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CDC Testing Pandemic trH3N2 Vaccine
Recombinomics Commentary 21:50
August 3, 2011

The CDC has released sequences (at GISAID) of new constructs, A/Minnesota/11/2010 X-203 and A/Minnesota/11/2010 X-203A, indicating these isolates are undergoing testing as pandemic trH3N2 vaccine target.  The first human case of trH3N2 in the United States was reported in late 2009. There have been eight additional cases in 2010 and 2011, and sequence analysis raises concerns that these isolates are transmitting in humans.  Several internal genes are virtually identical, including PB1 E618D, and there are similarities in the external genes.

The viruses are triple reassortants with human H3, N2, and PB1.  However, these genes trace back to the 1990’s when a swine infected with classical H1N1 was infected with a human H3N2 virus creating double reassortants.  In the late 1990's an avian infection of a swine infected with a double reassortant created a triple reassortant with a polymerase complex composed of human PB1 and avian PB2 and PA. 

The triple reassortants with human H3 and N2 are designated trH3N2, but the H3 and N2 have evolved significantly in swine, severely compromising the immunity to seasonal H3N2 as well as the H3N2 vaccine.  Consequently, one of the human trH3N2 isolates from Minnesota is the target of this new vaccine.  The decision to make this vaccine at this time raises concerns that unreported and unpublished infections have further supported human to human transmission.

The sequences released today also indicate new vaccines are being developed against pandemic H1N1, as well as seasonal H3N2 and influenza B, even though the recommendation to WHO and the FDA was to leave targets unchanged fro the 2011/2012 flu season in the northern hemisphere. 

Consequently, worldwide vaccine production is targeting isolates from 2009 or earlier, which appear to be no longer effective.

Detail on the reasons behind the emphasis on new vaccine targets at this time would be useful.

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