Getting Ready for Flu Season

Cell-based influenza vaccines will be used for the first time in 2013-14


By Heather Hindo, MD


Guidelines issued by the Advisory Committee on Immunization Practices for the 2013-14 influenza season again include recommended annual vaccination for everyone age 6 months and older.  An exciting development for this upcoming season is the first use of cell-based flu vaccines.


As we prepare for seasonal and possible pandemic influenza at Cottage Children’s Hospital, we encourage widespread use of influenza vaccine for protecting patients and workers. 

Colorized transmission electron micrograph of A/California/7/2009(H1N1), seen in gold


During our admission intake process, every patient is screened for eligibility for influenza vaccination and then administered vaccine, as indicated. Additionally, we have mandatory influenza vaccination for our health care providers.


Seasonal influenza vaccines are designed to protect against infection and illness caused by the three influenza viruses (two type A and one type B) that research indicates will be the most common each season. At CCH, we will be providing the trivalent inactivated Fluzone vaccine. In addition to the trivalent vaccines, some influenza vaccines will be quadrivalent (two type A and two type B). The quadrivalent vaccine addresses the 50 percent possibility of a mismatch for the B strain each season.  The strains included in the 2013/2014 northern hemisphere season include: 

  • A/California/7/2009(H1N1)-like (same strain as was used for 2009 H1N1 monovalent vaccines)
  • A/Texas/50/2012 (H3N2, replaces A/Victoria/361/2011)
  • B/Massachusetts/2/2012-like (B/Yamagata lineage), replaces B/Wisconsin/1/2010-like



Data published by the CDC reported a mid-season overall vaccine efficacy (adjusted for age group, study site, race/ethnicity, self-rated health status, and days from illness onset to enrollment) of 56 percent (95 percent CI=47 percent-63 percent) for the 2012-2013 influenza vaccine.  The CDC reported from their weekly surveillance that there had been 138 influenza-associated pediatric deaths from Sept. 30, 2012 to May 8, 2013 (see figure).


The nation’s first cell-based flu vaccine was approved by the U.S. Food and Drug Administration in November 2012. Although safety and efficacy are not yet established for people under 18 years of age, in clinical trials the cell-based flu vaccine reactions were similar to those with current vaccines.  Cell-based influenza vaccines are made by growing viruses in animal cells rather than in chicken’s eggs.  The potential benefits of the cell-based flu vaccine are that cell culture technique may be more flexible than the traditional technology, which relies upon an adequate supply of eggs.  It also allows for faster startup of the vaccine manufacturing process in the event of a pandemic.


While influenza vaccination does not confer 100 percent protection, it remains the best means of prevention, especially to protect our pediatric population.  Analysis of the 2013-2014 influenza season will hopefully yield more effective vaccines and vaccination strategies.


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