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Paradigm Shift Intervention Monitoring
The DoD-GEIS Flu Program at Brooks Air
Force Base released a series of partial H3N2 recently collected from
DoD dependents. Like the recently
released H1N1 sequences, many of the H3N2 samples were from
previously vaccinated patients, signaling vaccine failure against the
Perth/16/2009, which has been again recommended for the 2011/2012
vaccine target for the northern hemisphere.
The H3N2 from vaccinated patients fell into two sub-clades. The largest was related to A/Pennsylvania/02/2010, the dominant H3N2 circulating in the northern hemisphere. These sequences are closely related to the sequences from Australia, which were classified as low reactors. Several of those patients had also been vaccinated in 2010. The other sub-clade was small and all vaccinated patients were from South Korea.
These data again indicate vaccine failure for H3N2 is widespread. The antigenic differences are not well represented by the antigen characterization test, which is used to select new vaccine targets. The CDC has only identified 5 low reactors (1%) related to Perth/16, although most H3N2 sequences in the United States are related to the low reactors in Australia and the sequences from vaccinated patients in the United States (see list below).
The vaccine failures for H3N2 are in addition to the failures for H1N1, which is consistent with the Pneumonia and Influenza death rate, which is at 8.25% for week 7, which marks the fourth week in a row that the rate has been above the epidemic threshold. Historically, these elevated death rates are linked to vaccine failure. In 2008, when similar levels were seen, all three vaccine target were changed for the following year.
This season, none of the target have been changed, due to reliance of the vaccine committee on the unreliable and insensitive antigen characterization test, which continues to be hazardous to the world’s health.