The Evolving History of Influenza Viruses and Influenza Vaccines

Claude Hannoun

Expert Rev Vaccines. 2013;12(9):1085-1094.

Abstract and Introduction

Abstract

The isolation of influenza virus 80 years ago in 1933 very quickly led to the development of the first generation of live-attenuated vaccines. The first inactivated influenza vaccine was monovalent (influenza A). In 1942, a bivalent vaccine was produced after the discovery of influenza B. It was later discovered that influenza viruses mutated leading to antigenic changes. Since 1973, the WHO has issued annual recommendations for the composition of the influenza vaccine based on results from surveillance systems that identify currently circulating strains. In 1978, the first trivalent vaccine included two influenza A strains and one influenza B strain. Currently, there are two influenza B lineages circulating; in the latest WHO recommendations, it is suggested that a second B strain could be added to give a quadrivalent vaccine. The history of influenza vaccine and the associated technology shows how the vaccine has evolved to match the evolution of influenza viruses.

Introduction

In 1933, 80 years ago, the first human influenza virus was isolated after propagation in ferrets, followed shortly afterward by research on an influenza vaccine.^[1] Memories of the deadly influenza pandemic in 1918 were still very present and the disease caused fear. The discovery of the causal agent and the possibility of manipulating it in the laboratory opened the way to new means of investigation and progress.

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Table 1. Examples of mismatch between influenza vaccine B strain and circulating B strain.
Country	Year	Circulating influenza B strain	Vaccine strain	Mismatch (%)
Philippines and Thailand [33]	2002	96% VIC	YM	96
Australia [37]	2004	100% YM	VIC	100
Italy [39]	2004–2005	83% VIC	YM	83
New Zealand [35]	2005	82% VIC	YM	82
Myanmar [34]	2005	85% VIC	YM	85
Europe [29]	2005–2006	90% VIC	YM	90
Czech Rep [32]	2005–2006	92% VIC	YM	92
Hong Kong [38]	2005–2006	100% VIC	YM	100
Australia [36]	2007	76% YM	VIC	76

Box 1. Current nomenclature for influenza viruses (WHO 1980).
The formal nomenclature for the designation of influenza viruses was revised and published by the WHO [43]. The full and correct nomenclature includes: The type of virus (A, B or C); The host of origin (except for human); The geographic site of isolation: The strain number; The year of isolation (four-digit year for viruses isolated in 2000 or later; two-digit year for viruses isolated during the 1900s); The subtype [16 possible hemagglutinin and 9 possible neuraminidase subtypes]. Thus, a type A virus isolated in 1995 in Memphis Tennessee with a strain number of 123 and an H5N1 subtype is designated: Influenza A//Memphis/123/95 (H5N1)