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Abstract
Perspective
Authors
Peter Palese, Adolfo García-Sastre
Re: Influenza vaccines: present and future
Submitter: Subhash C Arya | subhashji@hotmail.com
Centre for Logistical Research and Innovation
Published December 12, 2002
The existing inactivated and the cold-adapted influenza vaccine have been succinctly reviewed by Palese and Garcia-Sastre (1). Certainly, FDA approval of the live attenuated influenza vaccine as well as the recipe of amantadine, rimantidine and oseltamivir would provide the clinicians with a powerful armory to reduce influenza virus associated mortality and morbidity. Irrespective of the availability of vaccines expressing either an altered NS1 gene or just comprised of DNA (1), influenza immune and/or chemoprophylaxis would be effective in tackling epidemics if the respective formulations were adequately primed to address adverse environments.
The immungenicity of the inactivated influenza vaccine lots is maintained at the stipulated level only if they were stored between 2-8oC. Exposure to higher temperature or any freezing would adversely affect their potency (2). Furthermore, antivirals also require constant storage at well-controlled temperature not exceeding 25-30oC. Inadvertent exposures to temperatures outside the stipulated range were likely everywhere. In refrigerators at the pediatric offices and clinics in Los Angeles, the inside temperature exceeded 8oC at 22% offices and clinics (3). Right at the beginning of the Century, the January 2001 power shut down in California was alarming. Similar episodes were unlikely in other parts of the world.
Designers of prospective influenza vaccines and chemotherapeutics should ensure that such products adequately resisted environmental rigors. In face of a pandemic, these formulations would have to be transported to different continents at a short notice. Addition of pirodavir and deuterium oxide to the most labile of the childhood vaccine, the live poliovirus vaccine has been remarkable. Their pre-addition resulted in maintenance of vaccine immunogenicity after a 10-hour exposure to 42oC (4). Innovative stabilization strategies should be important in prospective influenza vaccines incorporating better adjuvants (1). During the interim period, both the practitioners of clinical medicine and public health should appreciate the value of storage of influenza therapeutics and prophylactics in accordance with the recommendations by the manufacturers.
Subhash C Arya, MBBS,PhD
Research Physician
Centre for Logistical Research and Innovation
M-122 Greater Kailash-Part 2 New Delhi- 110048, India
Email subhashji@hotmail.com
References
1.Palese P, García-Sastre A. 2002. Influenza vaccines: present and future. J Clin Investigation 110:9-13
2.Physicians’ Desk reference. 2002. Medical Economics Company, Montvale: 56th edition
3.Bishai DM, Bhatt S, Miller LT, Hayden GF. 1992.Vaccine storage practices in pediatric offices. Pediatrics 89:193-196
4.Verheyden B, Andrus K, Rombart B. 2001. Capsid and viral RNA stabilization of the poliovaccine. Vaccine 19:1899-1905
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