Feb 28, 2024 ACIP Meeting - Influenza Vaccines
TLDRThe transcript discusses the influenza vaccine's effectiveness, particularly focusing on the 2023/2024 season. It highlights the role of the Influenza Work Group and the CDC in conducting studies and analyzing data. The meeting covers topics such as vaccine effectiveness in various age groups, the safety of the LAIV vaccine in children with asthma, and the potential exclusion of the influenza B/Yamagata lineage from future vaccines. The discussion also touches on the implications for public health policy and the importance of ongoing research in vaccine development.
Takeaways
- 📅 The meeting reconvenes to discuss influenza vaccines, with Dr. Jamie Loehr providing an introduction and overview.
- 🌟 Dr. Loehr acknowledges the hard work of ACIP members and CDC staff, highlighting their efforts in moving forward with vaccine initiatives.
- 📈 Three main topics are presented: annual review of vaccine effectiveness, LAIV vaccine in asthma and wheezing, and the exclusion of influenza B/Yamagata from vaccines.
- 💡 Preliminary estimates of vaccine effectiveness are given for both adults and children, covering outpatient visits and hospitalizations.
- 🧒 LAIV is not recommended for children aged two through four with a history of asthma or wheezing, and is a precaution for older children.
- 🦠 Influenza B/Yamagata has not been detected since March 2020, leading to recommendations for its exclusion from future vaccines.
- 🗣️ Dr. Frutos presents CDC's interim estimates of 2023/2024 seasonal influenza vaccine effectiveness, involving multiple networks and age groups.
- 📊 VE estimates are calculated using a test-negative design and adjusted for various factors, showing consistency across networks.
- 👨⚕️ Dr. Zhu discusses the use of California's public health data to calculate VE against laboratory-confirmed influenza, offering additional estimates ahead of traditional platforms.
- 🧬 Subtype information is not available for all positive influenza results, limiting the calculation of VE for influenza subtypes.
- 🤔 The discussion includes questions about the future of influenza vaccines, the potential detriment of repeated vaccinations, and the exploration of new vaccine options.
Q & A
What are the three main topics being presented in the influenza vaccine session?
-The three main topics are the annual review of vaccine effectiveness with preliminary estimates for both adults and children, the safety of LAIV vaccine in the context of asthma and wheezing in children, and the update on the plans for the exclusion of the influenza B/Yamagata lineage from future vaccines.
Who are the key members of the Influenza Work Group mentioned in the transcript?
-The key members mentioned are Dr. Jamie Loehr, Chair of the Influenza Work Group, Dr. Camille Kotton, and Dr. Lisa Grohskopf, the CDC lead.
What is the significance of the absence of confirmed detections of influenza B/Yamagata since March 2020?
-The absence of confirmed detections of influenza B/Yamagata suggests that this virus lineage is no longer circulating in the natural environment, leading to recommendations for its exclusion from future influenza vaccines.
What are the different settings in which the influenza vaccine effectiveness networks operate?
-The networks operate in various settings including out-patient clinics, emergency departments, urgent cares, and hospitals.
How is the vaccine effectiveness calculated?
-Vaccine effectiveness is calculated as 1 minus the adjusted odds ratio times 100%, taking into account factors such as geographic region, age, calendar time of illness, sex, race, and ethnicity.
What is the role of the CaliforniaImmunization Registry (CAIR) and CalREDIE in influenza vaccine effectiveness studies?
-CAIR and CalREDIE are used to report and track influenza vaccination records and positive influenza results, allowing for the calculation of vaccine effectiveness against laboratory-confirmed influenza in California.
What are the general findings from the study on the safety of LAIV4 in children with asthma?
-The study found that LAIV4 was not associated with an increased frequency of asthma exacerbations, increased asthma-related symptoms, or a decrease in peak expiratory flow rate in children with persistent asthma within six weeks following immunization.
What are the implications of the study's findings on LAIV4 for children with asthma?
-The findings suggest that LAIV4 may be a suitable option for children aged five years and older with asthma, including those with moderate to severe asthma, as it does not appear to increase the risk of asthma exacerbations or related symptoms.
How might the results of the LAIV4 study impact future vaccination recommendations?
-The results could lead to a reassessment of the current precautions regarding the use of LAIV4 in children with asthma, potentially leading to changes in vaccination guidelines and practices.
What is the process for updating vaccine composition based on surveillance data and recommendations?
-Vaccine composition is updated through a series of meetings involving the WHO and FDA, where recommendations are made based on surveillance data. National regulatory authorities, such as the FDA in the U.S., make the final decisions on vaccine composition.
What challenges might arise from the potential shift back to trivalent influenza vaccines?
-Challenges could include the need to reactivate or update electronic health record systems and billing codes to accommodate the change in vaccine composition, as well as ensuring a smooth transition for manufacturers and healthcare providers.
Outlines
📌 Introduction to Influenza Work Group and Vaccine Effectiveness
The paragraph introduces Dr. Jamie Loehr, the Chair of the Influenza Work Group, who provides an overview of the session. It discusses the annual review of vaccine effectiveness, preliminary estimates for both adults and children, and the presentation of three main topics: vaccine effectiveness against influenza, LAIV vaccine in the context of asthma and wheezing, and the exclusion of the influenza B/Yamagata lineage from vaccines. The CDC's Dr. Lisa Grohskopf is acknowledged for her contributions, and Dr. Frutos is introduced to present the CDC's interim estimates of the 2023/2024 seasonal influenza vaccine effectiveness.
🧬 Vaccine Effectiveness: Methods and Estimates
This paragraph delves into the specifics of how vaccine effectiveness is calculated, including the test-negative design, the inclusion of patients from various networks, and the adjustment for demographic and temporal factors. It presents the interim VE estimates for influenza A and B subtypes among children, adolescents, and adults across different healthcare settings. The data is shown to be consistent across networks, and the presentation includes detailed information on the methodology and results of the vaccine effectiveness study.
👨⚕️ LAIV Vaccine Safety in Children with Asthma
The focus of this paragraph is on the safety of the live attenuated influenza vaccine (LAIV) in children with asthma. It discusses the previous findings on LAIV safety in children with asthma, the need for further research, and the design of a study conducted by Dr. Creech and colleagues at various medical centers. The study aimed to assess whether LAIV4 is associated with increased asthma symptoms or exacerbations in children with persistent asthma. The results indicated that LAIV4 was not associated with increased frequency of asthma exacerbations or symptoms in the six weeks following immunization.
🌟 Influenza B/Yamagata Virus Surveillance and Vaccine Composition
This paragraph discusses the surveillance of the influenza B/Yamagata virus and the implications for vaccine composition. It highlights the history of quadrivalent vaccines, which were introduced to provide broader coverage against influenza B viruses. The recent absence of naturally occurring B/Yamagata viruses since March 2020 is noted, and the decision-making process for vaccine composition by various health authorities is outlined. The paragraph also touches on the upcoming FDA meeting to discuss the U.S. vaccine composition for the 2024-2025 season and the potential need to revert to trivalent vaccines.
🤝 Closing Remarks and Open Forum for Questions
The paragraph concludes the formal presentations with a summary of the key points and acknowledgments of the presenters and the Influenza Work Group. It opens the floor for questions and discussion, addressing concerns about the potential return to trivalent vaccines and the implications for electronic health record systems and billing codes. The need for early conversations and planning for the upcoming influenza season is emphasized.
Mindmap
Keywords
💡Influenza Vaccines
💡Vaccine Effectiveness
💡Live Attenuated Influenza Vaccine (LAIV)
💡Asthma
💡Influenza B/Yamagata
💡Immunization Safety
💡Vaccine Strains
💡Public Health
💡Vaccine Composition
💡Surveillance
Highlights
The meeting reconvenes to discuss influenza vaccines, with Dr. Jamie Loehr providing an introduction and overview.
Annual review of vaccine effectiveness is presented, including preliminary estimates for both adults and children.
The safety of LAIV vaccine in children with asthma and wheezing is discussed, noting current recommendations and ongoing reviews.
Influenza B/Yamagata lineage has not been detected since March 2020, leading to discussions on its exclusion from future vaccines.
Dr. Frutos presents CDC's interim estimates of 2023/2024 seasonal influenza vaccine effectiveness, covering various networks and age groups.
VE estimates for influenza A and B subtypes are provided, showing the vaccine's effectiveness across different settings and populations.
Dr. Zhu discusses interim influenza vaccine effectiveness in California, utilizing new public health data reporting requirements.
California's analysis shows adjusted VE against laboratory-confirmed influenza, highlighting the potential for timely in-season estimates.
A study on the safety of LAIV4 in children with asthma is presented, showing no increased frequency of asthma exacerbations or related symptoms.
The study on LAIV4 in asthmatic children was conducted at multiple centers over two influenza seasons, enhancing its generalizability.
LAIV4 is found to be non-inferior to IIV4 in terms of asthma exacerbations in children, suggesting it as a suitable option for asthmatic children.
The discussion addresses the potential for vaccine fatigue and the diminishing returns of annual influenza immunization.
The meeting touches on the status of quadrivalent influenza vaccines and the absence of influenza B/Yamagata lineage.
The WHO and FDA meetings have recommended the removal of influenza B/Yamagata from vaccines as soon as feasible.
The transition to quadrivalent vaccines has been largely completed, with only a few trivalent vaccines still available.
The process for manufacturers to revert to trivalent vaccines depends on their individual circumstances and regulatory pathways.
The importance of updating electronic health record systems and CBX codes for potential changes in vaccine composition is highlighted.
Transcripts
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