**OPTIONS FOR H1N1**

**OPTION 1. MAINTAIN CURRENT VACCINE STRAIN,**

> **A/NEW CALEDONIA/20/99**

**PRO MANUFACTURING IS WORKED OUT AND**

> **YIELD IS PREDICTABLE**
>
> **MOST OF THE VIRUSES THIS YEAR ARE**
>
> **A/NEW CALEDONIA/20/99-LIKE BY ANTIGENIC CHARACTERIZATION OF THE
> HEMAGLUTININ**
>
> **CON RELATIVELY FEW RECENT STRAINS FOR ANALYSIS**

**OPTIONS FOR H1N1**

**OPTION 2. CHANGE CURRENT VACCINE STRAIN TO A STRAIN MORE
REPRESENTATIVE OF CURRENTLY CIRCULATING VIRUSES**

> **PRO A MORE RECENT STRAIN MIGHT PROVIDE A CLOSER MATCH WITH THE
> HEMAGGLUTININ AND NEURAMINIDASE OF CONTEMPORARY STRAINS**
>
> **CON A NEW STRAIN MAY NOT PROVIDE SUPERIOR COVERAGE COMPARED TO
> CURRENT VACCINE STRAIN**
>
> **NO NEW STRAINS HAVE BEEN IDENTIFIED AND MANUFACTURING ISSUES HAVE
> NOT BEEN INVESTIGATED**

**OPTIONS FOR H1N1**

**OPTION 3. POSTPONE DECISION**

> **PRO A MORE RECENT STRAIN MIGHT PROVIDE A CLOSER MATCH WITH THE
> HEMAGGLUTININ AND NEURAMINIDASE OF CONTEMPORARY STRAINS**
>
> **CON NO NEW DATA APPEARS FORTHCOMING**

**OPTIONS FOR H3N2**

**OPTION 1. MAINTAIN CURRENT VACCINE STRAIN, A/PANAMA/2007/99**

**PRO MANUFACTURING IS WORKED OUT AND**

> **YIELD IS PREDICTABLE**
>
> **MOST OF THE VIRUSES THIS YEAR ARE A/PANAMA/2007/99-LIKE BY ANTIGENIC
> CHARACTERIZATION OF THE HEMAGLUTININ**
>
> **CON INFORMATION ABOUT NEWEST STRAINS IS NOT YET ANALYZED**
>
> **H3N2 INFLUENZA VIRUSES ARE OFTEN RESPONSIBLE FOR SIGNIFICANT
> MORBIDITY AND MORTALITY**

**OPTIONS FOR H3N2**

**OPTION 2. CHANGE CURRENT VACCINE STRAIN TO A STRAIN MORE
REPRESENTATIVE OF CURRENTLY CIRCULATING VIRUSES**

> **PRO A MORE RECENT STRAIN MIGHT PROVIDE A CLOSER MATCH WITH THE
> HEMAGGLUTININ AND NEURAMINIDASE OF CONTEMPORARY STRAINS**
>
> **H3N2 INFLUENZA VIRUSES OFTEN RESPONSIBLE FOR SIGNIFICANT MORBIDITY
> AND MORTALITY**
>
> **CON INFORMATION ABOUT NEWEST STRAINS IS NOT YET ANALYZED**
>
> **A NEW STRAIN MAY NOT PROVIDE SUPERIOR COVERAGE COMPARED TO CURRENT
> VACCINE STRAIN**
>
> **NO NEW STRAINS HAVE BEEN EVALUATED FOR MANUFACTURING ISSUES**
>
> **OPTIONS FOR H3N2**

**OPTION 3. POSTPONE DECISION**

> **PRO POSTPONING DECISION WOULD PROVIDE TIME TO ANALYZE NEWLY
> COLLECTED STRAINS**
>
> **A MORE RECENT STRAIN MIGHT PROVIDE A CLOSER MATCH WITH THE
> HEMAGGLUTININ AND NEURAMINIDASE OF CONTEMPORARY STRAINS**
>
> **H3N2 INFLUENZA VIRUSES OFTEN RESPONSIBLE FOR SIGNIFICANT MORBIDITY
> AND MORTALITY**
>
> **CON A NEW STRAIN MAY NOT PROVIDE SUPERIOR COVERAGE COMPARED TO
> CURRENT VACCINE STRAIN**
>
> **NO NEW STRAINS HAVE BEEN IDENTIFIED AND MANUFACTURING ISSUES HAVE
> NOT BEEN INVESTIGATED**

**OPTIONS FOR B**

**OPTION 1. RETAIN THE CURRENT VACCINE STRAINS,**

> **B/VICTORIA/504/2000 OR B/GUANGDONG/120/2000**
>
> **PRO MANUFACTURING IS WELL DEFINED AND**
>
> **PREDICTABLE**
>
> **CON SOME NEW VARIANT STRAINS HAVE BEEN IDENTIFIED IN THE VACCINE HA
> LINEAGE**
>
> **STRAINS IN THE B/SHANGDONG/7/97 HA LINEAGE ARE APPEARING IN
> INCREASING NUMBERS AND IN NEW REGIONS**
>
> **SOME INFLUENZA B STRAINS, PARTICULARLY THOSE IN THE B/SHANGDONG/7/97
> HA LINEAGE, ARE NOT WELL INHIBITED BY POST-INFECTION AND
> POST-IMMUNIZATION ANTISERA**

**OPTIONS FOR B**

**OPTION 2. CHANGE CURRENT VACCINE STRAIN TO ANOTHER INFLUENZA B
STRAIN**

> **PRO VACCINES MIGHT PROVIDE BROADER COVERAGE FOR CURRENT INFLUENZA B
> VIRUSES**
>
> **SEVERAL CANDIDATE STRAINS HAVE BEEN IDENTIFIED AND ARE BEING
> EXAMINED FOR SUITABILITY BY MULTIPLE MANUFACTURERS**
>
> **CON NEW STRAINS MAY CAUSE DIFFICULTIES IN MANUFACTURING UNTIL ALL
> PROCESS PARAMETERS CAN BE OPTIMIZED**

**OPTIONS FOR B**

**OPTION 3. POSTPONE DECISION**

> **PRO POSTPONING DECISION WOULD PROVIDE TIME TO FOR ADDITIONAL
> EVALUATIONS OF INFLUENZA B STRAINS**
>
> **A MORE RECENT STRAIN MIGHT PROVIDE A CLOSER MATCH WITH THE
> HEMAGGLUTININ AND NEURAMINIDASE OF CONTEMPORARY STRAINS**
>
> **CON A NEW STRAIN MAY NOT PROVIDE SUPERIOR COVERAGE COMPARED TO
> CURRENT VACCINE STRAIN**