Category: Flu Vaccine

Metabolic health (normal blood pressure, blood sugar and cholesterol levels, among other factors) influences the effectiveness of influenza vaccinations. Vaccination is known to be less effective in people with obesity compared to those with a healthier body mass index (BMI), but St. Jude Children's Research Hospital scientists have found it is not obesity itself, but instead metabolic dysfunction, which makes the difference. In a study published today in Nature Microbiology, the researchers found switching obese mice to a healthy diet before flu vaccination, but not after, completely protected the models from a lethal dose of flu, despite BMI.

We found that the vaccines worked effectively if at the time of vaccination an animal is metabolically healthy. And the opposite was also true: Regardless of what the mice looked like on the outside, if they had metabolic dysfunction, the vaccines did not work as well."

Stacey Schultz-Cherry, PhD, corresponding author, St. JudeDepartment of Host-Microbe InteractionsandCenter of Excellence for Influenza Research and Responseco-director

Prior research has shown that when exposed to influenza virus, even after vaccination, 100% of obese mice succumbed to disease. Contrary to the scientists' original expectations, when mice who were vaccinated while obese returned to a healthy weight, outcomes did not improve. These now outwardly healthy mice still all succumbed to disease when exposed to the real virus. Only switching to a healthy diet four weeks before vaccination improved survival, with drastic effect, despite high BMI.

"We were excited to see this effect because mice with obesity are so susceptible to severe disease and succumbing to the infection," Schultz-Cherry said. "Getting 100% survival with the vaccine where we had only seen 0% survival was impressive." The improved survival suggests the researchers have discovered a greater underlying principle determining influenza vaccine efficacy.

While studying how metabolic function influences influenza vaccine responses, the scientists found that poor metabolic health causes immune system dysfunction. T cells, the primary immune cells involved in anti-viral responses, failed to act in animals that had been in an unhealthy metabolic state at the time of vaccination, even during later viral exposure. Even when the animals ate a healthy diet after vaccination and maintained a normal BMI, the anti-flu T cells were "frozen" in that dysfunctional state.

However, a healthy diet before vaccination improved T-cell function, which resulted in a robust anti-flu response during later exposure.

"The T cells were better able to do their job in the metabolically healthy mice at the time of vaccination," Schultz-Cherry said. "It wasn't a matter of the numbers of them or the types of them. It was their functional activity. There were plenty of them in the lungs, not working. The healthy diet switched them from not working to functioning properly, but only if the switch occurred before vaccination."

The earlier healthy diet also improved inflammation. Pro-inflammatory cytokines are upregulated in obese animals. Schultz-Cherry's team found that models also returned to a lower basal cytokine level when switched to a healthy diet before vaccination.

"A healthy diet lowered some of the systemic meta-inflammation in these animals, and they regained some of the epithelial innate immune responses," said Schultz-Cherry. "We started seeing better signaling of things like interferons, which we know is problematic in obesity and in general saw the immune system starting to function the way that it should."

"What we found and are emphasizing is that it's not the phenotype of obesity that matters; it's really about metabolic health," Schultz-Cherry said. "It's metabolic health at that moment of vaccination that really makes a difference."

The study was restricted to mice, but it does open research opportunities to improve influenza vaccine efficacy in humans. The findings suggest methods of improving metabolic health may also improve subsequent influenza vaccinations. Given the recent introduction of metabolic improvement drugs, especially glucagon-like peptide 1 (GLP-1) agonists, there may be potential for a cooperative effect.

"We don't know for sure, but if the outcome of using GLP-1 drugs is weight loss and improved metabolic health, we would hypothesize that it will help," Schultz-Cherry said. "But we do know that we can do better protecting our vulnerable populations, and this study is a start for understanding how."

The study's co-first authors are Rebekah Honce, formerly of St. Jude, and Ana Vazquez-Pagan, formerly of the St. Jude Graduate School of Biomedical Sciences.

The study's other authors are R. Chris Skinner, University of Vermont, Brandi Livingston, Alexandra Mandarano, Benjamin Wilander, Sean Cherry, Virginia Hargest, Bridgett Sharp, Pamela Brigleb, Ericka Kirkpatrick Roubidoux, Lee-Ann Van de Velde, Maureen McGargill and Paul Thomas, St. Jude.

The study was supported by grants and contracts from the National Institute of Allergy and Infectious Diseases (HHSN27220140006C, 75N93019C00052, 75N93021C00016, F31AI161986, R01 AI140766-03 and 32AI106700-07) and ALSAC, the fundraising and awareness organization of St. Jude.

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Journal reference:

Honce, R., et al. (2024). Diet switch pre-vaccination improves immune response and metabolic status in formerly obese mice.Nature Microbiology. doi.org/10.1038/s41564-024-01677-y.

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Metabolic health determines effectiveness of influenza vaccination - News-Medical.Net

A recent study published in the journal Nature Communications observed antibody breadth and effector functions as important immune correlates that can be used to develop universal influenza vaccines. This vaccine could be effective against all influenza virus strains, even those having pandemic potential.

Study: Influenza antibody breadth and effector functions are immune correlates from acquisition of pandemic infection of children. Image Credit:Africa Studio / Shutterstock

Children are particularly vulnerable to influenza viruses that cause seasonal epidemics and sporadic pandemics. Seasonal influenza epidemics not only lead to an upsurge in hospital admissions but also increase mortality rates in older adults with comorbidities. Many studies have shown that seasonal influenza vaccines provide limited protection against influenza viruses that have the potential to cause a pandemic. However, the 2009 H1N1 pandemic (pH1N1) revealed the effectiveness of seasonal vaccines in protecting children and older adults from the infection. This protection could be due to cross-reactive antibody responses.

Compared to children, adults possess additional immune correlates, such as T-cell responses and non-neutralizing antibody functions. This is the reason why children require higher concentrations of HAI antibodies for an equivalent amount of immune protection from the infection. To design a next-generation vaccine, it is important to identify immune correlates of protection. In the context of pH1N1 infection, HA-stem-specific antibodies play a crucial role in providing protection, which is mediated by the Fc Receptor (FcR) function.

Some antibodies that can cross-react between pandemic, seasonal, and avian influenza viruses could reduce the severity of influenza virus infection. In this context, serum antibodies, particularly IgG, can facilitate effector functions, such as directing immune cells to kill infected cells, engulfing infected cells via antibody-dependent phagocytosis (ADCP), and promoting antibody-dependent cellular cytotoxicity (ADCC). These functions are mediated by Fc gamma receptors (FcR) 3a and FcR2a.

Mechanistically, FcR 3a and FcR2a employ macrophages and natural killer (NK) cells to remove viruses-infected cells. Cross-reaction of ADCC antibodies has been associated with targeting conserved antigenic sites of influenza virus hemagglutinin (HA), the Nucleoprotein (NP), and Matrix 1 (M1).

The current study identified several gaps in research regarding antibody effector functions. For instance, few studies have assessed the vaccine-induced ADCC changes, longitudinal durability of vaccine-induced antibody FcR binding and isotype changes, and the alterations in HA-specific antibody responses with vaccination and infection. The currently performed randomized placebo control trial (RCT) investigated the influenza-specific antibody breadth and function of seasonal (S1) H1N1 vaccination and pH1N1 infection.

The antibody features, particularly HAI titer, from seasonal vaccination that could have helped in reducing or delaying contraction of pH1N1 were assessed using selected archived samples. These samples were collected from NCT00792051, a randomized placebo-controlled trial and its follow-up study that used school children between 6 and 17 years old.

A subset of children who received any influenza vaccination in Year 1 (V1) or not (placebo-V0) was selected for secondary analyses, which helped determine the effectiveness of vaccination against pH1N1 infection.

The current study indicated that non-neutralizing antibodies are highly cross-reactive between different influenza strains and subtypes, which could play an important role in reducing the incidence and severity of infection.

Detecting antibody functions other than HAI is vital to developing next-generation vaccines. This study identified the serological correlates that play an important role in protecting children from pandemic infection. In 2009, when schools were closed for two months, H1N1 transmission was low. However, soon after schools reopened in September 2009, more than 50% of the students were infected within a few months. A very low community uptake of the monovalent pH1N1 vaccine has been documented.

The half-life of different antibody subclasses alters significantly. The current study observed that seasonal vaccination enhances Fc effector functions of pH1N1 specific NP, HA, and neuraminidase (NA) antibodies. However, their function was short-term as it waned off within one year of vaccination. A greater antibody decline was observed in unvaccinated children.

Seasonal vaccination did not boost FcR effector functions to other seasonal-specific antibody responses. Unvaccinated, uninfected children also exhibited increased FcR-mediated effector functions of pandemic-specific NA, HA, and NP antibodies. These children displayed a higher antibody level of NK cell function. pH1 antibodies against H3-HA responses were associated with cross-reactive avian H5-specific IgG, FcR2a, and FcR3a responses. This finding implies that cross-reactive responses are less focused and are not trained by seasonal virus exposure of other groups.

Considering the experimental results, vaccination and prior infection are not associated with the lack of infection in unvaccinated, uninfected children or susceptibility of V1S1 children. More research is required to understand the host factors leading to these outcomes.

Results also indicated that group 2 H3 HA-specific IgG3 antibodies are negative predictors of infection. However, seasonal H1 and pH1-IgG3 antibodies before infection were positively associated and, therefore, protected against infection.

This study shows how universal influenza vaccines, effective against seasonal to pandemic viruses, can be developed. Antibody breadth and FcR effector functions are two important immune correlates that could be exploited to develop this vaccine.

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Study shows potential for universal flu vaccine with broad antibody response - News-Medical.Net

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Researchers are pitching a new vaccine method for infants that offers continued protection with just a single dose, even if the virus mutates, according to a new study that could set the stage for universal vaccines.

A patient getting vaccine.

Vaccines for diseases like the flu are updated annually to accommodate for new variants, while vaccines for some diseases like COVID-19 are updated less frequently to target dominant variants of the virus circulating in the U.S.

There are different ways to create vaccines, but one of the most popular ways to make them is by including a weakened or inactive version of the virus, which in turn causes the bodys immune system to produce T-cells that attack the virus and prevent it from spreading.

This new vaccine strategytested on micealso uses a modified version of a virus, but instead of relying on the bodys immune system response, it uses small interfering RNA molecules (siRNA), which stop the spread of disease, to create separate vaccines that target different diseases, according to a study published Monday in the Proceedings of the National Academy of Sciences.

Diseases thrive because they produce a protein that can block the production of siRNAs, but the new vaccine strategy creates and uses a mutant virus that cant produce these proteins, which allows the bodys siRNAs to weaken the virus, regardless of if it mutates and makes a new variant.

The research team from the University of California, Riverside, believes because this strategy doesnt rely on the bodys immune response to disease, it will also be suitable for babies, whose immune systems are still developing.

The researchers tested this method in baby mice and discovered they also produce siRNA, so they vaccinated them against a mouse disease called Nodamura, and they found the vaccine induced rapid and complete protection against the virus.

It is broadly applicable to any number of viruses, broadly effective against any variant of a virus and safe for a broad spectrum of people, Rong Hai, a study author and virologist at the University of California, Riverside, said in a statement. This could be the universal vaccine that we have been looking for.

Though there are some approved vaccines for infants, vaccines for diseases like measles, COVID-19 and the flu can only be administered to people over the age of six months. This is because of their immature immune systems that cause a diminished response to these vaccines, and a potential lack of effectiveness, according to a study published in Vaccine. However, this group of people is one of the most susceptible to severe infection. Infants younger than six months have the highest risk of being hospitalized due to flu infection, according to the Centers for Disease Control and Prevention. In order to protect this population from infection, its recommended that all household members and people who come into close contact with them get vaccinated from these diseases. Some research shows vaccinated mothers may pass antibodies to fetuses through the umbilical cord, and newborns via breast milk that can continue to protect the babies from infection. Respiratory syncytial virus (RSV) vaccines given to pregnant mothers have proven to protect infants up to six months after birth, according to the CDC.

Though there arent any approved siRNA vaccines, researchers are working on ones that target COVID-19 and the flu. It was previously debated whether humans and other mammals use interfering RNA to kill viruses. However, the same team from the University of California, Riverside also conducted research in 2013 that discovered this theory was true. The team later went on to prove flu infection causes the body to produce interfering RNA, so theyre in the process of developing a flu vaccine that uses this strategy.

The researchers intend on creating this vaccine as a nasal spray rather than a shot. Respiratory infections move through the nose, so a spray might be an easier delivery system, Hai said. Theres already an approved nasal spray flu vaccine thats shown to be as effective in children as flu shots, according to the CDC. Several research teams are working on nasal COVID-19 vaccines, and both China and India have approved the use of nasal sprays in the form of boosters.

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New 'One-And-Done' Vaccine Method Could Protect InfantsFrom Covid, FluWith Just A Single Shot, Study Suggests - Forbes

Each year, the flu vaccine undergoes a meticulous process to ensure its efficacy in combating the influenza virus. With numerous strains of influenza circulating, it is important to accurately predict which strains will dominate each flu season. The effectiveness of the vaccine hinges on the accuracy, as it aims to either prevent individuals from contracting the flu or decrease the severity of illness if infection does occur.

To achieve this level of precision, scientists use multiple approaches. One such method is epidemiologic data analysis, which involves tracking the spread and prevalence of different flu strains across populations. By monitoring patterns of infection and transmission, researchers can identify trends and anticipate which strains are likely to predominate in the upcoming season.

Genetic data also plays a crucial role in the forecasting process. Laboratories worldwide conduct genetic sequencing on viral samples obtained from infected individuals, enabling scientists to analyze the genetic makeup of different flu strains. By comparing the genetic sequences of these strains, researchers can discern patterns of mutation and evolution, providing insights into how the virus may evolve over time and which strains are most likely to circulate in the future.

Furthermore, scientists examine the antigenic properties of flu viruses to assess their similarity to previous strains and predict their potential impact on vaccine effectiveness. Antigens, found on the surface of viruses, stimulate the production of antibodies in the bodys immune system. By studying these antigens, researchers can see how well the current vaccine will combat circulating flu strains.

Human serology studies also contribute valuable data to the forecasting process. These studies involve analyzing blood samples from individuals exposed to different flu strains to measure their immune response. By assessing levels of antibodies specific to various flu viruses, researchers can gauge population immunity and susceptibility to different strains, aiding in the prediction of which viruses are likely to cause outbreaks in the future.

Global surveillance efforts coordinated by organizations like the World Health Organization (WHO) further enhance the accuracy of flu forecasting. Through year-round monitoring of flu activity worldwide, including peak seasons in both the northern and southern hemispheres, epidemiologists can identify emerging strains and assess their potential threat to global public health. This global perspective enables researchers to anticipate how flu viruses may spread and evolve, informing vaccination strategies and pandemic preparedness efforts.

In addition to these methods, evolutionary analysis plays a critical role in flu forecasting. By examining the evolutionary dynamics of flu viruses, researchers can predict how different strains may compete with one another and evolve to evade immune detection. This understanding of viral evolution helps inform the development of vaccines that target the most prevalent and virulent flu strains, maximizing their effectiveness in protecting against seasonal influenza.

Olivia Khangi is a participant in the Niagara County NYS Public Health Corps Fellowship program at Mount St. Mary's and Lockport Memorial hospitals. The Right Way to Care by Catholic Health is produced by the hospitals' public relations and marketing department.

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THE RIGHT WAY TO CARE: Creating the flu vaccine - Lockport Union-Sun & Journal

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For the first time, we have vaccines that can protect older adults against three leadingand sometimes fatalrespiratory viral diseases: influenza, COVID and respiratory syncytial virus (RSV). This is a breakthrough; studies show that these vaccines are effective at protecting older adults from severe disease outcomes, including hospitalization and death.

Yet some seniorsincluding many who live in nursing homesarent getting these vaccines. And the prevaccine days of the COVID pandemic showed us how deadly respiratory illness could be among older people in group settings. As scientists at the Centers for Disease Control and Prevention, we have been tracking vaccination rates among older people. Given how easily these diseases are spread, and the possibility of severe disease with long and complex hospitalizations, we must do more to help inoculate them.

As this winter respiratory virus season winds down, its crucial we start planning for the next one. We can use the lessons weve learned from the vaccine rollouts for flu, COVID and RSV to give seniors the best shot at protection.

Older adults have a higher risk of severe disease and death from these respiratory virus infections compared to other age groups. Both their first-line innate immune responses and their slower, infection-specific adaptive immune responses decline. This decline, combined with higher rates of chronic diseases such as heart disease and diabetes andfor people who live in long-term care facilitiesan increased chance of disease spread, leaves older folks at risk for severe disease and death.

Improving the use of these vaccines through the fall and winter respiratory illness seasons could mean healthier seniors and fewer visits to urgent care and the emergency department and fewer hospitalizations.

In 20222023, experts estimate that flu vaccination prevented nearly 31,000 hospitalizations and 2,500 deaths among people ages 65 and older. COVID vaccination greatly lowered rates of hospitalizations and deaths among adults ages 65 years and older too. And in clinical trials, the new RSV vaccines had an efficacy of 83 to 89 percent in preventing symptomatic RSV in the lower respiratory tract in adults ages 60 years and older.

The CDCs latest data show that as of late March, 74 percent of adults age 65 years and older had gotten the flu vaccine and just 42 percent had received the updated COVID vaccine. Although coverage for influenza vaccine is trending slightly higher than at this point last year, COVID vaccine coverage remains about as low as last year. Among those ages 60 years and older, 24 percent had gotten an RSV vaccine. As of late March, only 43 percent of nursing home residents had received an updated COVID vaccine; as of December 10, 72 percent had received an influenza vaccine and 10 percent had received an RSV vaccine.

The fact that nearly three quarters of older adults received a flu vaccine this season, as opposed to less than half for the COVID vaccine, shows us that we have a lot of work to do to help people get up-to-date on COVID vaccines. And there is more to be done to help people and their providers understand whether an RSV vaccine is right for them.

The CDC surveyed unvaccinated older folks to better understand their reasons for not getting vaccinated, and the results varied. People 65 and older who said they were probably or definitely not going to get the influenza vaccine were concerned primarily about vaccine effectiveness and side effects and said they were not worried about the flu. For the COVID vaccine, participants most often shared concerns about heart-related or unknown serious side effects, followed by concerns about effectiveness and having vaccine fatigue, meaning they were likely burned out on vaccine information. The primary reasons for people age 60 and older not getting the RSV vaccine were not being worried about RSV, not knowing enough about RSV or the RSV vaccine, and the vaccine being too new.

These reasons for not getting vaccinated and the differences across vaccines are perhaps understandable in the context of where we are in the vaccine rollouts. Influenza vaccines have been licensed in the U.S. since the 1940s. In contrast, COVID vaccines were introduced little more than three years ago, and while these vaccines have undergone the most rigorous safety monitoring in U.S. history, some people still have misconceptions about the vaccines safety.

In addition, the vaccine fatigue expressed by respondents to the CDC survey is a genuine challenge. In the early days of COVID vaccines, older adults enthusiastically accepted vaccination. But over time, fewer and fewer seniors have been willing to get additional recommended doses. Many people are also less concerned about COVID itself, despite the fact that many people are still dying from it each day in the U.S.

RSV vaccines were licensed in 2023and from prior new vaccine rollouts we know that it can take years for vaccination coverage to increase. Moreover, instead of recommending that all adults 60 years and older get vaccinated, the CDC recommended that people and their health care providers have a conversation to determine if RSV vaccination is right for them. As a result, not all eligible adults are likely to get the vaccine.

Plus it is hard for some people to access vaccines. On one hand there is ample supply of all three vaccines, and they are covered by Medicare and many private insurance plans at no out-of-pocket cost. Still, there are around 400,000 people age 65 and older who are uninsured. Nonetheless, the health care provider or facility has to absorb the up-front costs of purchasing vaccines and then seek reimbursement for vaccination.

Furthermore, disparities in access to health care among ethnic and racial groups make getting respiratory vaccines challenging for some communities in the U.S. For example, during the 20222023 season, influenza vaccination coverage among adults ages 65 years and older ranged from 54 percent in American Indian/Alaska Native people to 71 percent in non-Hispanic white people.

There also are barriers to receiving these three vaccines within a relatively short period of time. Even though the CDC says that influenza, COVID and RSV vaccines can be given at the same time, not everyone is open to that. Furthermore, each of these vaccines became available at different points in time during this past season, which made it more difficult for people to receive these vaccines at once. For some, it may not have been a priority or a possibility to return for a follow-up visit for additional vaccines that they were unable to receive on prior visits.

Long-term care facilities face additional unique challenges to vaccinating residents, including the monumental task of strengthening vaccine confidence and demand not only among residents but also among staff at the facilities and family members involved in residents medical decisions. In addition, long-term care facilities may not have the necessary infrastructure, staffing and financial resources to routinely offer vaccines to residents. Furthermore, the end of the Public Health Emergency and transition from a federal COVID vaccine distribution system to a commercialized market ended certain regulatory flexibilities and continued the shift to more sustainable channels for vaccinating residents, though with fewer dedicated resources.

The relatively high influenza vaccination coverage among older adults suggests that it is possible to get more older people vaccinated for all recommended vaccines. The CDC is working to improve access to adult vaccines through programs such as the Bridge Access Program, which provides COVID vaccines at no cost to uninsured or underinsured adults. The CDC is working to strengthen confidence in and demand for vaccines; to communicate the benefits of vaccination to the public, and to use data to target vaccination efforts. In addition, because a strong recommendation from a health care provider remains the leading reason why people choose to get vaccinated, the CDC has worked to equip providers with resources on vaccine recommendations and on having effective conversations with patients about vaccines.

It will take ground-up efforts across every community, vaccination provider location and household around the U.S. to ensure that older adults get not only the respiratory virus vaccines but all recommended vaccines.

The views expressed in this article do not necessarily represent those of the Centers for Disease Control and Prevention.

This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.

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COVID, Flu and RSV Vaccines Are Lifesavers. Why Arent More Older Adults Getting Them? - Scientific American

With growing concern among biologists about the spread of the so-called bird flu to cattle in the U.S., the worry now is that more humans could catch the virus.

AUSTIN, Texas Microbiologists say that the recent discovery that avian flu has spread from birds to cattle came as a surprise. Texas was one of the first states to report that H5N1 had spread to dairy cattle in the state.

Last week, Texas health officials confirmed that avian flu spread to a farm worker in Texas who tended to cattle. Although theres been no indication that avian flu can spread from person to person, just in case the virus mutates, researchers are preparing.

The Texas Biomedical Research Institute (Texas Biomed) in San Antonio recently received U.S. government approval to begin looking into developing potential vaccines and antivirals that could combat avian influenza.

I think there is no cause for immediate alarm here. Weve been tracking this virus," Dr. Larry Schlesinger, president and CEO of Texas Biomed, said. But the future could indicate that the virus could continue to change in a way that might cause it to be more of a problem in humans. And we have to be highly vigilant on this particular strain of virus.

Schlesinger said theres no reason for undue concern that the flu will become commonplace among humans. But he said its important for biomedical researchers to investigate developing a vaccine, just in case.

On Thursday, South Dakota became the eighth state to confirm that a type of the virus labeled H5N1 was found in dairy cattle. North Carolina reported Wednesday that the same virus made its way to some dairy cattle there.

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Texas researchers developing possible vaccine to prevent human bird flu infections - KVUE.com

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On April 5, the CDC issued a health alert informing the public and the medical community that a person in the US had contracted avian flu something that had only happened once before. Less than a week earlier, the virus had been spotted in herds of dairy cows in the US.

So, how worrying is it that bird flu jumped to a person and what can we do to stop the virus from becoming a bigger problem in the future?

There are four types of influenza viruses: A, B, C, and D. Type A and B viruses regularly infect people, and certain type A viruses can infect birds, pigs, dogs, and several other species, too.

Usually, a subtype of influenza that infects one species doesnt readily infect another, but as the virus spreads, it can mutate or recombine with other flu viruses in ways that allow it to make the jump to a new species. In March 2024, the USDA reported that a strain of avian flu H5N1 2.3.4.4b had infected herds of dairy cows in five states, and chicken producers across the country are also culling millions of birds in efforts to control outbreaks in poultry.

A person working on a dairy farm with infected cows in Texas soon tested positive for the avian flu, leading experts to suspect he contracted the virus from a cow.

This is the first time avian flu has been detected in US livestock and the first time a human has seemingly contracted the virus from a mammal (and not from exposure to an infected bird), but that doesnt necessarily mean were on the brink of a new pandemic.

The chance of you getting sick from the milk of an infected cow is extremely low.

Even though these are the first reported cases of avian flu in cows, H5N1 has been detected in more than 30 mammal species previously, so the virus making the leap into one more isnt entirely surprising.

The fact that these are dairy cows and therefore in the human food chain does make this more noteworthy than, say, when the virus was spotted in tigers for the first time, but the chance of you getting sick from the milk of an infected cow is extremely low, thanks to pasteurization.

Farmers are also being directed to destroy milk from any cows they know are infected.

H5N1 virus particles (gold) grown in canine kidney cells (green)

It isnt entirely clear how the virus is spreading in cattle it could be spreading through the air, through contaminated milking equipment, or some other vector. While mammals usually contract H5N1 from a bird and then either recover or die without spreading the virus to other mammals, mammal-to-mammal transmission isnt entirely unheard of.

In 2022 and 2023, the virus appeared to spread between farmed minks, and some people whove contracted the virus in the past had no known contact with infected birds before getting sick, suggesting that they might have gotten it from another person or mammal, too.

That makes the spread of the virus between cows rare, but not unprecedented, and thankfully, the virus isnt making the animals too sick they have mild fevers, decreased appetites, and decreased milk production, but recover fairly quickly.

The farmer who caught the virus from a cow, meanwhile, only had one symptom conjunctivitis (pink eye) and is now recovering after treatment with an antiviral medication.

The US has been studying H5N1 for years and has stockpiled avian flu vaccines.

While the CDC notes that the current risk to the public remains low, the more opportunities the avian flu virus has to spread, the more chances it gets to mutate into something that is dangerous.

Thankfully, the US has been studying H5N1 for years and has stockpiled avian flu vaccines and treatments just in case the virus becomes more contagious or starts to cause more severe infections. Other ways to protect humans and livestock from the virus are in the works, too.

The fact that weve already developed avian flu vaccines means that, if a threatening strain of bird flu emerges, we should be in a better place than we were at the start of the COVID-19 pandemic, when we didnt have any coronavirus vaccines.

However, the vaccines we have for bird flu might not be as effective as they were when they were first developed.

By the time a targeted shot was designed and manufactured, the virus could be widespread.

Flu viruses mutate readily, and because a vaccine that works great against one strain might not be effective against another, developers of human flu vaccines tweak their shots every year to target the handful of strains they think will dominate the upcoming flu season.

Unfortunately, because it takes a long time to manufacture large quantities of flu vaccine using the traditional method growing the virus in chicken eggs and then inactivating it they need to pick a target 6-9 months in advance, and that long lead time can make it hard to choose the best one.

We could face this same problem with avian flu vaccines.

The strain that infected the Texas farmer was closely related to the ones used for existing avian flu shots, according to the CDC, but not an exact match. A strain that was able to spread from person to person could be significantly different, and by the time a targeted shot was designed and manufactured, the virus could be widespread.

Even if a potential epidemic strain wasnt radically different, though, a bird flu outbreak could actually kill a lot of the chickens that we need to lay the eggs to make a vaccine and the more the virus spreads, the more chances it has to mutate and dodge our immune defenses.

A lab worker injecting a human flu virus into eggs during the manufacturing process

mRNA vaccines the kind approved for COVID-19 can be designed and manufactured more quickly than traditional flu shots, and they dont require any birds or eggs, which could make them a better option in the event of a future avian flu outbreak.

Several vaccine makers are already developing the shots, too, including Moderna in March 2023, it announced that it was working on an mRNA-based avian flu vaccine, which it said it planned to test in humans before mid-year (though there hasnt been an update on the shot since).

Researchers at the University of Pennsylvania, meanwhile, published a paper in 2022 detailing a promising mRNA-based vaccine that targets 20 strains of flu, including H5N1, and in 2023, they shared a preprint of a study that found a version targeting H5N1 2.3.4.4b, specifically, was effective in animals.

More research is needed to get any mRNA shot for bird flu across the finish line, but developing them now before a threatening strain is already spreading means we have a better chance of having one ready if we need it.

Because the avian flu starts in birds, stopping them from getting infected in the first place could be an even better way to prevent a pandemic, not to mention save the lives of potentially millions of birds and protect the global supply of eggs and poultry.

Avian flu vaccines for birds could be one way to do that.

In 1994, Mexico became the first nation to vaccinate chickens against a strain of bird flu, and more than a dozen others have since followed suit, with China relying heavily on vaccination to protect its flocks.

US farmers have avoided avian flu vaccines for livestock due to issues with exporting poultry and eggs from vaccinated birds. Instead, as in many countries, they rely on culling to stop outbreaks if one bird tests positive, the entire flock is killed.

That could change, though.

Maybe its time to discuss vaccination.

In April 2023, the USDA began trialing several vaccines to protect birds against H5N1 2.3.4.4b, and the following month, the World Organisation for Animal Health an intergovernmental group focused on animal disease control suggested that vaccines should be considered.

Since almost every country that does international trade has now been infected, maybe its time to discuss vaccination, in addition to systematic culling which remains the main tool (to control the disease), Monique Eloit, WOAHs director general, told Reuters.

Vaccine development is slow going, though, with US Agriculture Secretary Tom Vilsack telling Congress in February 2024 that the USDA is probably 18 months or so away from identifying a vaccine that would be effective against the strain of avian flu thats currently spreading.

Even if the USDA does develop an effective vaccine for this strain, it then needs to work out the logistics of manufacturing and distributing the shots and then go through the process again for future strains.

Gene-editing offers a promising route towards permanent disease resistance.

A more radical idea for protecting poultry from avian flu is taking shape in the UK, where scientists are trying to use CRISPR to genetically engineer chickens that cannot catch the flu at all.

In 2023, the team announced that editing one gene stopped chickens from producing a protein that the avian flu virus uses to replicate itself inside cells. When intentionally exposed to the virus, just one out of 10 gene-edited birds was infected, and that one didnt spread the virus to any others.

The UK researchers suspect theyd need to make two more edits to the chickens to confer total immunity, and more research is needed to see how that might affect the health of the birds. If it proves safe and effective, though, the CRISPR approach could be a lasting solution to the bird flu problem in chickens.

Gene-editing offers a promising route towards permanent disease resistance, which could be passed down through generations, protecting poultry and reducing the risks to humans and wild birds, said Mike McGrew, the studys principal investigator, in October 2023.

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The threat of avian flu and what we can do to stop it - Freethink

Each year, the flu vaccine undergoes a meticulous process to ensure its efficacy in combating the influenza virus. With numerous strains of influenza circulating, it is important to accurately predict which strains will dominate each flu season. The effectiveness of the vaccine hinges on the accuracy, as it aims to either prevent individuals from contracting the flu or decrease the severity of illness if infection does occur.

To achieve this level of precision, scientists use multiple approaches. One such method is epidemiologic data analysis, which involves tracking the spread and prevalence of different flu strains across populations. By monitoring patterns of infection and transmission, researchers can identify trends and anticipate which strains are likely to predominate in the upcoming season.

Genetic data also plays a crucial role in the forecasting process. Laboratories worldwide conduct genetic sequencing on viral samples obtained from infected individuals, enabling scientists to analyze the genetic makeup of different flu strains. By comparing the genetic sequences of these strains, researchers can discern patterns of mutation and evolution, providing insights into how the virus may evolve over time and which strains are most likely to circulate in the future.

Furthermore, scientists examine the antigenic properties of flu viruses to assess their similarity to previous strains and predict their potential impact on vaccine effectiveness. Antigens, found on the surface of viruses, stimulate the production of antibodies in the body's immune system. By studying these antigens, researchers can see how well the current vaccine will combat circulating flu strains.

Human serology studies also contribute valuable data to the forecasting process. These studies involve analyzing blood samples from individuals exposed to different flu strains to measure their immune response. By assessing levels of antibodies specific to various flu viruses, researchers can gauge population immunity and susceptibility to different strains, aiding in the prediction of which viruses are likely to cause outbreaks in the future.

Global surveillance efforts coordinated by organizations like the World Health Organization (WHO) further enhance the accuracy of flu forecasting. Through year-round monitoring of flu activity worldwide, including peak seasons in both the northern and southern hemispheres, epidemiologists can identify emerging strains and assess their potential threat to global public health. This global perspective enables researchers to anticipate how flu viruses may spread and evolve, informing vaccination strategies and pandemic preparedness efforts.

In addition to these methods, evolutionary analysis plays a critical role in flu forecasting. By examining the evolutionary dynamics of flu viruses, researchers can predict how different strains may compete with one another and evolve to evade immune detection. This understanding of viral evolution helps inform the development of vaccines that target the most prevalent and virulent flu strains, maximizing their effectiveness in protecting against seasonal influenza.

Olivia Khangi is a participant in the Niagara County NYS Public Health Corps Fellowship program at Mount St. Mary's and Lockport Memorial hospitals. The Right Way to Care by Catholic Health is produced by the hospitals' public relations and marketing department.

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THE RIGHT WAY TO CARE: Creating the flu vaccine - Niagara Gazette

Introduction

Avian influenzaoften referred to as avian flu or bird fluis a virus that has circulated among the worlds migratory birds for at least a century. However, in recent decades, new, highly pathogenic strains of the virus have wreaked havoc on certain bird populations, particularly poultry livestock, and become a growing threat to humans and other mammals.

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Since 2020, cases have been rising in other birds and in mammals that were not previously susceptible. The global surge in outbreaks has forced agriculture companies to cull millions of poultry, the most consumed meat in the world, and threatened some endangered species. Meanwhile, drawing on the harsh lessons of the COVID-19 pandemic, scientists and policymakers are raising concerns about the prospect of avian flu morphing into the next zoonotic pandemic.

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First discovered in 1878, avian influenza is a viral disease that primarily infects birds, although some strains can spread to and kill mammals, including humans. The H5N1 strain, one of the most common today, was first identified in domestic waterfowl in 1996.

A curation of original analyses, data visualizations, and commentaries, examining the debates and efforts to improve health worldwide.Weekly.

Birds. The flu mainly spreads asymptomatically among wild aquatic birds, but domestic poultry are also susceptible and can become extremely ill and die. Twenty-five known subtypes of avian flu have been identified in birds. There are two main categories: low pathogenicity, which often causes little-to-no signs of disease, and high pathogenicity, strains that cause severe disease and poultry mortality. Highly pathogenic strains of avian influenza have a 90 to 100 percent mortality rate among poultry. Most infected livestock die within forty-eight hours.

Humans. Human cases of bird flu are extremely rare, but often deadly. Most people who have been infected have usually been directly exposed to infected poultry or contaminated environments by them. Human-to-human transmission is believed to have only occurred in a few isolated instances, but sustained transmission between humans has not yet been identified. The two strains of avian flu that have killed the most people are H5N1 and H7N9. The first human cases of H5N1 were detected in China in 1997, but the bulk of cases came between 2003 and 2015, with Egypt as a hot spot. To date, there have been 882 human cases, with 461 deaths across nearly two dozen countries, according to World Health Organization (WHO) data.

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H7N9 was also first reported in China in 2013, and it has killed more than six hundred people to date. Some non-fatal cases are asymptomatic, but common effects can include flu-like symptoms, conjunctivitis (pink eye), pneumonia, multi-organ failure, seizures, and neurological damage. Newer strains that later evolved, such as H5N6 and H5N8, are also infecting humans.

Other mammals. Since 2020, avian flu has been found in close to fifty mammal species across more than two dozen countries, considerably more widespread than past waves. The disease can often be deadly for mammals. There have been notable outbreaks in mink in Spain, seals in Peru, and even domestic cats and dogs in several countries. Most recently, at the beginning of 2024, H5N1 was found in seals in Antarctica for the first time.And as of March, avian flu wasreportedly worsening in marine mammals at rates that have prompted scientists to become concerned about mammal-to-mammal transmission, which would represent a much more dangerous threat to the affected ecosystems. In April, the virus was detected in U.S. cattle for the first time, affecting herds in several states. At least one farm worker, in Texas, was also infected.

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H5N1began circulatingin parts of Africa, Asia, and Europe in late 2021, but its reach has exploded since then: the virus has been recorded in more than eighty countries since 2022. There have been recent cases in all continents except for Australia.

In the current wave, relentless outbreaks in poultry have wracked U.S. agriculture nationwide as well. Avian flu has been recorded in forty-eight states and affected more than eighty-two million poultry, as of March 2024. European countries witnessed a similar pattern of surging infections, affecting some fifty million poultry across thirty-seven countries, though France suffered the brunt of these. Other countries, such as Japan and South Africa, experienced their worst avian flu outbreaks among farmed birds.

Avian flu outbreaks can cost farmers and consumers billions of dollars in lost profits and higher prices, and they disrupt important international trade. The ongoing avian flu outbreak in the United States, the worlds largest poultry meat producer and second-largest egg producer, caused economic losses around $2.53 billion by the end of 2023, and experts expect this cost will only rise amid new surges of the disease in 2024. Avian flu has led to the deaths or culling of more than eighty million poultry livestock. Per U.S. regulations, producers must cull all the birds in an infected flock, even if some of them do not have the disease. Amid the outbreak, the cost of a dozen eggs more than doubled to nearly five dollars in January 2023 before producers were able to restore their flocks. In recently infected cattle, U.S. farmers have reported reduced milk production, although it has had a limited effect on supplies thus far.

The reduction of poultry has exacerbated food security in some parts of the world, particularly in lower-income countries where poultry products are a major source of protein. South Africas poultry industry underwent major supply shortages in 2023 as its worst avian flu outbreak added to its chronic power outages, which further hampered poultry production. Studies in Egypt have recorded stunted growth in youth coinciding with past avian flu outbreaks.

Avian flu and the perceptions around it can also harm the global trade of poultry products. Amid a 2004 outbreak in the United States, for example, U.S. poultry exports dipped more than 20 percent after several countries imposed embargoes on U.S. poultry products. These trade constrictions also reduce incomes for producers whose flocks never even contracted the virus, as well as for others involved in the poultry value chain. These economic concerns have rendered several countries wary of vaccinating poultry for avian flu, as they do not want to risk potential embargoes from their trading partners.

The global spread is due in part to bird migration patterns, allowing infected birds to carry the disease thousands of miles to sites along their flyways. At the same time, the virus is increasingly mutating as it encounters new host animals and new species.

Outbreaks in the past often subsided in the summer when bird migrations ceased, yet this was not the case in the recent H5N1 strain, which was some of the cause for scientists concern. The constant stream of outbreaks across the world in 2023 triggered concerns that avian flu could become a year-round threat. The reasoning for the viruss persistence is still not fully clear, although some research has indicated that climate change and human activities are contributing factors. Climate changerelated fluctuation in conditions such as temperature are altering the timing of some bird behaviors, including migration and breeding. Meanwhile, habitat destruction and urbanization are also affecting breeding site availability. The confluence of these factors drives birds from different parts of the world to come into contact with each other for the first time and interact with more habitats, both natural and urban. Such encounters expand the opportunities for the virus to spread and mutate.

The corporate consolidation of U.S. factory farms, where poultry livestock are typically held in close quarters, also contributes to the rapid spread of the virus and mass poultry deaths. The environmental nonprofit Food and Water Watch said in a 2020 study [PDF] that 96 percent of U.S. chickens are raised under a production contract by major corporations, such as Tyson Foods or Perdue Farms.

Human cases of avian flu are rare, and experts say the threat to public health is generally low. However, human cases have a high fatality rate, at more than 50 percent. (At its peak, for comparison, the global COVID-19 death rate was reported to be around 8 percent, though it is widely thought to be far higher.) Still, health experts are worried about the risks to farm workers who could be regularly exposed to infected animals.

For a virus to have pandemic potential, it needs to be able to pass easily from person-to-person. H5N1 does not have the ability to do so, but scientists fear it could develop this feature.

The bigger picture is that this virus is not cooling off, CFR Senior Fellow Jennifer Nuzzo toldPolitico. Weve been worrying about this virus for twenty years, more than twenty years. And in the last year, it has really been remarkable in how far across the globe it has been spreading, and how many species its been affecting.

The WHO warns that the recent surge in avian flu outbreaks among mammals could increase the viruss ability to circulate more easily among humans. As viruses quickly spread and evolve, they can more easily mutate and create new strains that are more effective at infecting people. In April 2024, the United States reported its second-ever case of H5N1, a human who became infectedvia sick dairy cattle in Texas, raising concerns of growing mammal-to-mammal transmission. Amid these latest outbreaks, the Centers for Disease Control and Prevention (CDC) is also recommending against the consumption of raw milk, which is sold legally in most states.

Countries such as Egypt and Indonesia experienced the brunt of human cases in the 2015 wave, and in the current wave, Cambodia and the United Kingdom have the highest numbers, which are much lower still than those seen in the prior outbreaks. Nonetheless, the ongoing bouts of avian flu in countries that have never experienced cases in mammals has evoked international attention.

The Food and Agriculture Organization (FAO), WHO, and World Organization for Animal Health (WOAH) are urging countries to work together across sectors to prevent both human and animal infections. Their recommendations include enhanced surveillance and information sharing; increased biosecurity measures, such as vaccinating livestock; restricted contact with other farms and equipment; and proper hygiene and disinfection of farm equipment and facilities.

There are avian flu vaccines for humans and birds, but there are a number of challenges and uncertainties with both. For instance, there is global hesitancy over the bird vaccine for trade reasons, and the existing human vaccines are derived from previous strains, so it could take a while to develop new ones and implement them on a mass scale. Some countries fear that importing vaccinated birds will make conducting surveillance more difficult, as it will be harder to determine if birds have been infected or vaccinated. To some degree, there are concerns that importing eggs or meat from birds that have been vaccinated could inadvertently spread the disease within the importing countrys borders, though there is no evidence to suggest this is possible.

Avian flu vaccines are mostly administered to birds in countries where the flu is endemic, and that have minimal poultry trade, such as Egypt, Indonesia, Mexico, and most recently, France. Commercial poultry in the United States receive other vaccinations, such as against fowlpox, but not yet for avian flu. The U.S. Department of Agriculture (USDA) is testing several bird vaccines but has not approved any, mostly over concerns that requiring a vaccine will harm trade. Despite this roadblock, experts have increasingly called for the U.S. government to launch a vaccination campaign for poultry, which they say would reduce the risk of spillover that could trigger a pandemic. Some poultry vaccines have proven to be as high as 94 percent effective.

There is also a lot of uncertainty around the prospects of an avian flu vaccine for humans. Several major companies that manufacture them have said they could expedite the production of millions of doses in the event of a pandemic. The United States has an emergency stockpile of H5N1 vaccines, but experts have said that they would be insufficient if this particular strain were to start infecting people at a larger scale. Further, the shots have only been administered in trials and were derived from strains that circulated in 2004 and 2005. Some companies are working on developing vaccines that better match the highly pathogenic subvariant that is causing havoc today, but experts say it is unclear whether a human vaccine could be manufactured at a global scale while staying ahead of the curve on the viruss rapid mutation.

We shouldnt be overconfident in our ability to make vaccines that are safe and effective for avian flu because weve encountered challenges in the past with that antigen, says CFR Fellow Luciana Borio. Clinical trials involving H5N1 in the past have yielded lackluster results.

And as with many diseases, there is a global equity issue: these vaccines, which are not even past the testing phase, are already slated to go to richer countries first, leaving lower-income countries at risk. We cant do a repeat of what happened with COVID, where countries that were vaccine-producing waited until there was no more interest in vaccines in their populations before they really worked to consider the needs of developing countries and non-vaccine-producing countries, Borio says.

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What Is Avian Flu? - Council on Foreign Relations

If you are living with someone vulnerable, you should consider vaccination, as this will prevent you from spreading the flu, and so protects your loved ones."

LIFESTYLE NEWS - With influenza season fast approaching, stock of this years flu vaccine is currently available in South Africa.

There are different forms of flu caused by various virus strains, and each year the influenza virus mutates. A new vaccine is developed and needed every year for us to remain protected, says Dr Cathelijn Zeijlemaker, a family physician and medical director of Netcares Primary Care division.

Worldwide, between three and four million people fall seriously ill with influenza each year, resulting in hundreds of thousands of deaths. The World Health Organization (WHO) and the Department of Healths National Institute of Communicable Diseases (NICD) recognise vaccination as the most effective way to prevent flu.

Most at risk are those with a chronic condition, the elderly, pregnant women, and small children.

If you are living with someone vulnerable, you should consider vaccination, as this will prevent you from spreading the flu, and so protects your loved ones. This is also why every year Netcare encourages their healthcare personnel to receive the influenza vaccination.

Each year in September, the WHOs technical consultants advise which strains of the influenza virus should be included in the next years flu vaccine for the Southern Hemisphere to ensure that the protection provided is up to date.

The influenza vaccine does not cover all the common colds that one is exposed to during the winter season. Though the symptoms are similar, these are milder and shorter in duration.

Symptoms of influenza commonly include body aches, fever, nasal congestion, tiredness and coughing and stop you from continuing with your normal daily activities. Children tend to have the highest rates of seasonal flu infection, which can lead to wider transmission within communities.

Although most people start to feel better after a few days of rest, influenza can cause severe prolonged illness and complications. It is therefore very important to seek medical advice if you are not getting better, start to feel worse or experience chest pains or shortness of breath, she says.

To beat the seasonal flu, it is worthwhile having your annual influenza vaccine early, as it takes approximately two weeks for your body to develop full protection. Although the peak flu season usually coincides with the colder weather in winter, it is unpredictable when a flu outbreak will occur, she says.

Dr Zeijlemaker points out that it is not uncommon for the influenza vaccine to give mild side effects, like redness, mild swelling, and pain over the injection site, or a mild fever, mild rash, headache, or body aches. These begin soon after vaccination and are usually mild and short-lived. As with other medications, there is always a small chance of a severe allergic reaction.

Make sure you tell your doctor about your recent medical history before your vaccination, or if you are feeling unwell, as you may be advised to postpone the vaccination, she says.

Those who should consider vaccination include

In addition to having the flu shot, tips to help prevent the spread of flu include:

Prevention is always preferable to a bout of seasonal flu, and the doctors practising at Netcare Medicross facilities countrywide are here to take care of your familys every primary healthcare need all year round, Dr Zeijlemaker says.

Contact your local Netcare Medicross Medical and Dental Centre to book your familys influenza vaccinations or visit https://www.netcare.co.za/ to make an appointment with a general practitioner.

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Protect your family with the latest flu shot - George Herald