Oral Presentation Lorne Infection and Immunity 2018

Pandemic Influenza Vaccines (#38)

Kanta Subbarao 1
  1. WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, VIC, Australia

The epidemiologic success of influenza viruses that cause annual epidemics and sporadic pandemics, results from the remarkable ability of the virus to change gradually (antigenic drift) or abruptly (antigenic shift). The diversity and antigenic change in influenza viruses create a challenge for prevention and treatment.  Seasonal influenza vaccines and stockpiled pandemic influenza vaccines have to be updated periodically to keep pace with antigenic drift. Several strategies to develop broadly cross-reactive or universal influenza vaccines are being actively explored.  Combining different vaccine platforms and the inclusion of adjuvants increase the breadth of the immune response. We developed and evaluated pandemic live attenuated influenza vaccines (pLAIV) in clinical trials and found that intranasal pLAIV were highly restricted in replication in the upper respiratory tract and a vaccine-specific immune response was not reliably detected in the peripheral blood of human subjects. However, H5 and H7 pLAIVs primed subjects for a robust and rapid influenza-specific neutralizing antibody response upon subsequent intramuscular administration of inactivated subunit vaccine (pISV) boost. Similar findings have been reported with other vaccine platforms including DNA and vectored vaccines. We investigated the immunologic basis for this phenomenon in a non human primate model that recapitulates the serologic observations from clinical trials. Intranasal pLAIV induced a robust but highly localized B cell response in the local LNs that was recalled and detected systemically following parenteral pISV boost. Our observations highlight the potential of vaccination schedules that combine different types of influenza vaccines.