Is a Universal Flu Vaccine Possible?

Check out this answer from Consensus:

The development of a universal influenza vaccine is a complex but achievable goal. Significant progress has been made by targeting conserved viral epitopes, utilizing innovative vaccine platforms, and employing prime-boost strategies. While challenges remain, particularly in achieving balanced protection and addressing preexisting immunity, ongoing research and clinical trials are paving the way towards a UIV that could provide broad and durable protection against diverse influenza strains.

The development of a universal influenza vaccine (UIV) is a critical goal in public health due to the significant morbidity and mortality caused by influenza viruses. Current seasonal vaccines are limited by their strain-specific protection and the need for frequent updates. This synthesis explores the feasibility and progress towards creating a UIV that offers broad and long-lasting protection against various influenza strains.

Key Insights

• Challenges with Current Vaccines:
  • Seasonal vaccines are strain-specific and require frequent updates due to antigenic drift and shift1 2 5 8.
  • Current vaccines target the variable head of the hemagglutinin (HA) protein, which mutates frequently, reducing vaccine efficacy7.
• Targeting Conserved Viral Epitopes:
  • Universal vaccines aim to redirect the immune response towards conserved regions of the virus, such as the HA stalk and neuraminidase (NA)1 2 3 8.
  • Chimeric HA-based vaccines have shown promise in inducing broad, durable immune responses by targeting the conserved stalk domain2 9.
• Innovative Vaccine Platforms:
  • New technologies, including virus-like particles, T-cell-inducing peptides, recombinant proteins, synthetic viruses, and nucleic acid-based vaccines, are being explored to enhance cross-protective immunity8 10.
  • Headless HA-stabilized stem antigens presented on nanoparticles have elicited broad neutralizing antibodies in nonhuman primates and are in clinical trials6.
• Prime-Boost Strategies:
  • Combining live-attenuated vaccines with adjuvanted inactivated vaccines in prime-boost regimens has shown increased efficacy and broader protection in clinical trials2 3 9.
• Mucosal and T Cell Immunity:
  • Mucosal immune responses and cross-reactive T cell immunity are essential features for a UIV, with live attenuated influenza vaccines (LAIV) showing potential in this area3.
• Human Challenge Studies:
  • Human challenge studies are necessary to evaluate the efficacy and safety of UIVs, as preclinical data from naive animals may not fully translate to humans with preexisting immunity3.

Is a universal flu vaccine possible?

William  Rawlinson has answered Likely

An expert from UNSW Sydney in Virology, Microbiology, Molecular Biology

Influenza is a major medical, community, personal and financial impost on modern society. This makes people, communities and governments very interested in preventing influenza, and has lead to development of vaccines available for many years. The need to give these every year due to virus mutation, and the few alternatives available (avoidance, antivirals with some efficacy only if given early, other yearly vaccines) means there is strong pressure for change. The high mutation rates, and the ease of spread, have meant influenza remains a need, to which researchers continue to respond.

Unfortunately use of alternate vaccine approaches such as live vaccines, intranasal administration, intradermal administration, adjuvants, adding extra strains etc have not provided universal protection. However, there is a theoretical possibility to vaccinate against targets common between strains, using novel immunological approaches.

So given the will, given the resources, given additional knowledge of additional targets, and given improved immune modulation combined with the vaccine, influenza is likely to be prevented in the future by a universal vaccine. It is my view that this is a matter of time, and that is the major remaining question.

Is a universal flu vaccine possible?

Larisa Rudenko has answered Unlikely

An expert from Institute of Experimental Medicine in Virology, Immunology, Medicine

There is still no clear understanding what the “universal” vaccine means. All current developments of “universal” influenza vaccines are at the early stage and it will be more than a decade until clear and comprehensive data on their performance are obtained. This is a big mistake to put all the funding to this development alone. More research on the improvement of existing vaccines is urgently needed because the long history of their use in humans showed their safety and the correlates of protections for these vaccines have been identified. The adjuvanted inactivated and live attenuated influenza vaccines are cross-reactive enough by themselves, and we just need to work on their optimization to make them more efficacious and cross-protective.

Is a universal flu vaccine possible?

Marc-André D’Aoust has answered Unlikely

An expert from Medicago in Virology, Immunology, Biotechnology

At the pace at which vaccine technologies develop today and will develop in the future, it is possible that a universal flu vaccine will be obtainable someday. In the short term, however, a universal flu vaccine is unlikely to be available. An important challenge in developing a universal influenza vaccine is the demonstration of universality, meaning the demonstration that the vaccine will protect against any strain in every flu season. That demonstration requires lengthy clinical studies which will prevent the regulatory approval of an universal for several years. However, with the progress of recombinant vaccine technologies, we can expect vaccines providing broader protection to different strains or vaccines that can be administered every 2-5 years to come to market in the foreseeable future.

Is a universal flu vaccine possible?

Ger Rijkers has answered Likely

An expert from University College Roosevelt in Immunology

Targetting the core of the hemagglutinin molecule has been shown in mice to be effective for “every” strain of influenza. So yes, a universal flu vaccine is within reach.

Is a universal flu vaccine possible?

B Coleman has answered Likely

An expert from University of Toronto in Epidemiology, Biostatistics

A ‘universal’ influenza vaccine is possible, but not likely in the near future. Many, many virologists and vaccinologists are working on the issue, but given the nature of the influenza virus (it is a RNA virus that mutates constantly), development of a universal vaccine will involve a significant change in influenza vaccine production. A recent article by Sautto, Kirchenbaum and Ross (2018) is a good, open-access review of the current situation, https://virologyj.biomedcentral.com/articles/10.1186/s12985-017-0918-y

Is a universal flu vaccine possible?

Michael Greenberg has answered Unlikely

An expert from Sanofi in Virology, Immunology, Epidemiology, Pediatrics, Medicine, Pharmaceutics, Bioinformatics

A true universal flu vaccine is not likely in the near future. The problem is that the RNA virus made up of 8 genes has no error correction mechanisms and therefore mutates constantly. Efforts to date to develop a vaccine against the conserved sequences of the virus have not been immunogenic. Should such a region be identified, it’s likely that the virus will eventually develop mutations in that gene and render the “universal” vaccine less effective.

Is a universal flu vaccine possible?

Janet Daly has answered Unlikely

An expert from The University of Nottingham in Virology

There are many researchers developing a ‘universal flu vaccine’, but I am not convinced that we will have an ideal (i.e. effective, tolerated and truly universal) vaccine in the near future. The most effective influenza vaccines are those that stimulate antibodies that are specific for the infecting virus – that is why the seasonal influenza vaccine strains are reviewed each year (in an effort to ensure that they are similar to the strains that people are most likely to encounter). When a vaccine relies on cross-protective antibodies rather than strain-specific, much higher levels of antibody are required. Even the seasonal influenza vaccines with the best strains are not as effective as we might like them to be. They do not necessarily prevent everyone who has them from getting sick – but they do help to reduce the impact of infection and prevent deaths. Therefore, in the face of a novel influenza virus against which we do not have a vaccine, even a suboptimal universal flu vaccine may be better than no vaccine. On the other hand, the use of sub-optimal vaccines can have negative consequences, particularly on public confidence in vaccines, so I think we are some way off a universal flu vaccine becoming available.