flu shots near them by visiting GetMyFluShot.org.
Got a tip? Email Elena Rivera aterivera@kera.org
KERA News is made possible through the generosity of our members. If you find this reporting valuable, considermaking a tax-deductible gift today.Thank you.
TAMPA, Fla. MoneeVongsalathas her hands full.With twoyoung daughtersand a career, the flu is one stress she wants to cross off her list.
I choose to get the flu shot for my kids every year, Vongsalat said. My girls go to daycare and then I work around a lot of different people, in and out of homes. So, Im just trying to protect them as much as I can.
Credit: 10 Tampa Bay
Monee Vongsalat and her daughters
But as flu cases are going up, the number of people getting the flu shot is going down.
Centers forDiseaseControl and Preventiondatashows Americans are lagging in getting flu vaccines, compared to previous flu seasons.
Unfortunately,wereseeing fewer people come in for flu shots. And I think a lot of it is related to ourpast experienceduring COVID, during the pandemic, when there were lots of questions and concerns about vaccines,saidDr. Nichelle Threadgill, Chief Medical Officer atEvaraHealth.
According to CDC data, since the end of October,healthcare providers have given fewer vaccines per week than during those same weeks in thepreviousfour seasons.
Credit: CDC
CDC data on flu shot doses
Things are likely to get more significant and more severe especially after we think about the period after Christmas, when everyone's been getting together at home, at church, at parties, CDC Principal Deputy Director Dr. Nirav D. Shah told 10 Tampa Bay.
That creates particular concern for people of color, who are less likely to get vaccinatedandmore likely to experience serious health outcomes from the flu.
People of color often experience a lot of conditions a lot more severely, she said.A lot of it is related to baseline health. A lot of it is related to socioeconomics and access to healthcare. A lot of it is related to willingness to report conditions because of distrust in the medical system.
According to the CDC,itssafe to get your flu, COVID and RSV shots at the same time.All three infections are on the rise right now.Itwill take about two weeks beforeyourefully protected.
A newly discovered class of antibodies in human blood can neutralize different types of the flu virus and could be key to the development of broadly protective vaccines against the seasonal viruses, scientists say.
Circulating flu viruses constantly mutate, so "we need annual influenza virus vaccines to keep pace with continuing viral evolution," the researchers behind the discovery said in a statement. "Our work suggests that the barriers to eliciting more broadly protective immunity may be surprisingly low," they said.
There are four types of flu virus, known as influenza A, B, C and D, with A and B being responsible for the seasonal flu epidemics in the U.S. every year.
Influenza A comes in many subtypes whose differences lie in two proteins that the virus uses to infect our cells: hemagglutinin (H) and neuraminidase (N). For example, H1N1 and H3N2 are subtypes of influenza A that routinely infect people.
Within each subtype are different "strains" that constantly tweak their genetic code. For example, a strain of H1N1 is currently the dominant virus causing flu in the U.S. Influenza B, meanwhile, is divided into two lineages Yamagata and Victoria and is typically responsible for a much smaller proportion of flu cases.
Making effective flu shots relies on harnessing the protective power of antibodies immune proteins that attack invading pathogens but the virus' ability to quickly mutate makes this challenging. Flu vaccines prime the immune system to produce specific antibodies that latch onto a flu virus and prevent it from infecting cells after it invades the body. However, these vaccines are formulated to target specific strains, and because those strains mutate year over year, people then need a new flu shot each year to keep up.
Related: 'Long flu' is real, and we've likely 'ignored it for a long time'
In the new study, published Thursday (Dec. 21) in the journal PLOS Biology, scientists described a newfound class of antibodies in human blood samples that target multiple forms of the influenza A virus.
The research was conducted only in the lab, so the scientists aren't sure exactly how these antibodies contribute to the body's flu shot response. However, one day, these antibodies could be used to develop vaccines that are more effective at protecting people from multiple strains of flu at the same time.
To guard against influenza A, conventional flu vaccines usually prompt the immune system to produce antibodies against the H protein on the surface of the virus. Antibodies have previously been discovered that target two main types of hemagglutinin, called H1 and H3, at the same time. However, they can only do this if there is a specific mutation in H1, namely the insertion of an amino acid in the outer edge of the protein that binds to a receptor on the outside of our cells. This consequently limits the antibodies' efficacy against different flavors of flu virus.
Through lab experiments, the study authors identified antibodies that are abundant in human blood and can bind to certain H1 and H3 strains of influenza A, whether or not this hemagglutinin mutation is present. This means that they'd theoretically be able to provide broad protection against both subtypes of virus, potentially even as circulating strains mutate over time.
The authors also looked at how well these antibodies targeted strains of H1 and H3 that have circulated in the past. The antibodies reacted with H3 strains from the late 1980s to late 1990s and H1 strains from the early 2000s through to 2015.
This suggests the patients whose blood was sampled originally made the antibodies in response to H3 strains of the virus. Then, after a later exposure to H1 strains at a later date through either infection or vaccination, the antibodies became primed to target H1 as well.
These findings may have important applications for future vaccine design.
"Given the right series of influenza virus exposures/vaccinations, it is possible for humans to mount robust antibody responses that neutralize divergent H1N1 and H3N2 viruses, opening new avenues to design improved vaccines," the authors said in the statement.
In other words, there may be a way to ensure vaccines trigger the production of these broad-acting antibodies, to ensure the shots guard against both subtypes of the virus equally well.
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Researchers have identified a previously unrecognized class of antibodiesimmune system proteins that protect against diseasethat appear capable of neutralizing multiple forms of flu virus. These findings, which could contribute to development of more broadly protective flu vaccines, were published by Holly Simmons of the University of Pittsburgh School of Medicine and colleagues in the open access journal PLOS Biology.
A flu vaccine prompts the immune system to make antibodies that can bind to a viral protein called hemagglutinin on the outside of an invading flu virus, blocking it from entering a person's cells. Different antibodies bind to different parts of hemagglutinin in different ways, and hemagglutinin itself evolves over time, resulting in the emergence of new flu strains that can evade old antibodies. New flu vaccines are offered each year based on predictions of whatever the most dominant strains will be.
Extensive research efforts are paving the way to development of flu vaccines that are better at protecting against multiple strains at once. Many scientists are focused on antibodies that can simultaneously protect against flu subtypes known as H1 and H3, which come in multiple strains and are responsible for widespread infection.
Simmons and colleagues homed in on a particular challenge in this endeavora small change found in some H1 strains in the sequence of building blocks that makes up hemagglutinin. Certain antibodies capable of neutralizing H3 can also neutralize H1, but not if its hemagglutinin has this change, known as the 133a insertion.
Now, in a series of experiments conducted with blood samples from patients, the researchers have identified a novel class of antibodies capable of neutralizing both certain H3 strains and certain H1 strains with or without the 133a insertion. Distinct molecular characteristics set these antibodies apart from other antibodies capable of cross-neutralizing H1 and H3 strains via other means.
This research expands the list of antibodies that could potentially contribute to development of a flu vaccine that achieves broader protection through an assortment of molecular mechanisms. It also adds to growing evidence supporting a move away from flu vaccines grown in chicken eggscurrently the most common manufacturing approach.
The authors add, "We need annual influenza virus vaccines to keep pace with continuing viral evolution. Our work suggests that the barriers to eliciting more broadly protective immunity may be surprisingly low. Given the right series of influenza virus exposures/vaccinations, it is possible to for humans to mount robust antibody responses that neutralize divergent H1N1 and H3N2 viruses, opening new avenues to design improved vaccines."
More information: Simmons HC, Watanabe A, Oguin III TH, Van Itallie ES, Wiehe KJ, Sempowski GD, et al. (2023) A new class of antibodies that overcomes a steric barrier to cross-group neutralization of influenza viruses. PLoS Biology (2023). DOI: 10.1371/journal.pbio.3002415
Journal information: PLoS Biology
Flu season is here once again. And many questions have formed over the last couple of years about how you can stay safe from both the influenza (flu) and COVID-19 viruses, as well as how to tell if your symptoms may be caused by seasonal allergies or a different virus instead.
UChicago Medicine infectious diseases experts are here to help address your concerns and offer up some key advice on how to stay safe this season.
Below, Allison Bartlett, professor at University of Chicago Medicine and associate medical director of pediatric infection control, answers commonly asked questions.
Either virus can make you very sick or lead to death, which is why its essential to get vaccinated and also to avoid close contact with others when sick. There are definitely populations that are more at risk for severe complications from each infection. Older adults and people with chronic underlying health conditions seem to be much more likely to get severely ill with COVID-19. And kids, especially infants under 1, and pregnant women are more likely to have severe infections with influenza.
Unfortunately not. Having one virus does not protect you from the other.
The best way to tell what kind of respiratory virus you have is to get tested. Symptoms can be nearly impossible to tell apart. This is especially true between COVID-19 and the flu, with the notable exception that some people with COVID-19 lose their sense of taste and smell. Add in the fact that people can have one of these two viruses without symptoms, and its basically impossible to tell one from the other on your own.
Testing determines the best treatment for your symptoms and how long you should stay home from work or school. The good news is that many health care providers who are doing coronavirus tests should be able to test you for the flu at the same time. There are many other viruses that can cause respiratory symptoms, so even if you test negative for COVID and flu, you should practice good respiratory hygiene: cover your cough, throw tissues away after use, wash your hands frequently.
Many of the steps we take to protect ourselves from the coronavirus are the same things we need to do to keep us safe from influenza. The most important thing you can do to keep yourself and those around you safe from both viruses is to stay up-to-date on your COVID-19and flu vaccinations.
You should get a flu shot even if youve already had the flu this season. The vaccine prevents against four different strains of the virus and we expect at least one more (Flu B) to be circulating later this season.
Practicing these good habits is also a great way to stay healthy:
The flu shot can help prevent people from becoming sick from influenza but wont provide specific protection against COVID-19. And the COVID-19 vaccine alone will not prevent you from getting the flu. It is strongly recommended that you receive both vaccines for maximum protection.
Tamiflu or a flu shot will not directly treat or lessen the symptoms of COVID-19. But you can get vaccinated against the flu and COVID-19, which can help prevent an infection and lessen severity. And if you get sick with influenza or have been exposed to it, you can take antiviral medication like oseltamivir (Tamiflu) to prevent getting sick.
COVID-19 treatment options are available and vary depending on the severity of your symptoms and health history. Antiviral treatments can help prevent the virus from spreading and avoid serious illness.
If you have any symptoms, stay home, stay away from other people and try to isolate yourself to prevent the spread to others. Try to get tested within 48 hours of the start of your symptoms.
If its influenza, your health care provider can prescribe medication to help your symptoms improve faster.
If its COVID-19, your health care provider may recommend one of the treatment options referenced above.
The pneumonia vaccine helps protect against a variety of bacteria that can cause bacterial pneumonia. The pneumonia vaccine wont prevent flu or COVID-19, but it can help prevent complications that may come after.
We wish there were a list of things we could do to help our immune systems prevent us from getting sick with the flu or the coronavirus. But theres no magic immune-boosting drug only vaccination. Instead, focus on eating a healthy, varied diet and getting enough sleep. Also, make sure youve got any chronic medical conditions under control.
Once an exposure to COVID-19 has happened, theres not a lot we can do to modify who gets sick from it. If you have been exposed to influenza, your physician may give you some medication like Relenza (zanamivir), Tamiflu (oseltamivir) and Rapivab (peramivir) within 48 hours of exposure. However, the best thing you can do is focus on avoiding exposure.
In 2023, there are finally ways to protect infants and loved ones from RSV during virus season. Nirsevimab is a newly-approved, one-time injection that provides immediate protection to infants 0 to 8 months old and reduces risk of RSV-related hospitalization significantly. All infants born at Comer Childrens and Ingalls Memorial during RSV season will be offered this injection. Infants less that 8 months old at the start of RSV season can receive nirsevimab from their pediatrician and it can be given along with other routine immunizations.
UChicago Medicine is also offering two newly approved RSV vaccinations to eligible adults. A vaccine known as Abrysvo is available to pregnant individuals between their 32nd and 36th weeks. UChicago Medicine patients over 60 can also receive an RSV vaccine known as Arexvy. These adult vaccinations are available duringphysician office visits and both provide key protection for those at highest risk of severe RSV symptoms.
Note: Information in this article was accurate at the time of original publication. Because information about COVID-19 changes rapidly, we encourage you to visit the websites of the Centers for Disease Control & Prevention (CDC), World Health Organization (WHO), and your state and local government for the latest information.
As cold winter weather drives people indoors and flu, colds, and other seasonal respiratory viruses circulate, SARS-CoV-2, the coronavirus that causes COVID-19, has continued to mutate and spread. The latest strain to attract attention is called JN.1, and so far, it appears to be highly transmissible.
It can be difficult, if not impossible, to predict the evolution of the coronavirus and its descendants. But the Centers for Disease Control and Prevention (CDC) projects that JN.1 cases will increase through the winter. The World Health Organization (WHO) also declared JN.1 a variant of interest.
We dont know much about this new subvariant just yet, says Heidi Zapata, MD, PhD, a Yale Medicine infectious diseases specialist.
There are other subvariants, too, including HV.1, which in early December was the dominant strain in the United States, causing over 29% of cases, more than any other subvariant. (EG.5, which had been the dominant strain since the summer, dropped to second place in November and, by mid-December, accounted for less than 10% of cases. HV.1 is an EG.5 descendant and is considered to be similar to it.)
So far there is no evidence that JN.1 causes more severe cases of COVID or poses any more of a risk to public health than other circulating variants, the CDC says.
At the same time, COVID cases are rising, notes Dr. Zapata. I would say the most important thing for people to know is that the virus is out there, as are respiratory syncytial virus [RSV] and the flu, she says. Any new subvariant is a sign that the SARS-CoV-2 virus is still evolving; its still here with us, and we cant ignore it.
Here, Yale Medicine answers three questions about JN.1.
