Protecting against influenza: A conversation with David Ross, Vice President, Commercial Operations, North America, CSL Seqirus

Our industry is at the forefront of fighting the annual influenza virus. I recently had the chance to connect with David Ross, Vice President, Commercial Operations, North America, CSL Seqirus about how the industry is working to fight the annual flu and what lessons learned during COVID-19 are allowing us to better respond to influenza.

Q: You recently spoke at Foreign Policy’s Global Health Forum in Washington, DC. I’m wondering if you can build on that conversation by addressing what we’ve learned from COVID-19 that can be applied to the annual flu season?

Largely due to the COVID-19 pandemic, we’ve seen the general public become more aware of the role vaccines play in protecting public health, including how vaccines not only provide protection against an infection, but to also help limit severe disease and complications if one were to contract the disease. While COVID-19 and influenza have similarities, as they both cause respiratory illness, it’s important to remember that they are very different and need to be addressed accordingly.¹

Last season gave us insight into how to manage simultaneous vaccination campaigns for both influenza and COVID-19, and we now can take those learnings and turn them into actions as we prepare for the upcoming 2022/23 Northern Hemisphere season. For example, we should make sure vaccination programs continue throughout the influenza season, which doesn’t usually peak until February or March.² Typically, we see flu vaccination efforts start to lose momentum in November, which can lead to millions of missed opportunities to protect the public from influenza and its complications.

Additionally, according to the Centers for Disease Control and Prevention (CDC), receiving both COVID-19 and influenza vaccines at the same time is possible.³ Co-administration increases the likelihood of an eligible patient getting both the COVID-19 and influenza vaccines, and ensures health care providers are making the most of their time with the patient as the vaccinations will happen in one visit rather than having to return days later.

Q: There is often confusion about what the flu vaccine is intended to do because flu is so common - what value does vaccination provide and why should Americans receive one annually?

While influenza is common, it’s important to recognize that it’s a highly contagious respiratory disease that can come with broader health consequences.⁴ According to the CDC, influenza caused up to 52,000 deaths and 710,000 hospitalizations annually between 2010-2020 in the U.S.⁵

Influenza vaccines are designed to prompt the immune system to create antibodies that provide protection (or immunity) against infection with circulating influenza viruses.⁶ As such, vaccination remains the best tool to help reduce the risk of contracting influenza and potentially serious complications from influenza.

Annual influenza vaccines are recommended because the circulating strains of influenza virus change from year to year, which means that manufacturers need to re-formulate vaccines on an annual basis to help protect the public against influenza. CDC recommends annual vaccination against seasonal influenza for all eligible people six months of age and older as the single best preventive measure against the virus.

Getting vaccinated not only helps to protect yourself, but it can also protect the people around you, including those who are more vulnerable to serious flu illness, like young children, older adults and people with chronic health conditions. In fact, during the 2019/20 season, CDC estimates that influenza vaccines prevented an estimated 7.52 million illnesses, 3.69 million medical visits, 105,000 hospitalizations, and 6,300 deaths.⁷

Q: Heading into this flu season, is there concern about both COVID-19 and influenza circulating at the same time? What did we see this past year and how can vaccines help us mitigate this threat?

While influenza activity has been generally low during the COVID-19 pandemic, it has not gone away. In fact, it’s not a matter if influenza will return, but rather when and how severe it will be.

Take this year in the Southern Hemisphere for example where countries—specifically Australia and countries in South America—experienced an early and significant increase in influenza activity. Particularly in Australia, influenza disproportionately impacted teenagers and younger populations, with children under 16 years of age making up 60% of flu-related hospitalizations.⁸ Southern Hemisphere influenza surveillance has historically been a strong predictor of influenza activity for the following Northern Hemisphere influenza season, providing an early warning for the U.S.

As we plan for this upcoming flu season, we should assume that flu and COVID-19 viruses will be in circulation at the same time and that vaccination programs will continue to be concurrent. According to the CDC, COVID-19 vaccines may be administered to eligible individuals without regard to the timing of other vaccines, including seasonal influenza vaccines.⁹ Recent guidance from the CDC Advisory Committee on Immunization Practices recommends the use of updated bivalent COVID-19 boosters for people ages 12 and older.¹⁰ Receiving both COVID-19 and flu vaccines at the same time is possible. It’s critical that we do everything to ensure as many people as possible can get vaccinated against influenza as we gear up for the 2022/23 Northern Hemisphere season.

In the U.S. specifically, the 2021/22 season saw a significant drop in influenza vaccinations.¹¹ We can look to previous seasons in the U.S. for influenza and immunization trends and also learn from the current Southern Hemisphere season, where Australia and other countries experienced an early and significant increase in influenza cases.

We in the Northern Hemisphere should not ignore these important predictors and work with our stakeholders to ensure high influenza vaccination rates to help reduce the risk of severe flu complications and minimize the burden on the health care system.

Q: How did decades of research into new platform technologies help us not only achieve COVID-19 vaccines but also support innovation in developing future influenza vaccines?

Innovation in vaccine technology platforms for infectious diseases like COVID-19 and influenza is ever evolving to help ease the burden of these diseases on people and health systems. After years of scientific exploration, the COVID-19 pandemic accelerated the development and licensure of vaccines using mRNA technology.¹²

We’ve also seen a transformation over recent years in influenza vaccine innovation, some including adjuvant technology (designed to boost immune response), cell-based manufacturing processes (designed to produce a match to the circulating strains) and other approached and platforms. In addition, we are pursuing new vaccine technologies, such as combining cell based and adjuvanted technology, or aQIVc, and sa-mRNA, the next-generation self-amplifying mRNA platform.

While we’ve made much progress in addressing influenza, there remains a significant societal and healthcare burden, and we, at CSL Seqirus, are committed to investing in improved and innovative solutions for global influenza protection.

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¹ World Health Organization (WHO). 2021. Coronavirus disease (COVID-19): Similarities and differences between COVID-19 and Influenza. Retrieved from: https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-covid-19-similarities-and-differences-with-influenza. Accessed September 2022.
² Centers for Disease Control and Prevention (CDC). 2021. Influenza (Flu). Retrieved from: https://www.cdc.gov/flu/about/season/flu-season.htm#:~:text=In%20the%20United%20States%2C%20flu%20season%20occurs%20in%20the%20fall,last%20as%20late%20as%20May. Accessed September 2022.
³ CDC. 2022. Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States. Retrieved from: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html. Accessed September 2022.
⁴ CDC. 2022. Key Facts About Influenza (Flu). Retrieved from: https://www.cdc.gov/flu/about/keyfacts.htm. Accessed September 2022
⁵ CDC. 2022. Disease Burden of Flu. Retrieved from: https://www.cdc.gov/flu/about/burden/index.html#:~:text=CDC%20estimates%20that%20flu%20has,annually%20between%202010%20and%202020. Accessed September 2022.
⁶ CDC. 2022. Seasonal Flu Vaccines. Retrieved from: https://www.cdc.gov/flu/prevent/flushot.htm. Accessed September 2022.
⁷ CDC. 2020. Estimated Influenza Illnesses, Medical visits, and Hospitalizations Averted by Vaccination in the United States — 2019–2020 Influenza Season. https://www.cdc.gov/flu/about/burden-averted/2019-2020.htm. Accessed September 2022.
⁸ The WHO. (2002). Influenza Laboratory Surveillance information. Virus Detection by Subtypes Reported to FluNet. https://app.powerbi.com/view?r=eyJrIjoiZTkyODcyOTEtZjA5YS00ZmI0LWFkZGUtODIxNGI5OTE3YjM0IiwidCI6ImY2MTBjMGI3LWJkMjQtNGIzOS04MTBiLTNkYzI4MGFmYjU5MCIsImMiOjh9 Accessed September 2022.
⁹ CDC. 2022. Timing, spacing, and interchangeability of COVID-19 vaccines. Retrieved from: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#timing-spacing-interchangeability. Accessed September 2022.
¹⁰ CDC. 2022. CDC Recommends the First Updated COVID-19 Booster. Retrieved from: https://www.cdc.gov/media/releases/2022/s0901-covid-19-booster.html. Accessed September 2022.
¹¹ CDC. 2022. Latest U.S. Flu Vaccination Coverage Estimates Continue to Show Concerning Drops in Coverage Among People at Increased Risk for Flu Complications. Retrieved from: https://www.cdc.gov/flu/spotlights/2021-2022/study-shows-drop-in-flu-coverage.htm. Accessed September 2022.
¹² Nature. 2021. The tangled history of mRNA vaccines. Retrieved from: https://www.nature.com/articles/d41586-021-02483-w. Accessed September 2022.