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Vaccine Pandemic Conerns
Recombinomics Commentary 04:05
August 4, 2011

DR. GELLIN: I am always impressed by what a body of work that is. Two questions. One of them, you had mentioned about the low reactors and the biological issues at the lab in London, is that the same issue for the H1 as well as the H3? Because they showed, I think, that there was a higher percentage of H1 low reactors in the London lab, as well. The question really is that a lab problem or does that signal some other evolution, since they have had more H1 this year?

DR. COX: Yes. What we know for H1N1 viruses is that if you isolate them in a particular cell line, you tend to get more of the variance with changes within that region that I mentioned -- the 153 to 158 region. They had been using the particular cell line that pulls out that particular variant or that selects for that particular variant.

They have subsequently switched to normal MDCK cells. I think what they are seeing is a combination of the two phenomena. Plus, they receive a lot of viruses that have been isolated COT, the special kind of MDCK cells. I think it is a combination of they are receiving viruses with changes that cause that reduction in activity and then having some additional low reactors, but they are scattered throughout the tree.

The above quotes are from the US FDA's Vaccine Advisory meeting in February. CDC was complaining about the high level of LOW REACTORS being reported by other centers (Mill Hill), which the CDC attributed to lab error (use of cell lines that select for low reactors) creating "spontaneous mutations" leading to isolates "scattered throughout the tree". However, these "lab errors" are precisely the changes that identify low reactors, as well as those that target the lung, causing more severe and fatal disease. This is why the CDC discounted the importance of D225G and D225N, which have been linked to severe and fatal cases. At the February meeting the old vaccine targets were unanimously recommended (with one abstention on H1N1), in spite of record high pneumonia and influenza death rates.

That meeting was followed by testing using eggs, including samples where H1N1 was previously isolated on "normal" MDCK cells. The new isolates (on eggs) had a high frequency of Q226R and now the CDC is testing new vaccine targets for pandemic H1N1 (which have K157E and Q226R), seasonal H3N2, influenza B, as well as pandemic H3N2 (trH3N2). Pandemic H3N2 has D225G and would likely be selected in egg isolates, which may have markedly increased the number of detected (but unreported) trH3N2 isolates.

This sequence of events raises concerns that low reactors, including H1N1 with Q226R, are widespread and associated with severe and fatal cases.  The vaccine made with the new target with K157E and Q226R was tested against the old vaccine and the testing was characterized as TWO WAY LOW FAIL, signaling vaccine failure (the old vaccine poorly recognized the new target, and the new vaccine poorly recognized.the old target).

Vaccine targets are usually selected in February at the selection meeting pruduction of a new vaccine which is distibuted in September for teh flu season in the northern hemisphere.  The release of the sequences in August strongly suggests that these new targets were not used for the vaccine under production for September shippingt.

Information on shipments dates of new vaccines and the reasons behind the selection of the new targets, including pandemic H3N2 (trH3N2), are past due, like production of an effective influenza vaccine.

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