Seasonal influenza vaccine performance and the potential benefits of mRNA vaccines

ABSTRACT

Influenza remains a public health threat, partly due to suboptimal effectiveness of vaccines. One factor impacting vaccine effectiveness is strain mismatch, occurring when vaccines no longer match circulating strains due to antigenic drift or the incorporation of inadvertent (eg, egg-adaptive) mutations during vaccine manufacturing. In this review, we summarize the evidence for antigenic drift of circulating viruses and/or egg-adaptive mutations occurring in vaccine strains during the 2011–2020 influenza seasons. Evidence suggests that antigenic drift led to vaccine mismatch during four seasons and that egg-adaptive mutations caused vaccine mismatch during six seasons. These findings highlight the need for alternative vaccine development platforms. Recently, vaccines based on mRNA technology have demonstrated efficacy against SARS-CoV-2 and respiratory syncytial virus and are under clinical evaluation for seasonal influenza. We discuss the potential for mRNA vaccines to address strain mismatch, as well as new multi-component strategies using the mRNA platform to improve vaccine effectiveness.

KEYWORDS:

• Influenza
• vaccination
• vaccine effectiveness
• vaccine manufacturing
• antigenic drift
• egg-adaptive mutations
• mRNA vaccines

Acknowledgments

The authors disclose that this work was funded by Moderna, Inc. Medical writing and editorial assistance, under the direction of the authors, and was provided by Renee Gordon, PhD, of MEDiSTRAVA in accordance with Good Publication Practice (GPP 2022) guidelines and funded by Moderna, Inc.

Disclosure statement

Parinaz Ghaswalla, Yoonyoung Park, Nevena Vicic, Jintanat Ananworanich, Raffael Nachbagauer, and Deborah Rudin are employees of Moderna, Inc., and may hold stock/stock options in the company.

Colin Russell has received speaking and/or consulting fees related to influenza vaccines from Moderna, Sanofi, GSK, Roche, and CSL/Sequiris.

Ron Fouchier reports no conflicts of interest in this work.

Author contributions

Employees of Moderna, Inc. had a role in the concept/design of the work, data analysis/interpretation, as well as the drafting/critical review of the manuscript content and its approval for publication. Concept/design of the work: Parinaz Ghaswalla, Yoonyoung Park, Nevena Vicic, Jintanat Ananworanich, Raffael Nachbagauer, Deborah Rudin.

Analysis/interpretation of data for the work and/or drafting or critical review of content for intellectual contribution: Colin A. Russell, Ron A. M. Fouchier, Parinaz Ghaswalla, Yoonyoung Park, Nevena Vicic, Jintanat Ananworanich, Raffael Nachbagauer, Deborah Rudin.

Final draft approval: Colin A. Russell, Ron A. M. Fouchier, Parinaz Ghaswalla, Yoonyoung Park, Nevena Vicic, Jintanat Ananworanich, Raffael Nachbagauer, Deborah Rudin.

Data availability

Data sharing is not applicable to this article as no datasets were generated, and all analyzed data are in the public domain; data sources are cited in this article.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2024.2336357.

Additional information

Funding

The work was supported by the Moderna, Inc.