Subbarao Kanta
WHO Collaborating Centre for Reference and Research on Influenza and Department of Microbiology and Immunology, University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria 3000, Australia.
Cold Spring Harb Perspect Med. 2021 Sep 1;11(9):a038653. doi: 10.1101/cshperspect.a038653.
Live attenuated, cold-adapted influenza vaccines exhibit several desirable characteristics, including the induction of systemic, mucosal, and cell-mediated immunity resulting in breadth of protection, ease of administration, and yield. Seasonal live attenuated influenza vaccines (LAIVs) were developed in the United States and Russia and have been used in several countries. In the last decade, following the incorporation of the 2009 pandemic H1N1 strain, the performance of both LAIVs has been variable and the U.S.-backbone LAIV was less effective than the corresponding inactivated influenza vaccines. The cause appears to be reduced replicative fitness of some H1N1pdm09 viruses, indicating a need for careful selection of strains included in multivalent LAIV formulations. Assays are now being implemented to select optimal strains. An improved understanding of the determinants of replicative fitness of vaccine strains and of vaccine effectiveness of LAIVs is needed for public health systems to take full advantage of these valuable vaccines.
减毒活、冷适应流感疫苗具有几个理想的特性，包括诱导全身、黏膜和细胞介导的免疫，从而产生广泛的保护作用、易于接种以及产量高。季节性减毒活流感疫苗（LAIVs）在美国和俄罗斯研发，并已在多个国家使用。在过去十年中，自2009年大流行H1N1毒株被纳入后，两种LAIVs的表现参差不齐，且美国主干LAIV比相应的灭活流感疫苗效果更差。原因似乎是一些H1N1pdm09病毒的复制适应性降低，这表明需要仔细选择多价LAIV制剂中包含的毒株。目前正在实施相关检测以选择最佳毒株。公共卫生系统需要更好地了解疫苗毒株复制适应性的决定因素以及LAIVs的疫苗效力，以便充分利用这些有价值的疫苗。
