Flu Vaccine Developments Amid Rising Cases with Keipp Talbot, MD, MPH

In the latest influenza surveillance reports from the Centers for Disease Control and Prevention, which observed a steady increase in cases early in the year, the message issued by the CDC has remained the same: the flu season is just beginning, and it’s not too late to receive a flu vaccination.

Though most reported cases of the flu in the US this year have been influenza A (H3N2), there exist a myriad of different strains that have been met with seemingly endless research and development for different flu vaccines.

In an interview with HCPLive, Keipp Talbot, MD, MPG, Associate Professor of Medicine in the Division of Infectious Diseases at Vanderbilt University, spoke of innovations in the realm of flu vaccines, and how new developments in the management of shingles and COVID-19 could inform future iterations of the flu vaccine.

Major developments in flu vaccines were made during the avian influenza that occurred in the early 2000s. Since then, several new types of flu vaccines have been under development, with some making their way to market.

Today, there exist high-dose flu vaccines for older patients over the age of 65 years, as well as adjuvanted flu vaccines intended to bolster the immune system. However, many of these are based on older technology.

To “move the needle forward” in advancing vaccine technology, Talbot suggested future iterations of the flu vaccine should focus on the more vulnerable members of the population.

“I think the other thing that we forget about with flu is the people who get the most sick with influenza are people whose immune systems are hard to teach…those that are immunocompromised, those that are older,” Talbot said. “So, we really need to learn how to make vaccines to teach those immune systems that are having trouble learning so they can really learn how to fight the flu.”

Part of this learning process comes from advancements made with the Shingrix vaccine, which Talbot explained contains an adjuvant that creates “an incredibly effective” immune response in older patients.

Changes that occurred with the COVID-19 virus, as well as the vaccines that were developed to fight against it, also harbor a myriad of possibilities for flu vaccine development, with the emergence of RNA (mRNA) vaccines being considered as potential candidates for flu prevention.

“It’s always kind of a race for us to figure out what might circulate and will that grow,” she explained. “Messenger RNA gives us more time because we don’t have to grow (vaccines) in eggs, but we still have to make a really good, educated guess.”

Time, she explained, was another factor in the development of new influenza vaccines.

“When we do these studies, we want to make sure that they're safe; the benefit always has to be greater than the risk,” Talbot said. “So, we're going to go through all those steps. We did all the same steps for (COVID-19), but we squeezed them in really tight and overlapped them and did some of them in parallel. But we usually don't do that, so it's going to take a little bit longer for vaccine like the flu vaccine.”