influenza

COVID-19- and Flu-Ravaged Lungs Could Be Repaired with mRNA Therapy

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Ravaged Lungs Could Be Repaired with mRNA Therapy

Infection in lungs

Respiratory infections, such as those caused by SARS-CoV-2 or influenza, can damage the lungs’ delicate network of capillary blood vessels, compromising oxygen delivery and carbon dioxide removal. To overcome this damage, the lungs depend on the regenerative capacities of vascular endothelial cells. As valuable as these cells are, they can, according to University of Pennsylvania scientists, benefit from a little help.

The scientists, led by Andrew Vaughan, PhD, focused on a repair pathway involving vascular endothelial growth factor α (Vegfa) and the TGF-β receptor 2 (TGF-βR2). Using animal models and human tissue samples, the scientists showed that delivering Vegfa via lipid nanoparticles (LNPs) greatly enhances modes of repair for damaged blood vessels.

Details were published recently in Science Translational Medicine, in an article titled, “TGF-βR2 signaling coordinates pulmonary vascular repair after viral injury in mice and human tissue.”

“Mice deficient in endothelial Tgfbr2 exhibited prolonged injury and diminished vascular repair,” the article’s authors wrote. “Loss of endothelial Tgfbr2 prevented autocrine Vegfa expression, reduced endothelial proliferation, and impaired renewal of aerocytes thought to be critical for alveolar gas exchange.”

“We developed a lipid nanoparticle that targets the pulmonary endothelium, Lung-LNP (LuLNP),” the authors continued. “Delivery of Vegfa mRNA, a critical TGF-βR2 downstream effector, by LuLNPs improved the impaired regeneration phenotype of endothelial cell Tgfbr2 deficiency during influenza injury.”

Vaughan’s team and other investigators had previously shown that endothelial cells are among the unsung heroes in repairing the lungs after viral infections. But Vaughan’s team noted that its work demonstrated that a “more granular understanding of the fundamental mechanisms driving reconstitution of lung endothelium” could inform efforts to facilitate therapeutic vascular repair.

“Here we’ve identified and isolated pathways involved in repairing this tissue, delivered mRNA to endothelial cells, and consequently observed enhanced recovery of the damaged tissue,” Vaughan said. “These findings hint at a more efficient way to promote lung recovery after diseases like COVID-19.”

The team found Vegfa’s involvement in this recovery, while building on work in which they used single-cell RNA sequencing to identify TGF-βR2 as a major signaling pathway. The researchers saw that when TGF-βR2 was missing, it stopped the activation of Vegfa. This lack of signal made the blood vessel cells less able to multiply and renew themselves, which is vital for the exchange of oxygen and carbon dioxide in the tiny air sacs of the lungs.

“We’d known there was a link between these two pathways, but this motivated us to see if delivering Vegfa mRNA into endothelial cells could improve lung recovery after disease-related injury,” said first author Gan Zhao, PhD, a postdoctoral researcher in the Vaughan laboratory.

The Vaughan laboratory then reached out to Michael J. Mitchell, PhD, of the School of Engineering and Applied Science, whose laboratory specializes in LNPs, to see if delivery of this mRNA cargo would be feasible.

“LNPs have been great for vaccine delivery and have proven incredibly effective delivery vehicles for genetic information,” said Mitchell, who is an associate professor of bioengineering at Penn Engineering and a co-author of the paper. “But the challenge here was to get the LNPs into the bloodstream without them heading to the liver, which is where they tend to congregate as its porous structure lends favor to substances passing from the blood into hepatic cells for filtration. So, we had to devise a way to specifically target the endothelial cells in the lungs.”

The Mitchell laboratory’s LNPs proved effective in delivering Vegfa into endothelial cells, and as a result, the researchers saw a marked improvement in vascular recovery in their animal models. Within the animal models, the researchers saw improved oxygen levels, and in some, the treatment helped them recover their weight better than the control group. These treated mice also had less lung inflammation, shown by lower levels of certain markers in their lung fluid, and their lungs showed less damage and scarring, with more healthy blood vessels.

“We’re looking forward to testing this delivery platform for other cell types in the lung, and it will be important to evaluate whether TGF-βR2 signaling is important in other injury contexts including chronic conditions like emphysema and chronic obstructive pulmonary disease,” Vaughan said. “With this proof-of-concept being well validated, we’re sure that we’ll pave the way for new mRNA-based strategies for treating lung injury.”

mRNA Vaccine Provides Broad Protection against All Known Influenza Subtypes

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Researchers at the Perelman School of Medicine at the University of Pennsylvania have developed an experimental multivalent mRNA-based vaccine against all 20 known subtypes of influenza virus. Their approach differs from previous attempts to craft a universal flu vaccine, by including antigens specific to each subtype, rather than just a smaller set of antigens shared among subtypes. This strategy harnesses the same mRNA technology as that employed in the Pfizer and Moderna SARS-CoV-2 vaccines. The mRNA technology that enabled those COVID-19 vaccines was pioneered at Penn.

Tests in animal models showed that the vaccine dramatically reduced signs of illness and protected from death, even when the animals were exposed to flu strains different from those used in making the vaccine.

The team suggests that their technology could lead to the development of a universal flu vaccine that protects against potential future pandemics. “The idea here is to have a vaccine that will give people a baseline level of immune memory to diverse flu strains, so that there will be far less disease and death when the next flu pandemic occurs,” said study senior author Scott Hensley, PhD, a professor of microbiology at in the Perelman School of Medicine. Hensley and colleagues reported on the development of their mRNA vaccine in Science, in a report titled, “A multivalent nucleoside-modified mRNA vaccine against all known influenza virus subtypes.” Hensley and his laboratory collaborated in the study with the laboratory of mRNA vaccine pioneer Drew Weissman, MD, PhD, the Roberts Family professor in vaccine research and director of vaccine research at Penn Medicine.

Influenza viruses periodically cause pandemics with enormous death tolls. The best known of these was the 1918–19 “Spanish flu” pandemic, which killed tens of millions of people worldwide. Flu viruses can circulate in birds, pigs, and other animals, and pandemics can start when one of these strains jumps to humans and acquires mutations that adapt it better for spreading among humans. The authors explained, “There are at least 18 different influenza A virus (IAV) subtypes that circulate in animal reservoirs, and these viruses occasionally enter the human population and cause a pandemic.”

Current flu vaccines are “seasonal” vaccines that protect against recently circulating strains, but would not be expected to protect against new, pandemic strains. And even with increased global surveillance, it is difficult to predict which flu strain will cause the next flu pandemic, making a universal vaccine important. As the investigators noted, “Although surveillance programs and modeling studies have increased our knowledge of pandemic risk, we cannot accurately predict which influenza subtype will cause the next pandemic.”

There are several universal influenza vaccines in development to provide protection against diverse influenza virus subtypes, the team continued. Most of these vaccine candidates include a limited number of antigens that have epitopes that are conserved across different influenza virus subtypes.

In contrast, the strategy employed by the Penn Medicine researchers is to vaccinate using immunogens—a type of antigen that stimulates immune responses—from all known influenza A and influenza B virus (IBV) subtypes in order to elicit broad protection. This vaccination strategy is not expected to provide “sterilizing” immunity that completely prevents viral infections. “Instead of focusing on immunogens to elicit antibodies against epitopes that are conserved among many different influenza virus strains, we designed a vaccine that encodes separate immunogens from all known IAV subtypes and IBV lineages,” the team explained.

Their newly reported study confirmed that the vaccine elicited a memory immune response that can be quickly recalled and adapted to new pandemic viral strains, significantly reducing severe illness and death from infections. “It would be comparable to first-generation SARS-CoV-2 mRNA vaccines, which were targeted to the original Wuhan strain of the coronavirus,” Hensley said. “Against later variants such as Omicron, these original vaccines did not fully block viral infections, but they continue to provide durable protection against severe disease and death.”

For their flu vaccine, the researchers prepared 20 different nanoparticle encapsulated mRNAs, each encoding a different hemagglutinin antigen. The experimental mRNA-lipid nanoparticle vaccine developed by Hensley and colleagues encoded hemagglutinin (HA) antigens from all 20 known influenza A and B virus subtypes.

When injected and taken up by the cells of recipients, the vaccine then resulted in production of copies of the key flu virus hemagglutinin protein, for all 20 influenza hemagglutinin subtypes—H1 through H18 for influenza A viruses, and two more for influenza B viruses. “For a conventional vaccine, immunizing against all these subtypes would be a major challenge, but with mRNA technology, it’s relatively easy,” Hensley said.

Tested in mice, the mRNA vaccine elicited high levels of antibodies, which stayed elevated for at least four months, and reacted strongly to all 20 flu subtypes. Multivalent protein vaccines produced using more traditional methods elicited fewer antibodies and were less protective compared to the multivalent mRNA vaccine in the animals.

Moreover, the new vaccine seemed relatively unaffected by prior influenza virus exposures, which can skew immune responses to conventional influenza vaccines. The researchers observed that the antibody response in the mice was strong and broad whether or not the animals had been exposed to flu virus before. The team also carried out tests in ferrets that were vaccinated using a prime-boost approach, and challenged with an avian H1N1 virus, to mimic a pandemic caused by an unknown viral strain. The results of these experiments confirmed that compared with unvaccinated animals challenged by the same virus, the vaccinated ferrets lost less weight, and all survived, whereas two of the four unvaccinated ferrets died. Unvaccinated animals also displayed more clinical signs of disease relative to vaccinated animals after infection.

“Further studies will be required to fully elucidate the mechanisms by which the 20-HA mRNA vaccine provides protection,” the authors acknowledged. Their reported findings suggested that protection against antigenically matched strains is mediated by neutralizing antibodies, whereas protection against mismatched viral strains may occur through non-neutralizing mechanisms, such as antibody-dependent cellular cytotoxicity (ADCC).

Hensley and his colleagues currently are designing human clinical trials. The researchers envision that, if those trials are successful, the vaccine may be useful for eliciting long-term immune memory against all influenza subtypes in people of all age groups, including young children. “We think this vaccine could significantly reduce the chances of ever getting a severe flu infection,” Hensley said. As the team noted in their report, “It is likely that mRNA influenza vaccines that are imperfectly matched to novel pandemic influenza virus strains will not provide sterilizing immunity but will instead limit disease severity and protect against death through non-neutralizing mechanisms.”

In an accompanying perspective, Alyson A Kelvin, PhD, and Darryl Fallzarano, PhD, at the University of Saskatchewan, noted that the strengths of the mRNA platform for pandemic vaccine production include flexibility of antigen design, increased numbers of potential viral targets, speed of production, and inexpensive, scalable manufacturing. “These strengths are important when designing and producing vaccines for a highly diverse, unpredictable family of viruses that can easily spread globally in a matter of weeks,” they noted. However, they commented, “questions remain regarding the regulation and approval pathway of such a vaccine that targets viruses of pandemic potential but are not currently in human circulation.”

In principle, Hensley added, the same multivalent mRNA strategy could be used for other viruses with pandemic potential, including coronaviruses. “Multivalent mRNA-LNP vaccines may be applied against other variable pathogens, such as coronaviruses and rhinoviruses,” the scientists concluded. “For example, SARS-CoV-2mRNA vaccines are being updated to include multiple spike components to combat antigenically distinct strains. Additional studies will be required to determine the maximum number of antigens that can be simultaneously delivered through mRNA-LNP vaccines and the underlying immunological mechanisms that allow for the induction of responses against multiple antigens.”

Spanish flu-like virus could emerge from birds.

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Bird flu viruses are just a few genetic steps away from the flu virus that caused the deadly 1918 Spanish flu pandemic, a new study shows.

An international team of virologists identified the key genetic components — similar to those in the virus behind the 1918 pandemic — in influenza viruses in wild ducks.

The findings, published in the journal Cell Host and Microbe , suggest that 1918-like pandemic viruses may emerge in the future.

“Because avian influenza viruses in nature require only a few changes to adapt to humans and cause a pandemic, it is important to understand the mechanisms involved in adaptations … so we can be better prepared,” says study lead author Yoshihiro Kawaoka of the University of Wisconsin-Madison.

The Spanish flu killed up to 50 million people across the world in 1918.

Previous genetic analysis indicates the deadly virus was a type of influenza A of avian origin, although this finding is controversial.

Wild birds harbour a large gene pool of influenza A viruses that could cause pandemics, but the likelihood of birds harbouring a virus similar to the 1918 pandemic virus has been unclear.

To assess the risk, the scientists used reverse genetic methods to recreate a virus that differed from that of the Spanish flu by only 3 per cent of the amino acids that make the virus proteins.

In the animals it was tested on, the new virus was less pathogenic than the Spanish flu — but more so than avian flu.

However, the scientists then discovered seven mutations in three virus genes that allowed it to spread as easily as the Spanish flu in ferrets, an animal commonly used in influenza transmission studies.

Consisting of genetic factors already present in wild bird populations, the virus showed that genetic ingredients capable of combining to create a dangerous pathogen that could produce a human pandemic exist in nature.

Surveillance strategies

Kawaoka says the discovery could help scientists develop more effective strategies to combat the emergence of such a disease.

“Research findings like this help us assess the risk of outbreaks and could contribute to routine surveillance of influenza viruses,” he says.

The research also shines light on the bird flu virus’s adaptive mechanisms for spreading to mammals.

A mutation of a protein on the surface of the virus, for example, allows it to cling to an organism’s cells and could increase the virus’s ability to infect human respiratory tracts.

The researchers also discovered that the virus they created reacted to the current vaccine against seasonal flu — which is effective against H1N1 flu responsible for a 2009 pandemic — indicating that the current vaccine could offer protection against a pandemic.

The scientists also noted that the virus was sensitive to oseltamivir, an antiviral medication to prevent and slow the flu.

 

Man flu is no myth say scientists, with ‘manly’ men more susceptible

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Men with high levels of testosterone have a secret flaw – less effective immune systems, researchers have discovered

Man flu may not be a myth after all, as scientist have found that men with high levels of testosterone have a hidden flaw – weak immune systems.

The discovery could explain why men are more susceptible than women to a whole range of bacterial, viral, fungal and parasitic infections, researchers said.

It may also be the reason why men’s immune systems respond less strongly to vaccinations against influenza, yellow fever, measles and hepatitis, along with many other infectious diseases.

Those who take testosterone supplements in the quest to gain muscle meanwhile, could be making themselves more susceptible to illness.

“This is the first study to show an explicit correlation between testosterone levels, gene expression and immune responsiveness in humans,” said US lead scientist Professor Mark Davis, from Stanford University.

“It could be food for thought to all the testosterone-supplement takers out there.”

The researchers studied how the immune systems of 34 men and 53 women were stimulated by the flu vaccine.

The jab generated a bigger boost in protective antibodies in women, with further analysis revealing activity that, in high testosterone men, was associated with a weakened antibody response. Men with low testosterone were not affected the same way.

Testosterone’s anti-inflammatory properties may explain why it can weaken the immune system, said scientists writing in the journal Proceedings of the National Academy of Sciences.

Prof Davies said the reason why testosterone weakens the immune system yet boosts muscle power and aggression, may be linked to the man’s evolutionary role.

Men are more likely than women to suffer injuries from competitive encounters, as well as their traditional roles of hunting, defence and potentially dangerous physical work, Prof Davies said. The dampening down the immune system makes male less susceptible to a potentially fatal over-reaction to infections, especially those from wounds.

“Ask yourself which sex is more likely to clash violently with, and do grievous bodily harm to, others of their own sex,” Prof Davis added.

‘Unpredictable pandemics’ warning

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The world needs to be prepared for “unpredictable pandemics” from viruses making the leap from animals to people, scientists in Taiwan say.

Their warning follows the first reported case of a common bird flu, H6N1, being detected in a woman, earlier this year.

The patient recovered and no other cases have been detected.

But the Lancet Respiratory Medicine report said “intensive” monitoring of bird flu was needed.

In May 2013, the first human case of an H6N1 bird flu was detected in a woman in Taiwan. One of her neighbours bred ducks, geese and chickens – although the precise source of the infection has not been detected.

Many sub-types of influenza, such as those that cause seasonal flu or the swine flu pandemic, are known to infect people, but H6N1 is not one of them.

The report, by the Centres for Disease Control in Taiwan, said: “The occurrence of a human case of H6N1 infection shows the unpredictability of influenza viruses.

Influenza

“Our report highlights the need for influenza pandemic preparedness , including intensive surveillance for ever evolving avian influenza viruses.”

Prof Wendy Barclay, from Imperial College London, said these infections may have happened in the past but improved technology had meant this one had been discovered.

She said: ” Is this a truly new thing or are we now just better at seeing it?”

She told the BBC she expected far more of these cases to be reported in the next few years as more hospitals were geared up to look for novel bird flus.

Prof Barclay added: “This is a single case with no evidence of human transmission, but as always we should keep an eye on it and do studies to see how close it is to being able to spread between humans.”

Vaccination Against Seasonal Influenza May Reduce the Risk of Cardiovascular Events.

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For many people, getting a seasonal flu shot may help them avoid a week or more of misery. But for some individuals, especially those with heart disease, vaccination against influenza appears to help reduce the likelihood of major adverse cardiovascular events, such as heart attack and stroke.

Researchers, whose findings appear today in JAMA, found that receiving influenza vaccine was associated with a 36% lower risk of cardiovascular events compared with not being immunized against flu. For individuals with recent acute coronary syndrome, such as a heart attack or unstable angina, influenza vaccine was associated with a 55% lower risk of cardiovascular events within 12 months compared with those who had a recent acute coronary syndrome but did not receive the vaccine. The findings are based on a systematic review and meta-analysis involving 6 randomized clinical trials, 5 published and 1 unpublished. These trials collectively enrolled 6735 patients with a mean age of 67 years; 36% had a history of heart disease.

Lead author Jacob A. Udell, MD, MPH, of the University of Toronto in Canada, discusses his team’s findings.

news@JAMA: Why did you do the study?

Dr Udell: There have been reports suggesting that getting the flu shot was protective against heart attack and stroke, but most of these reports were observational. So we went back and systematically reviewed all clinical trials involving vaccine or placebo to see if this signal of cardioprotection was reproducible and consistent across the studies.

news@JAMA: What did you find?

Dr Udell: We found there was a 36% risk reduction overall for getting a cardiac event in those who were vaccinated compared with those who did not get the vaccine. We also found that those who had a heart attack had even more benefit. So in the higher-risk patients, the flu vaccine gave more benefit.

news@JAMA: Although your study cannot answer this question, can you speculate why influenza vaccination is associated with reduced heart risk?

Dr Udell: The flu may be a severe illness, causing a lot of inflammation, and that will have an effect on all your organs, including the heart and brain. This inflammation may also disrupt stable hardened arteries and free atherosclerotic plaque, causing a heart attack. Another theory is that the flu may push people over a tipping point, especially among the frail and elderly.

news@JAMA: So what would you tell others about the implications of your study findings for vaccination against influenza?

Dr Udell: For the skeptics out there, I’d note that we now have yet another reason why receiving influenza vaccine might be a beneficial thing to do. And those hospitalized with a heart attack should be vaccinated before they walk out the door so they don’t have care gaps that could be very dangerous.

23 Seniors Have Died So Far This Year After Receiving Flu Shots.

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Package insert for Fluzone flu vaccine marketed to seniors reveals 23 seniors died during drug trial

The annual marketing campaign pushing people to receive flu vaccinations is in full force. CVS Pharmacies is offering a 20% off shopping pass if you purchase a flu vaccine.

As you can see in the screen shot below, taken from the CVS website, senior citizens over the age of 65 are being targeted to get the “high-dose” flu vaccine.

The FAQ at the CVS website defines the “high-dose” flu vaccine: “Containing four times the amount of antigen (the part of the vaccine that causes the body to produce antibody) in regular flu shots, high-dose flu shots, along with the additional antigen produced, are intended to create a stronger immune response.”

The name of this flu vaccine that is marketed for seniors is called “Fluzone.” You can find it being marketed to seniors at all the major pharmacies in the United States.

Package inserts for flu vaccines show a multitude of side effects, including death, and yet they are marketed the same as over-the-counter drugs with no prescription needed. Why?

Because in the United States vaccines enjoy complete immunity from lawsuits in the market place. If you are injured or die from a vaccine, you or your family cannot sue the manufacturer of the vaccine. This law enacted by Congress, was upheld by the U.S. Supreme Court in 2011.

Therefore, they are marketed with the same marketing techniques as any other high-profit product. With the baby boomer generation moving into their senior years, today’s seniors are seen as an especially lucrative market.

So financial incentives like discounts on other products, as CVS is doing, is quite common in order to boost vaccine sales.

Walgreens has a different program that especially boosts sales of vaccines:

While vaccine rates in the U.S. among children are close to 90%, rates in other parts of the world (where pharmaceutical companies do not have immunity from the law for adverse effects) are much lower. So, in partnership with Walgreens, a non-profit organization (Shot@Life) buys up the vaccines and sends them to these countries for free (who doesn’t want something for free, especially when you live in a poor country??)

This is a brilliant marketing plan for the pharmaceutical companies, as the U.S. government gives the organization buying the vaccines non-profit status, allowing them to receive tax deductible donations to pay for the vaccines. Walgreens is probably a contributor to the program as a tax write off.

With legal immunity to market dangerous products, don’t expect those doing the marketing and making the profits to warn you of the side effects. You need to find this information yourself, usually from the Internet.

For those pro-vaccine forces that warn people how dangerous it is to get information from the Internet, the information we are about to share is directly from the FDA website (at least at the time of this writing – they have been known to remove items from their website if it gets too much publicity and makes them look bad), and you can look it up yourself.

The high-dose Fluzone vaccine being marketed this flu season to seniors, which has four times the amount of antigens that the regular flu shot has, as well as the non-high dose version, had 23 seniors die during drug trials.

In the section documenting adverse effects, this is what is written:

Within 6 months post-vaccination, 156 (6.1%) Fluzone High-Dose recipients and 93 (7.4%) Fluzone recipients experienced a serious adverse event. No deaths were reported within 28 days post-vaccination. A total of 23 deaths were reported during the period Day 29–180 post-vaccination: (0.6%) among Fluzone High-Dose recipients and 7 (0.6%) among Fluzone 1 recipients. The majority of these participants had a medical history of cardiac, hepatic, neoplastic, renal, and/or respiratory diseases. No deaths were considered to be caused by vaccination.

This statement stating that 23 seniors died, which really should be headline news but is buried in a package insert on the FDA website, begs several questions:

1. By what basis can they conclude that “No deaths were considered to be caused by vaccination”??

2. If, as it is implied, these 23 deaths were all caused by pre-existing conditions, why were there no deaths in the first 28 days? Shouldn’t the deaths, if not attributable to the vaccine but pre-existing conditions, be equally spread out through all time periods?
3. How does the medical history for these 23 seniors compare to the medical history of those who did not die? Were there any significant differences? The range of symptoms given in the package insert can very well cover almost all seniors during the flu season.

Besides death, which is just one “serious adverse event,” there were 226 other “serious” adverse events, for a total of 249 serious adverse events, out of only 3,833 participants.

If this does not constitute a dangerous drug that should probably not even be on the market, then I don’t know what does. And yet, it is sold to unsuspecting seniors and others like candy at these drug stores.

One of these other adverse side effects (besides death) is Guillain-Barré syndrome, which has symptoms similar to polio. If you are brought into an emergency room with the paralyzing effects of Guillain-Barré syndrome (GBS), the first question the doctors will ask you is if you just received the flu shot. Read one story here of how one man went from being able to bench-press 275 pounds to struggling how to walk after receiving last year’s flu shot: Miami Man Contracts Guillain-Barré Syndrome, Nearly Dies After Getting Flu Shot.

The CDC would like you to believe that the risk of GBS from the flu shot is only one out of one million. But if that is the case, why is there a warning on package inserts of flu vaccines, and why is it the first question EMTs ask when dealing with GBS emergencies?

The package insert for Fluzone states: “If Guillain-Barré syndrome (GBS) has occurred within 6 weeks of previous influenza vaccination, the decision to give Fluzone High-Dose should be based on careful consideration of the potential benefits and risks.”

I wonder how many vaccine sales people at these pharmacies give “careful consideration” to this adverse side effect, or any others, before injecting you?

 

Source: undergroundhealth.com

      

All children offered flu nasal spray

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  • Flu is a respiratory illness linked to infection by the influenza virus.
  • Symptoms usually include headache, fever, cough, sore throat, aching muscles and joints.
  • Influenza occurs most often in winter and usually peaks between December and March.
  • The virus was first identified in 1933.
  • There are two main types that cause infection: influenza A and influenza B
  • New strains of the virus are constantly emerging, which is why the flu vaccine should be given each year.

A flu vaccine nasal spray is being offered to every two and three-year-old in Scotland for the first time.

Previously, only children in “at risk” groups were offered the protection.

Scotland’s largest ever immunisation programme was launched by First Minister Alex Salmond, who received the vaccine in a surgery in Aberdeenshire.

He said that as an asthmatic, he gets the injection every year and urged other eligible Scots to get protected before the winter.

A fifth of the Scottish population will be offered a free flu vaccine, including people aged over 65 and those with conditions that put them at greater risk.

For the first time, all two and three-year-olds – about 120,000 children – will be offered the vaccine, as well as 100,000 primary school pupils in health board areas which are taking part in a pilot programme.

The programme will be rolled out to eventually see about one million children aged between two and 17 have the chance to be immunised towards the end of 2015.

The vaccine will take the form of a nasal spray rather than an injection.

Scotland’s senior medical officer said the spray, which is being phased in this autumn and rolled out over the next two years, was more effective in children than injections, as well as simpler to administer.

Speaking after receiving his own vaccine, Mr Salmond said it was better to be safe than sorry.

“As an asthmatic, I get my flu vaccination every year to make sure I’m protected and ready for the winter and I’m delighted to launch this national campaign,” he said.

“It is hugely successful and the existing programme has seen 2,000 fewer hospitalisations and 25,000 fewer GP consultations.

“For the first time this winter we are taking extra precautions to protect families by making sure children are also offered this vital vaccine.”

Senior medical officer Dr Nicola Steedman said every year she sees examples of how devastating flu can be.

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She added: “For those with existing health conditions such as asthma, diabetes, heart or liver problems, flu can result in serious complications.

“Furthermore, those who are pregnant or over 65 are also at increased risk of flu and its complications and should be vaccinated to help protect against flu, even if they currently feel healthy and fit.

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“Flu can also be very serious for children, particularly the youngest ones who have little or no immunity to the infection, which is why we are rolling out the new childhood flu immunisation programme.”

All two and three-year-olds in England and Wales will be also offered the vaccine this winter. In Wales, children aged 11 to 12 will also be eligible, while children aged between two and 10 in certain areas of England will be offered protection.

Source: BBC

Scientists take big step towards universal flu vaccine

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Scientists say they have made a significant leap towards creating a vaccine that would protect against every form of flu.

The influenza virus is a constantly shifting target so seasonal flu vaccines rapidly become useless and new ones are needed each year.

A team at Imperial College London say they have made a “blueprint” for a universal flu vaccine.

Their discovery is published in the journal Nature Medicine.

Influenza is able to change the proteins that protrude from the surface of the virus as readily as people change outfits.

However, the material on the inside is common to many strains of flu. Vaccine researchers believe targeting the core of the virus may be the way to develop a universal vaccine.

“Start Quote

We have the know-how, we know what needs to be in the vaccine and we can just get on and do it”

Prof Ajit Lalvani Imperial College London

A specific part of the immune system, called T-cells, is thought to be able to recognise proteins in the core. A team at Imperial used the 2009 swine flu pandemic to test the theory.

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Milder symptoms

Swine flu was a new virus from a mix of bird and pig flu.

The outer shell should have been a completely new experience to the immune system, but the core may have been encountered before in other flu viruses.

The team compared levels of one kind of T-cells at the start of the pandemic with symptoms of flu in 342 staff and students at the university.

They showed that the higher the levels of the T-cells a patient had, the milder their symptoms were.

Researchers then teased out the specific part of the immune system that offered some pandemic flu protection and which part of the virus it was attacking.

Prof Ajit Lalvani, who led the study, told the BBC: “It’s a blueprint for a vaccine. We know the exact subgroup of the immune system and we’ve identified the key fragments in the internal core of the virus. These should be included in a vaccine.

“In truth, in this case it is about five years [away from a vaccine]. We have the know-how, we know what needs to be in the vaccine and we can just get on and do it.”

‘Long journey’

This would be a distinct approach compared with other forms of vaccination, such as the MMR jab. These trigger the immune system to produce antibodies that can attack an invader.

The prize could be huge. Seasonal flu kills between 250,000 and 500,000 people each year and new pandemics have the potential to take doctors by surprise and kill large numbers of people.

Yet the researchers admit it is “generally harder” to develop a T-cell vaccine than provoke an antibody response. The challenge will be to get a big enough T-cell response to offer protection and a response that will last.

Prof John Oxford, of Queen Mary University of London, said: “This sort of effect can’t be that powerful or we’d never have pandemics. It’s not going to solve all the problems of influenza, but could add to the range of vaccines.

“It’s going to be a long journey from this sort of paper to translating it into a vaccine that works.”

Prof Sarah Gilbert, who is developing a universal flu vaccine at the

Jenner Institute in Oxford, said: “Live attenuated influenza vaccines which are given by nasal spray and will be used in children in the UK from this autumn are much better at increasing the number of influenza-specific T cells, but these vaccines only work in young children who haven’t yet had much exposure to influenza virus, so we need an alternative approach for adults.

“The new publication contains information on the precise characteristics of the influenza-specific T cells which were protective, and this information will be useful in monitoring the immune response to vaccination when testing novel influenza vaccines which are designed to provide protection against pandemic as well as seasonal influenza viruses.”

Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis.

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Abstract

Objective To evaluate risk factors for severe outcomes in patients with seasonal and pandemic influenza.

Design Systematic review.

Study selection Observational studies reporting on risk factor-outcome combinations of interest in participants with influenza. Outcomes included death, ventilator support, admission to hospital, admission to an intensive care unit, pneumonia, and composite outcomes.

Data sources Medline, Embase, CINAHL, Global Health, and the Cochrane Central Register of Controlled Trials to March 2011.

Risk of bias assessment Newcastle-Ottawa scale to assess the risk of bias. GRADE framework to evaluate the quality of evidence.

Results 63 537 articles were identified of which 234 with a total of 610 782 participants met the inclusion criteria. The evidence supporting risk factors for severe outcomes of influenza ranged from being limited to absent. This was particularly relevant for the relative lack of data for non-2009 H1N1 pandemics and for seasonal influenza studies. Limitations in the published literature included lack of power and lack of adjustment for confounders was widespread: adjusted risk estimates were provided for only 5% of risk factor-outcome comparisons in 39 of 260 (15%) studies. The level of evidence was low for “any risk factor” (odds ratio for mortality 2.77, 95% confidence interval 1.90 to 4.05 for pandemic influenza and 2.04, 1.74 to 2.39 for seasonal influenza), obesity (2.74, 1.56 to 4.80 and 30.1, 1.74 to 2.39), cardiovascular diseases (2.92, 1.76 to 4.86 and 1.97, 1.06 to 3.67), and neuromuscular disease (2.68, 1.91 to 3.75 and 3.21, 1.84 to 5.58). The level of evidence was very low for all other risk factors. Some well accepted risk factors such as pregnancy and belonging to an ethnic minority group could not be identified as risk factors. In contrast, women who were less than four weeks post partum had a significantly increased risk of death from pandemic influenza (4.43, 1.24 to 15.81).

Conclusion The level of evidence to support risk factors for influenza related complications is low and some well accepted risk factors, including pregnancy and ethnicity, could not be confirmed as risks. Rigorous and adequately powered studies are needed.

What is already known on this topic

  • Certain patient populations are thought to be at higher risk for developing complicated or severe influenza illness
  • These groups are prioritised for vaccination as well as for antiviral treatment
  • The quantity and quality of evidence on risk factors for developing complicated or severe influenza illness is limited
  • While some risk factors could be corroborated, evidence to support other, well established risk factors for severe outcomes could not be found

What this study adds

Source: BMJ