The impact of candidate influenza virus and egg-based manufacture on vaccine effectiveness: Literature review and expert consensus
Influenza is associated with significant morbidity and mortality worldwide. Whilst vaccination is key for the prevention of influenza infection, there are many factors which may contribute to reduced vaccine effectiveness, including antigenic evolution via both antigenic drift and egg-adaptations. D...
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| Veröffentlicht in: | Vaccine 2020-08, Vol.38 (38), p.6047-6056 |
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| creator | Rajaram, Sankarasubramanian Wojcik, Radek Moore, Catherine Ortiz de Lejarazu, Raúl de Lusignan, Simon Montomoli, Emanuele Rossi, Alessandro Pérez-Rubio, Alberto Trilla, Antoni Baldo, Vincenzo Jandhyala, Ravi Kassianos, George |
| description | Influenza is associated with significant morbidity and mortality worldwide. Whilst vaccination is key for the prevention of influenza infection, there are many factors which may contribute to reduced vaccine effectiveness, including antigenic evolution via both antigenic drift and egg-adaptations. Due to the currently dissociated and indirect evidence supporting both the occurrence of these two phenomena in the egg-based manufacturing process and their effects on vaccine effectiveness, this topic remains a subject of debate.
To review the evidence and level of agreement in expert opinion supporting a mechanistic basis for reduced vaccine effectiveness due to egg-based manufacturing, using an expert consensus-based methodology and literature reviews.
Ten European influenza specialists were recruited to the expert panel. The overall research question was deconstructed into four component principles, which were examined in series using a novel, online, two-stage assessment of proportional group awareness and consensus. The first stage independently generated a list of supporting references for each component principle via literature searches and expert assessments. In the second stage, a summary of each reference was circulated amongst the experts, who rated their agreement that each reference supported the component principle on a 5-point Likert scale. Finally, the panel were asked if they agreed that, as a whole, the evidence supported a mechanistic basis for reduced vaccine effectiveness due to egg-based manufacturing.
All component principles were reported to have a majority of strong or very strong supporting evidence (70–90%).
On reviewing the evidence for all component principles, experts unanimously agreed that there is a mechanistic basis for reduced vaccine effectiveness resulting from candidate influenza virus variation due to egg-based manufacturing, particularly in the influenza A/H3N2 strain. Experts pointed to surveillance, candidate vaccine virus selection and manufacturing stages involving eggs as the most likely to impact vaccine effectiveness. |
| doi_str_mv | 10.1016/j.vaccine.2020.06.021 |
| format | Article |
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To review the evidence and level of agreement in expert opinion supporting a mechanistic basis for reduced vaccine effectiveness due to egg-based manufacturing, using an expert consensus-based methodology and literature reviews.
Ten European influenza specialists were recruited to the expert panel. The overall research question was deconstructed into four component principles, which were examined in series using a novel, online, two-stage assessment of proportional group awareness and consensus. The first stage independently generated a list of supporting references for each component principle via literature searches and expert assessments. In the second stage, a summary of each reference was circulated amongst the experts, who rated their agreement that each reference supported the component principle on a 5-point Likert scale. Finally, the panel were asked if they agreed that, as a whole, the evidence supported a mechanistic basis for reduced vaccine effectiveness due to egg-based manufacturing.
All component principles were reported to have a majority of strong or very strong supporting evidence (70–90%).
On reviewing the evidence for all component principles, experts unanimously agreed that there is a mechanistic basis for reduced vaccine effectiveness resulting from candidate influenza virus variation due to egg-based manufacturing, particularly in the influenza A/H3N2 strain. Experts pointed to surveillance, candidate vaccine virus selection and manufacturing stages involving eggs as the most likely to impact vaccine effectiveness.</description><identifier>ISSN: 0264-410X</identifier><identifier>EISSN: 1873-2518</identifier><identifier>DOI: 10.1016/j.vaccine.2020.06.021</identifier><identifier>PMID: 32600916</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adaptation ; Antigenic drift ; Antigens ; Consensus ; Disease prevention ; Egg-adaptations ; Eggs ; Experts ; Fatalities ; Humans ; Immune system ; Influenza ; Influenza A ; Influenza A Virus, H3N2 Subtype ; Influenza Vaccines ; Influenza, Human - prevention & control ; Laboratories ; Literature reviews ; Manufacturing ; Manufacturing industry ; Meetings ; Morbidity ; Older people ; Population ; Seasons ; Streptococcus infections ; Surveillance ; Vaccination ; Vaccine ; Vaccine efficacy ; Vaccines ; Viruses</subject><ispartof>Vaccine, 2020-08, Vol.38 (38), p.6047-6056</ispartof><rights>2020 The Author(s)</rights><rights>Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.</rights><rights>2020. The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-a0ac137e522868963b6bb926919124300765b466f9b9778b22617f0e092e17da3</citedby><cites>FETCH-LOGICAL-c440t-a0ac137e522868963b6bb926919124300765b466f9b9778b22617f0e092e17da3</cites><orcidid>0000-0001-8934-0930 ; 0000-0003-4493-3841</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2432846714?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32600916$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rajaram, Sankarasubramanian</creatorcontrib><creatorcontrib>Wojcik, Radek</creatorcontrib><creatorcontrib>Moore, Catherine</creatorcontrib><creatorcontrib>Ortiz de Lejarazu, Raúl</creatorcontrib><creatorcontrib>de Lusignan, Simon</creatorcontrib><creatorcontrib>Montomoli, Emanuele</creatorcontrib><creatorcontrib>Rossi, Alessandro</creatorcontrib><creatorcontrib>Pérez-Rubio, Alberto</creatorcontrib><creatorcontrib>Trilla, Antoni</creatorcontrib><creatorcontrib>Baldo, Vincenzo</creatorcontrib><creatorcontrib>Jandhyala, Ravi</creatorcontrib><creatorcontrib>Kassianos, George</creatorcontrib><title>The impact of candidate influenza virus and egg-based manufacture on vaccine effectiveness: Literature review and expert consensus</title><title>Vaccine</title><addtitle>Vaccine</addtitle><description>Influenza is associated with significant morbidity and mortality worldwide. Whilst vaccination is key for the prevention of influenza infection, there are many factors which may contribute to reduced vaccine effectiveness, including antigenic evolution via both antigenic drift and egg-adaptations. Due to the currently dissociated and indirect evidence supporting both the occurrence of these two phenomena in the egg-based manufacturing process and their effects on vaccine effectiveness, this topic remains a subject of debate.
To review the evidence and level of agreement in expert opinion supporting a mechanistic basis for reduced vaccine effectiveness due to egg-based manufacturing, using an expert consensus-based methodology and literature reviews.
Ten European influenza specialists were recruited to the expert panel. The overall research question was deconstructed into four component principles, which were examined in series using a novel, online, two-stage assessment of proportional group awareness and consensus. The first stage independently generated a list of supporting references for each component principle via literature searches and expert assessments. In the second stage, a summary of each reference was circulated amongst the experts, who rated their agreement that each reference supported the component principle on a 5-point Likert scale. Finally, the panel were asked if they agreed that, as a whole, the evidence supported a mechanistic basis for reduced vaccine effectiveness due to egg-based manufacturing.
All component principles were reported to have a majority of strong or very strong supporting evidence (70–90%).
On reviewing the evidence for all component principles, experts unanimously agreed that there is a mechanistic basis for reduced vaccine effectiveness resulting from candidate influenza virus variation due to egg-based manufacturing, particularly in the influenza A/H3N2 strain. Experts pointed to surveillance, candidate vaccine virus selection and manufacturing stages involving eggs as the most likely to impact vaccine effectiveness.</description><subject>Adaptation</subject><subject>Antigenic drift</subject><subject>Antigens</subject><subject>Consensus</subject><subject>Disease prevention</subject><subject>Egg-adaptations</subject><subject>Eggs</subject><subject>Experts</subject><subject>Fatalities</subject><subject>Humans</subject><subject>Immune system</subject><subject>Influenza</subject><subject>Influenza A</subject><subject>Influenza A Virus, H3N2 Subtype</subject><subject>Influenza Vaccines</subject><subject>Influenza, Human - prevention & control</subject><subject>Laboratories</subject><subject>Literature reviews</subject><subject>Manufacturing</subject><subject>Manufacturing industry</subject><subject>Meetings</subject><subject>Morbidity</subject><subject>Older people</subject><subject>Population</subject><subject>Seasons</subject><subject>Streptococcus infections</subject><subject>Surveillance</subject><subject>Vaccination</subject><subject>Vaccine</subject><subject>Vaccine 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impact of candidate influenza virus and egg-based manufacture on vaccine effectiveness: Literature review and expert consensus</title><author>Rajaram, Sankarasubramanian ; Wojcik, Radek ; Moore, Catherine ; Ortiz de Lejarazu, Raúl ; de Lusignan, Simon ; Montomoli, Emanuele ; Rossi, Alessandro ; Pérez-Rubio, Alberto ; Trilla, Antoni ; Baldo, Vincenzo ; Jandhyala, Ravi ; Kassianos, George</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-a0ac137e522868963b6bb926919124300765b466f9b9778b22617f0e092e17da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adaptation</topic><topic>Antigenic drift</topic><topic>Antigens</topic><topic>Consensus</topic><topic>Disease prevention</topic><topic>Egg-adaptations</topic><topic>Eggs</topic><topic>Experts</topic><topic>Fatalities</topic><topic>Humans</topic><topic>Immune system</topic><topic>Influenza</topic><topic>Influenza 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Vincenzo</au><au>Jandhyala, Ravi</au><au>Kassianos, George</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of candidate influenza virus and egg-based manufacture on vaccine effectiveness: Literature review and expert consensus</atitle><jtitle>Vaccine</jtitle><addtitle>Vaccine</addtitle><date>2020-08-27</date><risdate>2020</risdate><volume>38</volume><issue>38</issue><spage>6047</spage><epage>6056</epage><pages>6047-6056</pages><issn>0264-410X</issn><eissn>1873-2518</eissn><abstract>Influenza is associated with significant morbidity and mortality worldwide. Whilst vaccination is key for the prevention of influenza infection, there are many factors which may contribute to reduced vaccine effectiveness, including antigenic evolution via both antigenic drift and egg-adaptations. Due to the currently dissociated and indirect evidence supporting both the occurrence of these two phenomena in the egg-based manufacturing process and their effects on vaccine effectiveness, this topic remains a subject of debate.
To review the evidence and level of agreement in expert opinion supporting a mechanistic basis for reduced vaccine effectiveness due to egg-based manufacturing, using an expert consensus-based methodology and literature reviews.
Ten European influenza specialists were recruited to the expert panel. The overall research question was deconstructed into four component principles, which were examined in series using a novel, online, two-stage assessment of proportional group awareness and consensus. The first stage independently generated a list of supporting references for each component principle via literature searches and expert assessments. In the second stage, a summary of each reference was circulated amongst the experts, who rated their agreement that each reference supported the component principle on a 5-point Likert scale. Finally, the panel were asked if they agreed that, as a whole, the evidence supported a mechanistic basis for reduced vaccine effectiveness due to egg-based manufacturing.
All component principles were reported to have a majority of strong or very strong supporting evidence (70–90%).
On reviewing the evidence for all component principles, experts unanimously agreed that there is a mechanistic basis for reduced vaccine effectiveness resulting from candidate influenza virus variation due to egg-based manufacturing, particularly in the influenza A/H3N2 strain. Experts pointed to surveillance, candidate vaccine virus selection and manufacturing stages involving eggs as the most likely to impact vaccine effectiveness.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>32600916</pmid><doi>10.1016/j.vaccine.2020.06.021</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8934-0930</orcidid><orcidid>https://orcid.org/0000-0003-4493-3841</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Vaccine, 2020-08, Vol.38 (38), p.6047-6056 |
| issn | 0264-410X 1873-2518 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; ProQuest Central UK/Ireland |
| subjects | Adaptation Antigenic drift Antigens Consensus Disease prevention Egg-adaptations Eggs Experts Fatalities Humans Immune system Influenza Influenza A Influenza A Virus, H3N2 Subtype Influenza Vaccines Influenza, Human - prevention & control Laboratories Literature reviews Manufacturing Manufacturing industry Meetings Morbidity Older people Population Seasons Streptococcus infections Surveillance Vaccination Vaccine Vaccine efficacy Vaccines Viruses |
| title | The impact of candidate influenza virus and egg-based manufacture on vaccine effectiveness: Literature review and expert consensus |
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