What does the influenza vaccine contain? Michigan strain H1N1 added to the vaccine mix

According to the Centers for Disease Control and Prevention, seasonal influenza activity usually begins in October. The number of cases tends to reach a national peak between December and February.

And yet, sometimes, the flu season starts earlier.

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Kent County experienced an epidemic in mid-August among 120 people who attended the National Rural Letter Lettercar Association conference in Grand Rapids. Several people related to the conference were tested positive for a strain of influenza A (H1N1) virus.

"The best thing to do to prepare for this flu season is to start vaccinating as many people as possible," said Minicuci. "The flu vaccine is recommended for all people 6 months and older."

But have you ever wondered what the serum contains in your arm each fall?

With influenza viruses constantly changing, scientists from more than 100 influenza centers around the world are working on surveillance and sending their data and samples to the World Health Organization. These scientists collaborate with other public health experts to determine which strains are most likely to spread during the coming season. The vaccines are then developed to target these strains.

This year's vaccine cocktail includes:

• A / Michigan / 45/2015 (H1N1) pdm09 virus type
• A / Singapore / INFIMH-16-0019 / 2016 A (H3N2) -like virus (updated)
• B / Colorado / virus similar to the Victoria lineage virus (updated)
• And some will also have a fourth strain: the virus type B / Phuket / 3073/2013 (Yamagata lineage).

Did you catch "Michigan" in the first listed strain? It is an H1N1 virus that Mr. Minicuci first isolated from a Michigan laboratory and submitted to the CDC.

Scientists at the University of Michigan's Flu Vaccine Assessment Laboratory play a key role in helping public health experts determine which vaccines are most effective and isolating strains of the virus that may be useful in combating spread of the virus.

"The strain was identified and tested at the University of Michigan in Ann Arbor with Dr. Arnold Monto's research team," said Minicuci. "It's how each strain is named, as to where they are identified."

The free press met with Emily Martin, assistant professor of epidemiology at the School of Public Health at the University of Michigan. She works in the laboratory that identified the strain for the first time. We asked him questions about what people should know about the flu season this year:

QUESTION: Is it a badge of honor to have a Michigan strain included in this year's vaccine or is it more of a dubious distinction?

REPLY: In the world of the flu, it is an honor to have collected a strain that is part of the vaccine. In fact, the original live vaccine that became FluMist in 2003 – which was developed here at the University of Michigan and the strain of virus that became this vaccine was titled A / Ann Arbor. It has long been called the A / Ann Arbor vaccine and people were very proud of it. It has been updated since.

Q: How did the sample known as A / Michigan / 45/2015 (H1N1) pdm09 get into this year's flu vaccine?

A: We are one of … six active surveillance programs set up throughout the country throughout the year to determine the quality of the flu shot.

So the figures that come out in the middle of the influenza season and evaluate how it works, we contribute to that figure from the University of Michigan. It's a huge program, and it's really exciting to work.

We work in partnership with several local hospitals. When patients come in and have respiratory symptoms, we find out whether or not they have the flu, and we find out if they have been vaccinated or not and what vaccine they have received. Then we work with the CDC to share our data with people across the country to see if the flu shot is working.

There are about 3,500 people in total with whom we work each year.

Q: What is the effectiveness of the influenza vaccine in general?

A: We follow him from year to year. In the years when we mainly have H1N1 viruses, the efficiency is higher. It will be in the range of 60 or 70%. The years we have H3N2 – unfortunately, the last three years – we can see estimates of efficiency ranging from 20 to 30%. We believe that the vaccine always prevents the disease, even at this level. He always avoids influenza illness, but not as much as we would like.

The final estimate of the vaccine's effectiveness for the 2017-2018 influenza season was 25% against the H3n2 strain; 65% against the H1N1 flu and 49% against the B flu.

Q: If vaccine efficacy rates vary a lot, why should I take the dose?

A: With all the research we have done to try to make a better vaccine, it is always better to get it than not to get it. People who get vaccinated as a whole – even if it's not as good as we want – get less flu than people who do not get the vaccine.

There is more recent data … that indicates that when people have the vaccine and are infected anyway, they have a less serious disease. This is still an active area of ​​research, but the data seems to suggest that this might be true.

Q: Since influenza vaccine takes about two weeks to produce antibodies and protect a person, what is the best time to get the flu shot?

A: Right now, there is a vigorous debate in the literature among scientists about when to get it. But our best data tells us that if you get it now – in the fall before the end of the month of October – you should be well protected throughout the season. You should be fine.

It's best to get it when you have the opportunity, then remove it and push the vaccine later, then forget about it. You want to try to get it by the end of October, especially in places like university campuses, where things travel fast. … Shortly after the start of the school year, we will sometimes see an influenza activity.

Q: Is it important to go to a doctor's office, for example, or is it acceptable to get the vaccine at a pharmacy?

A: Get it where you can get it. There are a number of vaccines available on the market, but for the most part, everyone offers a similar vaccine.

Some of the differences we are seeing in the manufacturing sector now is that we are seeing most vaccines with four strains. We now find that some vaccines contain more antigen and are high-dose vaccines. Older people may be interested in asking their doctor for a high dose vaccine. It may be a little harder to find in a pharmacy or in a place that is not a medical office.

There are new vaccines on the market that are produced in cells rather than eggs. There is still a lot of research to find out if one is better than another.

For people allergic to eggs, I would go through your doctor to get a vaccine. The guidelines on egg allergy have been updated and it is now much clearer. There are options for people allergic to eggs. There are vaccines that are not produced in the available eggs. This is one of the options.

Q: I've heard that vaccines are not safe. Is it true?

A: I think that people who are reluctant to receive vaccines must first know that I am vaccinating my family.

It's not just about protecting yourself against the flu, but protecting people against the flu. And so, it's not just an individual consideration. If you have vulnerable people in your life, it is also important to protect them. There are also specific scientific conversations, but I think this message is often lost in the vaccine debate.

In vaccines given to children (the preservative derived from mercury), thimerosal is no longer used.

Some flu vaccines still use preservatives. It's important to remember that … although it's in the mercury-like family, thimerosal is a different mercury compound we hear about in the environment, like the mercury you're concerned about when you eat certain types of fish, or that pregnant women have to watch in a diet. This is a different component. It is structurally different from this other type of mercury.

Q: Which vulnerable people should we care about most in the community?

A: The very young and the oldest will be the most vulnerable. Influenza in an elderly person, especially in an elderly person with any respiratory condition, can have a lasting effect on their quality of life.

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Anyone with chronic diseases, especially lung diseases, people with heart disease and pregnant women, may suffer serious complications from influenza. During the pandemic, we saw this a lot with pregnant women.

Q: What is the risk of seeing another influenza pandemic on the scale of the 1918 Spanish flu that has killed more than 20 million people worldwide?

A: I think what people are observing in terms of pandemic influenza is looking at the flu that is circulating in birds and other animals and the possibility that they are spreading in the general population. It would be a public health emergency because we would need new and different vaccines. And it is a virus that our immune system has seen nothing close and that would be a critical situation.

You know, 1918 was an interesting situation because we did not have vaccines like we do now. So they controlled everything by social means, telling people to wear masks and not to gather and things like that. We now have many more tools than we did not have at the time, which is great.

The pandemics we have seen since then have not been so devastating because we have had these tools. We were able to make vaccines quickly.

Q: Can the flu shot make a person sick?

If the vaccine makes you a little sick, a bit sore and tired for a day or two, it's your immune system that works. And that's not something that concerns us a lot.

Most people get vaccinated now, in the fall, when the season starts to change and everybody goes back to school and a lot of viruses circulate, like rhinovirus. The risk is high that you are infected with something during this time of year. Often it's only coincidence that you have been vaccinated when many rhinoviruses and other viruses have made people sick at the same time.

Depending on how you count it, there are about 13 other respiratory viruses that cause flu-like symptoms, and we would vaccinate against the hurricane if we could. But we do not have vaccines against them.