Vaccines for Pandemic Influenza

Description

Recent years have seen unprecedented outbreaks of avian influenza A viruses. In particular, highly pathogenic H5N1 viruses have not only resulted in widespread outbreaks in domestic poultry, but have been transmitted to humans resulting in numerous fatalities. The rapid expansion in their geographic distribution and the possibility that these viruses could acquire the ability to spread from person to person raise the risk that such a virus could cause a global pandemic with high morbidity and mortality. An effective influenza vaccine represents the best approach to prevent and control such an emerging pandemic. However, current influenza vaccines are directed at existing seasonal influenza viruses, which have limited antigenic relationships to the highly pathogenic H5N1 strains. Concerns about pandemic preparedness have greatly stimulated research activities to develop effective vaccines for pandemic influenza viruses, and to overcome the limitations inherent in current approaches to vaccine production and distribution. These limitations include the use of embryonated chicken eggs as the substrate for vaccine production; which is time-consuming and could involve potential biohazards in growth of new virus strains. Other limitations include the requirement that the current inactivated influenza vaccines be administered using needles and syringes, requiring trained personnel, which could be a bottleneck when attempting to vaccinate large populations in mass campaigns. In addition, the current inactivated vaccines which are delivered by injection elicit limited protective immunity in the upper respiratory tract where the infection process is initiated. Most of these limitations of the current vaccines are being addressed by research on novel approaches to vaccine development and delivery that are described in many of the chapters in this volume. Front Matter....Pages i-xviii Front Matter....Pages 1-1 Pandemic Influenza as a Current Threat....Pages 3-24 Antigenic Cross-Reactivity Among H5N1 Viruses....Pages 25-40 Front Matter....Pages 42-42 Seasonal Influenza Vaccines....Pages 43-82 Generation and Characterization of Candidate Vaccine Viruses for Prepandemic Influenza Vaccines....Pages 83-108 Live Attenuated Vaccines for Pandemic Influenza....Pages 109-132 Influenza Vaccines for Avian Species....Pages 133-152 Development and Application of Avian Influenza Vaccines in China....Pages 153-162 Front Matter....Pages 164-164 Designing Vaccines for Pandemic Influenza....Pages 165-176 Attenuated Influenza Virus Vaccines with Modified NS1 Proteins....Pages 177-195 DNA Vaccines Against Influenza Viruses....Pages 197-210 Recombinant Proteins Produced in Insect Cells....Pages 211-225 Influenza Neuraminidase as a Vaccine Antigen....Pages 227-241 Recombinant Vectors as Influenza Vaccines....Pages 243-267 Influenza Virus-Like Particles as Pandemic Vaccines....Pages 269-289 Pandemic Influenza Vaccines....Pages 291-321 Adjuvants for Pandemic Influenza Vaccines....Pages 323-344 Front Matter....Pages 346-346 Transcutaneous Immunization with Influenza Vaccines....Pages 347-368 Microneedle-Based Vaccines....Pages 369-393 Front Matter....Pages 396-396 Animal Models for Evaluation of Influenza Vaccines....Pages 397-412 Immunosenescence and Influenza Vaccine Efficacy....Pages 413-429 Front Matter....Pages 396-396 Vaccines for Pandemic Influenza: Summary of Recent Clinical Trials....Pages 431-451 Considerations for Licensure of Influenza Vaccines with Pandemic and Prepandemic Indications....Pages 453-470 Strategies for Broad Global Access to Pandemic Influenza Vaccines....Pages 471-493 Prioritization of Pandemic Influenza Vaccine: Rationale and Strategy for Decision Making....Pages 495-507 Back Matter....Pages 509-512