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New research raises hopes in quest to find universal flu vaccine

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3 Star

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New research raises hopes in quest to find universal flu vaccine

Our Review Summary

The story attempts to present the results of a phase 1 trial of a new approach to a flu vaccine. But it unfortunately falls well short of ideal. Suggesting the new vaccine target flu virus proteins and the existing vaccine attacks others is simply not correct. Vaccines activate portions of the immune system. The fact that the virus used in the new vaccine is a dramatically attenuated cousin of the smallpox virus is missed entirely as was the study design and outcomes. While the story did point out the vaccine was a long way off from availability, the limitations of the approach were not discussed in any detail.  

 

Why This Matters

The available flu vaccines contain inactivated or killed flu virus. Proteins on the outer surface of the virus activate the immune system response reducing the likelihood of infection or reducing symptoms. Different strains of the virus have different surface proteins. The strains of flu virus that cause illness can change from year to year, making it necessary to change the vaccine annually. The makeup of the vaccine is based on the best available evidence at the time of manufacture and changes from year to year consistent with the various strains presumably causing infection. Although the existing vaccines are very effective when they contain the correct virus strains, the guesswork involved sometimes falls short. Even when the vaccines are on target, they are less effective in the elderly. The elderly suffer the majority of the 36,000 deaths seen annually in the US. A vaccine that works against all strains of the flu virus and works better in the elderly would be a major advantage. The new vaccine under development by the Oxford Jenner Institute is said to take advantage of the internal proteins’ ability to activate T cells. This represents a new approach to way the body can respond to exposure to the flu. However, the approach is not totally new – having been first identified in 1983.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

Since this vaccine is not yet available, a discussion of costs is not necessary.   

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory
The story waivers in its description of the presumed benefits of the approach. On the one hand, the story uses phrases such as, “…the method is effective…” “first successful trial…” “The initial results are positive…” One has to read to the end of the story to get to any qualifiers, “…there is no evidence presented to say if it really results in protection against infection…” This mixed message provides the reader with an incomplete and puzzling picture.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory
Given that this was a Phase I trial, the purpose of which is to evaluate the safety of the approach, the story should have mentioned the adverse effects. Most participants reported minor side effects, but 5 out of 8 people who received a higher dose of the vaccine experienced severe nausea, vomiting, malaise, and chills.  

Does the story seem to grasp the quality of the evidence?

Not Satisfactory
The story provides muddled and inaccurate information to the reader from the opening sentence on. The vaccine is called a “treatment” and it is suggested that it, “…works by targeting protein cells inside the influenza A virus, instead of current vaccines that attack proteins on the outside of the flu virus.” Vaccines work by priming the immune system to recognize foreign proteins and do not work like a drug. While the story rightly indicates that more research is needed before this vaccine can be developed, it failed to point out that this was only a phase I trial evaluating the vaccine’s safety. It also would have been useful if the story was more explicit in highlighting that efficacy cannot be determined with just 11 people in each treatment arm. Furthermore, it should be noted that the trial only included people aged 18 to 50 years old and, therefore, the results do not apply to those who are at the highest risk of dying from the flu—the very young and the very old.

Does the story commit disease-mongering?

Satisfactory
The story provides an accurate picture of the annual human cost of the flu in the United States.  

Does the story use independent sources and identify conflicts of interest?

Satisfactory
The story includes comments from one independent source—the chair of microbiology at Mount Sinai School of Medicine.

Does the story compare the new approach with existing alternatives?

Not Satisfactory
The story missed a wonderful teaching moment by not emphasizing that the current vaccines are very effective is preventing the flu across a wide spectrum of patients. Overall, the existing vaccine reduces the risk of getting the flu by 70-90% in the general population.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

It’s clear from the story that the vaccine is in the early stage of development and will not be available for at least several more years.

Does the story establish the true novelty of the approach?

Not Satisfactory

In reality, this approach to developing vaccines was originally suggested in a study in 1983. The approach used by scientists at the Jenner Institute is novel in that a Modified Vaccinia Ankara (MVA) virus was used. It would have been an interesting sideline to point out that this is a close relative to the smallpox virus that has shown promise as a delivery system for a variety of vaccines. 

Does the story appear to rely solely or largely on a news release?

Satisfactory
This piece does not rely on a press release.

Total Score: 4 of 9 Satisfactory

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