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Since the 2013-2014 influenza season, WHO recommends the tetravalent influenza vaccine instead of trivalent vaccine for the prevention of infection with seasonal influenza viruses. Trivalent influenza vaccines contains 3 virus strains: A/H1N1, A/H3N2, and B/ Yamagata or B/Victoria The tetravalent vaccine includes two lineages of influenza B. Since it is very difficult, even impossible to determine exactly which lineage of influenza B viruses will predominantly circulate at the forthcoming influenza season, and because there is very little cross-protection between B/ Yamagata or B/Victoria, it might be worth switching to a tetravalent vaccine. The purpose of this dissertation is to justify the use of the tetravalent vaccine, examining the burden of influenza B compared with influenza A, its impact and the immunogenicity and the safety of a tetravalent vaccine versus a trivalent vaccine. Depuis la saison grippale 2013-2014, l'OMS préconise le vaccin anti-influenza tétravalent à la place du vaccin trivalent pour la prévention de l'infection par le virus de la grippe saisonnière. Les vaccins trivalents utilisés comportent 3 souches de virus influenza : une souche Al H 1N1, une souche A/H3N2, et une souche B/Yamagata ou BNictoria. Le vaccin tétravalent inclut les deux lignées influenza B. Comme il est très difficile, voire impossible de déterminer avec exactitude quelle lignée de virus influenza B circulera de manière prédominante lors de la saison grippale future, et qu'il y a très peu de protection croisée entre B/Yamagata et BNictoria, il pourrait être intéressant de passer à un vaccin tétravalent. L'objectif de ce mémoire sera de justifier l'utilisation d'un vaccin tétravalent, en examinant le poids d'influenza B par rapport à influenza A, son impact, et l'immunogénicité et la sécurité d'un vaccin tétravalent par rapport à un vaccin trivalent.

Influenza Vaccines

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Aim: This study aimedto investigate the knowledge and attitudes of healthcareworkers regardinginfluenza, influenza vaccination,and vaccination practicesin emergency departments in Gothenburg, Sweden. Method: This cross-sectional studyuseda self-administered questionnaire distributed tonurses, assistant nurses,and physiciansin three emergency departments atThe Sahlgrenska University Hospital in January-February2014. Results: Among214 participants, 56% were nurses, 27% assistant nurses,and 17% physicians. The response ratewas 77%. A total of 66 participants (31%)werevaccinated against influenza during the previous12 months.The highest vaccination coverage occurredin the oldestage group(56%;P<0.05).Past vaccinationstrongly predicted future vaccinationbehavior (P<0.001). Ourdata revealed nosignificant difference invaccination coverage betweenprofession, work experience, hospital,or gender. The mean knowledge score was higher among vaccinated vs. unvaccinated health care workers (17.9 ± 2.7vs.16.8 ± 2.6, respectively; P< 0.05). Moreover, influenza risk perception was higher among participants who were vaccinated during the previous12 months compared to unvaccinated participants (P< 0.001). Interestingly, more un vaccinated health care workers believed that personal behavior determines health (higher internal locus of control) compared to vaccinated workers(P< 0.05). More than half of vaccinated health care workers stated that they got vaccinated to avoid influenza. Almost half of the unvaccinated workers voiced concern about vaccine side effects. Fourteen percent of all respondents mentioned patient protection as an important factor in their decision to receive influenza vaccination. Conclusion:This study demonstrates a need for improved knowledge about influenza and influenza vaccinationin health care workers. Increased risk perception of influenza can increase vaccination coverage in emergency department personnel,and may reduce the incidence of healthcare.

Influenza vaccines.

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Influenza vaccines

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Influenza vaccines --- Vaccination --- Influenza vaccines --- Vaccination

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Each year, the times of vaccination bring the subject of influenza to the forefront. Episodically, pandemic flu outbreaks in the world, leading to fears, rumors and controversies. For the sake of quality, this work will be limited to these flu pandemic. The first part of this study consists in a short introduction about the virus in order to understand the mechanisms inducing the mutations that make it so unusual. The origin of epidemics and pandemics as well as their mechanisms of emergence will be discussed later. Given the risk of a pandemic, WHO has established a complete scheme of action to react quickly to this threat. Consideration will be given to this plan, as well as to the various characteristics required for the selection of a candidate vaccine. The second part of this work will be more oriented more towards the fight against H1N1 in 2009. The galenic of the vaccine marketed by GSK Pandemrix will be analyzed as well as the various steps involved in obtaining it. The question of the safety of adjuvants will also be thoroughly studied. Finally, this work will conclude with a summary analysis of vaccine pharmacovigilance La grippe est un thème qui revient annuellement au-devant de la scène lorsqu’arrivent les périodes de vaccination. Épisodiquement, des grippes pandémiques se déclarent dans le monde entrainant craintes, rumeurs et controverses. Dans un souci de qualité, ce travail se limitera à ces grippes pandémiques. Après une courte introduction concernant le virus permettant de comprendre les mécanismes induisant les mutations qui le rendent si atypique, j’aborderai l’origine des épidémies et des pandémies ainsi que leurs mécanismes d’émergences. Face à ce risque de contagion, l’OMS a mis en place un plan d’action afin de réagir au plus vite à cette menace. Ce plan, ainsi que les différentes caractéristiques requises pour la sélection d’un vaccin candidat, feront ensuite l’objet d’une réflexion. La deuxième partie de ce travail sera d’avantage tournée vers la lutte contre la grippe A H1N1 de 2009. La galénique du vaccin Pandemrix commercialisé par GSK sera analysée, ainsi que les différentes étapes menant à l’obtention de celui-ci. La question de l’innocuité des adjuvants sera également approfondie. Enfin, ce travail se clôturera par un résumé des analyses de pharmacovigilance du vaccin.

Pandemics --- Influenza Vaccines