@article{TEXTUAL,
      recid = {6802},
      author = {Subramanian, Rahul and Graham, Andrea L. and Grenfell,  Bryan T. and Arinaminpathy, Nimalan},
      title = {Universal or Specific? A Modeling-Based Comparison of  Broad-Spectrum Influenza Vaccines against Conventional,  Strain-Matched Vaccines},
      journal = {PLOS Computational Biology},
      address = {2016-12-15},
      number = {TEXTUAL},
      abstract = {Despite the availability of vaccines, influenza remains a  major public health challenge. A key reason is the virus  capacity for immune escape: ongoing evolution allows the  continual circulation of seasonal influenza, while novel  influenza viruses invade the human population to cause a  pandemic every few decades. Current vaccines have to be  updated continually to keep up to date with this antigenic  change, but emerging ‘universal’ vaccines—targeting more  conserved components of the influenza virus—offer the  potential to act across all influenza A strains and  subtypes. Influenza vaccination programmes around the world  are steadily increasing in their population coverage. In  future, how might intensive, routine immunization with  novel vaccines compare against similar mass programmes  utilizing conventional vaccines? Specifically, how might  novel and conventional vaccines compare, in terms of  cumulative incidence and rates of antigenic evolution of  seasonal influenza? What are their potential implications  for the impact of pandemic emergence? Here we present a new  mathematical model, capturing both transmission dynamics  and antigenic evolution of influenza in a simple framework,  to explore these questions. We find that, even when matched  by per-dose efficacy, universal vaccines could dampen  population-level transmission over several seasons to a  greater extent than conventional vaccines. Moreover, by  lowering opportunities for cross-protective immunity in the  population, conventional vaccines could allow the increased  spread of a novel pandemic strain. Conversely, universal  vaccines could mitigate both seasonal and pandemic spread.  However, where it is not possible to maintain annual,  intensive vaccination coverage, the duration and breadth of  immunity raised by universal vaccines are critical  determinants of their performance relative to conventional  vaccines. In future, conventional and novel vaccines are  likely to play complementary roles in vaccination  strategies against influenza: in this context, our results  suggest important characteristics to monitor during the  clinical development of emerging vaccine technologies.},
      url = {http://knowledge.uchicago.edu/record/6802},
}