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Commentary
These sequences from vaccine breakthrough patients provide additional data indicating the current vaccine no longer offers significant protection from the H1N1 currently in circulation. The S188T sub-clade is the dominant clade in the northern hemisphere represented by 11 of the 17 breakthrough sequences, signaling widespread vaccine failure. This failure is largely missed by the antigen chacterization assay, which has failed to identify these sequences as low reactors (only the sequence from India with S188T and S186P was designated a low reactor). The assay has been used to claim that these common sequences were antigenically indistinguishable from the current H1N1 vaccine target, A/California/7/2009, which was used to justify the decision to keep the vaccine target unchanged. The vaccine breakthrough sequences are consistent with the UK data which showed that the H1N1 vaccine only protected 50% of recipients in the first half of the 2011/2012 season. This rate is probably low because the S188T sub-clade is becoming increasingly dominant throughout the northern hemisphere. These data and sequences demonstrate the fatal flaw in the current antigen characterization assay and the recommendation to leave the target unchanged. The vaccine target recommendation should be re-evaluated by an independent scientific committee, and the current WHO influenza consultants, who comprise latest committee, should be removed. S188T A/Korea/AF21778/2010 A/Korea/AF21780/2010 A/Korea/AF21783/2010 A/Japane/AF21777/2011 A/Korea/AF21784/2011 A/Korea/AF21785/2011 A/Korea/AF21786/2011 A/Korea/AF21787/2011 A/Korea/AF21788/2011 A/Korea/AF21789/2011 A/Korea/AF21790/2011 S186P A/Korea/AF21779/2010 A/Korea/AF21781/2010 A/Korea/AF21782/2010 A/North Carolina/AF21797/2011 A189T A/Arizona/AF21768/2011 A/New Jersey/AF21791/2011 Media link Recombinomics
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