Sanofi Pasteur, the vaccine division of Sanofi, announced today the launch of its 4-strain influenza vaccine FluQuadri in India. FluQuadri will be India’s first quadrivalent vaccine to provide broader protection against influenza to population above three years of age.
 

Currently, the majority of seasonal influenza vaccines are trivalent, meaning that they protect against: two A strains and one single B lineage (B/Victoria or B/Yamagata) of Influenza virus. However, over the recent flu seasons, co-circulation of both B lineages has been consistently observed, making it difficult for the World Health Organization (WHO) to recommend which B strain should be incorporated in trivalent influenza vaccines.

Given the change in epidemiology, quadrivalent vaccination represent the next logical step to an advanced level of protection. The WHO includes quadrivalent influenza vaccines in its recommendations, stating “Quadrivalent influenza vaccines that could potentially provide wider protection against influenza B viruses are becoming available and recommendations should not be limited to trivalent vaccine.”

Dr Vijay Yewale, Director and Consultant Pediatrician said, “There are 2 different sub-types of influenza type B causing disease in human. The vaccine available until now included only one of the influence B sub-types and thus protects against only against the one included in the vaccine. The influenza vaccine is freshly prepared twice in a year and influenza viruses types, both A and B are included in the vaccine based on the scientific prediction made about the types likely to circulate in the year."

He said the decade between 2000 and 2010, 50 per cent of the times in Europe and USA the disease causing B sub-type in circulation was different from the one included in the vaccine. This would leave vaccinated individuals unprotected against the sub-type that’s not included in the vaccine, he added.

"A quadrivalent vaccine offers protection against all four sub-types – two Influenza B and the two Influenza A sub-types. This protects them against all the circulating sub-types,”Dr Yewale. India has also seen circulation of type B influenza strains. The IDSP (Integrated Disease Surveillance Program) annual report 2017 stated that in the wake of high number of influenza deaths and cases in Gujarat, an expert committee noted that one of the main reasons of flu epidemic in Gujrat was that during last year, the H3N2 and B sub-types of influenza virus were circulating, but not H1N1, leading to a build-up of the susceptible population.

As a result, the committee has suggested that in future, in all IEC (Information Education Communication) material the words “swine flu” to be replaced by the words “seasonal flu” and all references to H1N1 be omitted. In another instance, a surveillance project for acute febrile illnesses, anchored at the Manipal Centre for Virus Research in Karnataka, found that influenza accounts for nearly 20 per cent of fevers across rural areas in 10 Indian States and during the years when the H1N1 burden is low in these regions, H3N2 and Influenza B circulation tends to spike.