Research Papers:

A(H1N1)pdm09 influenza infection: vaccine inefficiency

Nehemya Friedman, Yaron Drori, Rakefet Pando, Aharona Glatman-Freedman, Hanna Sefty, Ravit Bassal, Yaniv Stein, Tamy Shohat, Ella Mendelson, Musa Hindiyeh and Michal Mandelboim _

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Oncotarget. 2017; 8:32856-32863. https://doi.org/10.18632/oncotarget.16459

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Nehemya Friedman1,2,*, Yaron Drori1,2,*, Rakefet Pando3, Aharona Glatman-Freedman3,4, Hanna Sefty3, Ravit Bassal3, Yaniv Stein3, Tamy Shohat2,3, Ella Mendelson1,2, Musa Hindiyeh1,2, Michal Mandelboim1,2

1Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat-Gan, Israel

2Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

3The Israel Center for Disease Control, Israel Ministry of Health, Tel-Hashomer, Israel

4Departments of Pediatrics and Family and Community Medicine, Valhalla, New York, USA

*These authors contributed equally to this work

Correspondence to:

Michal Mandelboim, email: [email protected]

Keywords: influenza A, H1N1, vaccine, Clade 6B

Received: November 22, 2016     Accepted: March 14, 2017     Published: March 22, 2017


The last influenza pandemic, caused by the swine A(H1N1)pdm09 influenza virus, began in North America at 2009. Since then, the World Health Organization (WHO) recommended integration of the swine-based virus A/California/07/2009 strain in yearly vaccinations. Yet, infections with A(H1N1)pdm09 have continued in subsequent years. The reasons for this are currently unknown. During the 2015–2016 influenza season, we noted an increased prevalence of A(H1N1)pdm09 influenza virus infection in Israel. Our phylogenetic analysis indicated that the circulating A(H1N1)pdm09 strains belonged to 6B.1 and 6B.2 clades and differed from the vaccinating strain, with approximately 18 amino acid differences found between the circulating strains and the immunizing A/California/07/2009 strain. Hemmaglutination inhibition (HI) assays demonstrated higher antibodies titer against the A/California/07/2009 vaccinating strain as compared to the circulating Israeli strains. We thus suggest that the current vaccination was not sufficiently effective and propose inclusion of the current circulating A(H1N1)pdm09 influenza viruses in the annual vaccine composition.

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