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The influenza season of 2020-2021 wasn’t much of a season. So, with such an unusual preceding year, along with all other COVID-related surprises, what can we really say about flu season 2021-2022?

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Nina Cosdon is the assistant editor for Contagion. Before joining MJH Life Sciences, she graduated magna cum laude from Denison University in 2021 with a degree in Communication. You can find her reading, hiking, or antiquing, or by emailing her at ncosdon@mjhlifesciences.com.

Investigators from the University of Chicago have long been interested in understanding how influenza infection affects individuals with different genetic ancestry. In a study published this week in 

they explored how various cell types respond to viral infection.

The investigators used single-cell RNA-sequencing to analyze gene expression patterns in peripheral mononuclear blood cells. The cells, collected from men of European or African ancestry, were exposed to the flu in a laboratory setting.

The investigators examined the gene expression signatures of various immune cell types to determine how each cell type’s gene expression was affected by influenza infection. 

The blood cells from individuals with European ancestry demonstrated an increase in type 1 interferon pathway activity during early influenza infection. This elevated pathway activation was correlated with greater capability to hinder virus replication.

Luis Barreiro, PhD, the study’s senior author and an associate professor of medicine at UChicago, said, “Interferons are proteins that are critical for fighting viral infections...Inducing a strong type I interferon pathway response early upon infection stops the virus from replicating and may therefore have a direct impact on the body’s ability to control the virus.”

Barreiro noted, “Unexpectedly, this central pathway to our defense against viruses appears to be amongst the most divergent between individuals from African and European ancestry.”

The study authors pointed out that this difference in immune pathway activation could be a cause of influenza disparities across racial groups, such as non-Hispanic Black Americans being the most likely to be hospitalized due to the flu.

However, they emphasized that these results are not proof of genetic differences in disease susceptibility, but rather of differing environmental and lifestyle factors among racial groups that could influence gene expression and alter immune response.

Barreiro said, “There’s a strong relationship between the interferon response and the proportion of the genome that is of African ancestry, which might make you think it’s genetic, but it’s not that simple. Genetic ancestry also correlates with environmental differences. A lot of what we’re capturing could be the result of other disparities in our society, such as systemic racism and healthcare inequities. Although some of the differences we show in the paper can be linked to specific genetic variation, showing that genetics do play some role, such genetic differences are not enough to fully explain the differences in the interferon response.”

Articles

Individuals from European backgrounds had higher type 1 interferon pathway activity during early influenza infection than individuals with African genetic heritage. 

Genetic Ancestry May Determine Immune Response to Influenza

Low- and middle-income countries have experienced COVID-19 vaccine delays and shortages. Even though vaccines and other pharmaceuticals are frequently tested in low-income countries, they often do not reap the benefits of this technology.

sought to examine the authorization and dispersal of COVID-19 vaccines recommended by the World Health Organization (WHO) in the countries where they were tested.

The cross-sectional study analyzed the COVID-19 vaccines authorized for emergency use by the WHO through September 7, 2021. Using the WHO COVID-19 Vaccine Tracker and Landscape and the McGill University COVID-19 Vaccine Tracker, the investigators identified all completed clinical trials for the authorized vaccines. They noted trial primary completion dates, phases, and country locations. Countries were assigned a national income group based on the 2021 World Bank historical classifications.

Using regional and national regulatory agency websites, the investigators determined whether countries hosting vaccine clinical trials also authorized them for use. They also extracted data on doses obtained from the UNICEF COVID-19 Vaccine Market Dashboard and Airfinity COVID-19 platform.

The investigators calculated the proportion of countries hosting clinical trials who had authorized any vaccine tested in their population and vaccine delivery. They determined the number of people 15 years and older who received a full vaccination series of the tested vaccine. All descriptive statistical analyses were performed using Microsoft Excel spreadsheet software.

There are 6 COVID-19 vaccines authorized for emergency use by WHO, tested in a total of 25 countries. Among 11 high-income countries who completed clinical vaccine trials, 90.9% (n=10) authorized the tested vaccine and received sufficient doses to vaccinate an average of 51.7% of their populations 15 years and older. Lower middle- and upper middle-income countries had respective authorization rates of 100% and 90.9%, with median vaccination rates of 31.0%.

Moderna completed clinical trials in 2 countries, Janssen completed trial in 10 countries, and AstraZeneca completed trials in 14. Janssen received authorization in 80% of these countries, while AstraZeneca did in 85.7%. Across all vaccine manufacturers, high-income countries received more doses to vaccinate larger proportions of their countries’ populations 15 and older. COVAX delivered an average of 15.4%, 48.8% and 78.8% of their vaccines in low-, lower middle-, and upper middle-income countries, respectively.

Countries of all income levels have largely authorized the vaccines their populations tested, but high-income countries continue to receive more doses to vaccinate a larger proportion of their populations.

The study authors noted “These wealth-based access inequities among countries hosting trials parallel general disparities in COVID-19 vaccine access, as high-income countries have successfully procured and administered doses ahead of low- and middle-income countries.”

COVID-19 vaccines are frequently tested in low- and middle-income countries, but they have experienced significant delays in vaccinating their own populations.

COVID-19 Vaccines Tested in Low-Income Countries, But Distributed in Wealthy Nations

. Prior to joining MJH Life Sciences in 2020, he has covered a variety of fields and markets including diabetes, oncology, ophthalmology, IT, travel, and local news. You can email him at 

A new COIVD-19 variant has been discovered after being identified in Africa and in 1 case in Hong Kong by a traveler from South Africa, according to a 

The South Africa Minister of Health Joe Phaahla made the announcement on Thursday of the discovery of the variant, identified as B.1.1.529. It is unknown where it first emerged, but has been seen in South Africa and Botswana and contains as many as 30 mutations in the spike protein.

"Initially it looked like some cluster outbreaks, but from yesterday, the indication came from our scientists from the Network of Genomic Surveillance that they were observing a new variant," Phaahla said.

The United Kingdom Health Security Agency (UKHSA) also announced on Thursday that it has suspended travel from 6 African countries including South Africa, Namibia, Lesotho, Botswana, Eswatini and Zimbabwe.

"UKHSA is investigating a new variant,” the United Kingdom Minister of Health Sajid Javid said yesterday. “More data is needed but we're taking precautions now. From noon tomorrow [Friday] 6 African countries will be added to the red list, flights will be temporarily banned, and UK travelers must quarantine.”

The latest development means that residents of the UK arriving home from those African countries must quarantine for 10 days at a hotel.

The World Health Organization (WHO) is meeting today to assess the variant and give it an official name. "WHO is convening a meeting...to better understand the timeline for studies that are under way and to determine if this variant should be designated as a variant of interest or variant of concern," WHO spokesperson Christian Lindmeier, said.

The strain identified as B.1.1.529 is causing some travel restrictions from some African countries.

New COVID-19 Variant Identified, Steps Made to Prevent Spread

Brian P. Dunleavy has been covering health and medical research for more than 25 years, for United Press International and EverydayHealth.com, among other outlets. He is also the former editor of Infectious Disease Special Edition. In addition, he has written on other subjects for Biography.com, History.com, the 

, among others. He holds a master’s degree from the University of Missouri School of Journalism.

In what sadly could be called an exception to the rule, it appears Americans took the urgings of the nation’s public health leadership to heart and got vaccinated against influenza for the 2020-21 winter season.

 released November 12th by the US Centers and Disease Control and Prevention (CDC) and published in 

) found that uptake of flu vaccine between September and December of last year was 9% higher than it was during the same period in 2018 and 2019. However, the report also showed that vaccine uptake among children ages 6 to 23 months and ages 2 to 4 years declined by 13.9% and 11.9%, respectively, from 2018-19 to 2020.

 over the past 3 flu seasons, so these findings are consistent with recent trends,” coauthor Patricia Castro Roman, researcher with the Immunization Services Division at the CDC’s National Center for Immunization and Respiratory Diseases and member of the agency’s COVID-19 Rapid Response Team, told 

. “CDC works each year to eliminate barriers to vaccination and increase the number of people who receive a flu vaccine. Efforts include targeted outreach to raise awareness about the importance of flu vaccination, such as engaging in public awareness campaigns, and collaborating with community-based organizations so that their leaders can be the trusted messengers of flu vaccination messages. Whether last year’s increase is attributable to some of these flu immunization campaigns is unclear.”

An example of the agency’s outreach efforts includes a 

 with the Ad Council and American Medical Association that urges Americans to get their annual flu shot, according to Castro Roman.

In addition, federal public health officials, most notably Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, led a 

 in the fall of 2020 pushing Americans to get the flu shot. This was, of course, in the period immediately before COVID-19 vaccines were cleared for use and there were concerns over circulation of both viruses posing a “diagnostic challenge.”

However, as we’ve seen with the COVID-19 vaccination efforts, not everyone pays attention to public health messaging from federal officials, with 

, sadly, too often at the center of controversy.

Still, for the 11 jurisdictions included in this CDC analysis, there were nearly 16.9 million influenza vaccine doses distributed between September and December 2020, compared with an average of 15.5 million for these same regions during the same weeks in 2018 and 2019. The biggest increases were seen in adults (14.6% for ages 18 to 49 years; 15.3% for ages 50 to 64 years; 9.5% for age 65 years and older), though, unlike younger children, those ages 13 to 17 years saw a 12.9% rise in doses distributed.

“Although the reasons for the drop in flu vaccination coverage among children were not assessed in this study, we do know that disruptions from the COVID-19 pandemic resulted in many children missing well-child visits and routine recommended vaccines,” Castro Roman said. “Decisions about whether to vaccinate children against flu might have been influenced by the time of year the annual well-child check-up was conducted, or by COVID-19–related barriers to health care access, including provider office closures or fear of contracting COVID-19 while getting the flu vaccine. In addition, because many students were out of school and learning virtually, some parents might have perceived their children were at lower risk for flu.”

Unfortunately, the good news may end there. According to Castro Roman, 

preliminary in-season estimates of flu vaccine coverage

 this fall suggest that uptake for this season so far is lower than last, including among children. This is significant, given that factors such as reduced population immunity due to 

 could create conditions for “a more severe season,” she said.

“It will be important to watch vaccination coverage estimates carefully to see whether these early indications of lower coverage remain consistent,” Castro Roman said.

Indeed, and whether the public will listen to the advice of health leaders.

Analysis documents 9% rise in shots distributed after federal officials pushed for vaccination.

Public Health Watch: 2020 Flu Vaccine Uptake Shows Some Public Health Messaging Takes Hold

Welcome to our series, 1 Big Question, which asks 1 question to the medical community and we get their feedback on an important infectious disease topic.

In this episode, our 1 Big Question is: Will PrEP have a prominent role and significant impact in HIV prevention?

We interviewed Gary Spinner, DMSc, PA, MPH, AAHIVS, medical director of the HIV/AIDS Program, Southwest Community Health Center, Randy Matthews, PhD, MD, senior principal scientist, Merck, and Carl Schmid, executive director, HIV+Hepatitis Policy Institute.

Check out our video to hear their insights.

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Saskia v. Popescu, PhD, MPH, MA, CIC, is a hospital epidemiologist and infection preventionist. During her work as an infection preventionist, she performed surveillance for infectious diseases, preparedness, and Ebola-response practices. She holds a doctorate in Biodefense from George Mason University where her research focuses on the role of infection prevention in facilitating global health security efforts. She is certified in Infection Control and has worked in both pediatric and adult acute care facilities.

Disruptions to health care due to large-scale events, like that of the COVID-19 pandemic, can trickle into so much of what we need for public health, including routine vaccinations.

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The Scynexis ibrexafungerp (Brexafemme) therapy cleared signs and symptoms of vaginal yeast infection in 73.9% of patients.

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The Infectious Diseases Society of America (IDSA) released new expert-informed guidelines for treating antimicrobial-resistant AmpC β-lactamase-producing Enterobacterales (AmpC-E), carbapenem-resistant Acinetobacter baumannii (CRAB), and Stenotrophomonas maltophilia infections.

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Genetic Ancestry May Determine Immune Response to Influenza

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