BALTIMORE—Influenza is a topic of discussion every year as flu season hits and people seek out their annual vaccinations, and it's also the topic of a new research contract for the University of Maryland School of Medicine (UMSOM). The Center for Vaccine Development and Global Health (CVD) at UMSOM has received a contract from the National Institute of Allergy and Infectious Disease (NIAID), part of the U.S. National Institutes of Health, to conduct clinical testing of influenza vaccines. UMSOM will receive roughly $2.5 million initially, with the potential for more than $200 million in funding over the course of seven years if all options are exercised, according to a press release by UMSOM's Joanne Morrison.
Dr. Kathleen Neuzil, Professor of Medicine and Pediatrics and director of the CVD, will lead the contract, which will evaluate improved seasonal flu vaccines and conduct controlled human influenza challenge studies for the NIAID's Collaborative Influenza Vaccine Innovation Center program (CIVICs).
“Influenza virus is a common and serious infection that causes annual outbreaks in all age groups. While current influenza vaccines have been critical in reducing disease, the virus is constantly changing. The CIVICs program will address the need to develop and test influenza vaccines that protect against new and emerging strains, and ultimately prevent more disease,” Neuzil commented in a statement.
The CIVICs program, which was jointly developed by NIAID's Division of Allergy, Immunology and Transplantation and the Division of Microbiology and Infectious Diseases, seeks to not only improve seasonal vaccines, but also to develop a “universal” vaccine against emerging strains. This program boasts multidisciplinary research across a variety of institutions for preclinical, clinical and human challenge study. With this NIAID contract, a CVD CIVIC Clinical Core will be established that will share CIVICs' goal of improved seasonal vaccines and a universal vaccine, according to Morrison's article.
“This contract brings together a broad cross-section of researchers at UMSOM, who are experts in virology, vaccinology and immunology. For decades, CVD has been a leader in researching and developing interventions for the most challenging diseases that impact the world’s most vulnerable populations. With this generous funding, and Dr. Neuzil’s expertise and leadership, CVD will be able to make pathbreaking discoveries and test new vaccines against this persistent infection that affects millions of people around the world,” said Dr. E. Albert Reece, dean of UMSOM, executive vice president for Medical Affairs at UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor.
The U.S. Centers for Disease Control and Prevention (CDC) estimates that during the 2018-2019 flu season, 43 million people were affected. An NIH Fact Sheet reports that according to recent studies, 5 to 20 percent of the U.S. population contracts influenza each flu season, with more than 200,000 hospitalized and 36,000 deaths. On the global scale, three million to five million cases occur each year, with up to 500,000 deaths. While flu vaccines help prevent illness, they must be developed on an annual basis due to antigenic drift, in which “the genes that encode influenza surface proteins can undergo small changes … which enables the virus to evade immune responses generated to prior exposure or vaccination.”
In related research from NIAID, a team led by Stanford University scientists and funded by NIAID found that oral antibiotics can affect a patient's response to season flu vaccines. Oral antibiotics are known to impact the microbiome by killing good bacteria along with the bad bacteria they are targeting. In this study, all participants received a seasonal flu vaccine, and half of them were given a five-day course of a broad-spectrum antibiotic regimen (neomycin, vancomycin and metronidazole). Blood serum and stool samples were taken from the participants several times up to one year after vaccination to track immune response and “the diversity and abundance of the organisms in their gut microbiomes,” according to an NIAID press release. Patients with little prior immunity to the strains in the vaccine who took the antibiotic regimen had impaired responses to a certain strain in the vaccine; according to the authors, this indicates that those patients would likely have less protection against infection by that strain than individuals who had not received antibiotics.