Clinical Expectations for Better Influenza Virus Vaccines—Perspectives from the Young Investigators’ Point of View

Abstract

The influenza virus is one of a few viruses that is capable of rendering an otherwise healthy person acutly bedridden for several days. This impressive knock-out effect, without prodromal symptoms, challenges our immune system. The influenza virus undergoes continuous mutations, escaping our pre-existing immunity and causing epidemics, and its segmented genome is subject to reassortment, resulting in novel viruses with pandemic potential. The personal and socieoeconomic burden from influenza is high. Vaccination is the most cost-effective countermeasure, with several vaccines that are available. The current limitations in vaccine effectivness, combined with the need for yearly updating of vaccine strains, is a driving force for research into developing new and improved influenza vaccines. The lack of public concern about influenza severity, and misleading information concerning vaccine safety contribute to low vaccination coverage even in high-risk groups. The success of future influeza vaccines will depend on an increased public awarness of the disease, and hence, the need for vaccination—aided through improved rapid diagnositics. The vaccines must be safe and broadly acting, with new, measurable correlates of protection and robust post-marketing safety studies, to improve the confidence in influenza vaccines.

The Future of Influenza Vaccines: A Historical and Clinical Perspective

“…Thus, in recent decades, vaccine development has shifted toward rational design, in which scientific knowledge about the specific pathogen–host interaction guides the vaccine development process [ 4 ]. For influenza vaccines specifically, pre-clinical and clinical studies have focused on new delivery platforms—virus-like particles [ 5 ], viral vectors [ 6 ], nucleic acids [ 7 , 8 ], peptide epitopes [ 8 ], nanoparticles [ 8 ]—and on novel immunogens that mimic evolutionarily conserved, functionally constrained parts of the virus [ 5 , 9 , 10 ] or that enhance the recruitment of cell-mediated [ 10 , 11 , 12 ] or mucosal [ 6 , 13 ] immune responses. These new approaches may significantly improve the effectiveness of influenza vaccines of the future.…”

Brown J. Influenza: The Hundred Year Hunt to Cure the Deadliest Disease in History. Nova York: Atria Books; 2018.

“…Brown sugere ser difícil uma única. De fato, se o objetivo for uma vacina universal contra a gripe que cubra todas as cepas de influenza, novo método de engenharia de vacinas, ainda inexistente, é necessário 7 . Tal vacina teria efeito neutralizante, inibindo, assim, a infecção 7 .…”