General Medicine and Primary Care

Host: Jennifer Caudle, DO

Guest: Blen Girmay, MD

Because standard-dose vaccines usually produce only modest immunogenic responses in people age 65 years and older, the Advisory Committee on Immunization Practices, as of June 2022, recommended this age group receive either an adjuvanted or higher-dose seasonal influenza vaccine.1,2,3 A pragmatic, head-to-head randomized study compared FLUAD and the high-dose influenza vaccine over the course of two influenza seasons.2 Joining Dr. Jennifer Caudle to discuss this study and its findings from the first season (2023-2024) is Dr. Blen Girmay, a Johns Hopkins fellowship-trained primary care geriatrician at Inova Health System in Fairfax, Virginia.

References:

1. Coleman BL, Sanderson R, Haag MDM, McGovern I. Effectiveness of the MF59-adjuvanted trivalent or quadrivalent seasonal influenza vaccine among adults 65 years of age or older, a systematic review and meta-analysis. Influenza Other Respir Viruses. 2021;15(6):813-823.
2. Klein N. Oral presentation presented at: IDWeek 2024 Meeting; October 16-19, 2024. Los Angeles, CA.
3. Grohskopf LA, Ferdinands JM, Blanton LH, Broder KR, Loehr J. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2024-25 Influenza Season. MMWR Recomm Rep. 2024;73(5):1-25.

Immune imprinting refers to how the immune system's first encounter with a virus, such as influenza, leaves a lasting imprint that shapes future immune responses.1,2 However, influenza vaccines may affect this process—particularly when egg-based ones are used. Tune in to learn about the impact of immune imprinting, the role that vaccines play in this process, and how switching to non-egg-based vaccines could help redirect immune responses and possibly create more effective defenses in people of all ages.3,4

References:

1. King SM, Bryan SP, Hilchey SP, Wang J, Zand MS. First impressions matter: Immune imprinting and antibody cross-reactivity in influenza and SARS-CoV-2. Pathogens. 2023;12(2):169. doi:10.3390/pathogens12020169
2. Zhang A, Stacey HD, Mullarkey CE, Miller MS. Original antigenic sin: How first exposure shapes lifelong anti-influenza virus immune responses. J Immunol. 2019;202(2):335–340. doi:10.4049/jimmunol.1801149
3. Rockman S, Laurie K, Ong C, et al. Cell-based manufacturing technology increases antigenic match of influenza vaccine and results in improved effectiveness. Vaccines (Basel). 2022;11(1):52. doi:10.3390/vaccines11010052
4. Liu F, Gross FL, Jefferson SN, et al. Age-specific effects of vaccine egg adaptation and immune priming on A(H3N2) antibody responses following influenza vaccination. J Clin Invest. 2021;131(8):e146138. doi:10.1172/JCI146138

USA-CRP-24-0038 July 2025

Guess what? The CDC's Advisory Committee on Immunization Practices had a unanimous vote in favor of a preferential recommendation of vaccines for the cool adults who are 65 and older—one of these options is adjuvanted influenza vaccines.1 Talk about a milestone in the world of public health! Now the burning question is why on earth did they decide on adjuvant vaccines? Let's unravel this immunization mystery together, shall we?

Reference:

1. Grohskopf LA, Blanton LH, Ferdinands JM, Chung JR, Broder KR, Talbot HK, Morgan RL, Fry AM. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices - United States, 2022-23 influenza season. MMWR Recomm Rep. 2022 Aug 26;71(1):1-28. doi: 10.15585/mmwr.rr7101a1

USA-CRP-23-0037 12/23

Host: Charles Turck, PharmD, BCPS, BCCCP

Guest: Stephen I. Pelton, MD

In the last two pre-pandemic flu seasons, approximately half of hospitalizations from influenza in the US were in adults 65 and older.1,2 A recent real-world study evaluated the relative effectiveness of adjuvanted influenza vaccine versus high-dose vaccine in preventing test-confirmed influenza hospitalizations in this age group across three flu seasons between 2017 and 2020.3 Dr. Charles Turck sits down with Dr. Stephen Pelton, an author on this study, to explore the findings and their implications for influenza vaccination strategies in older adults. Dr. Pelton is a Professor of Pediatrics at the Boston University Chobanian and Avedisian School of Medicine.

References:

1. Pelton SI, Nguyen VH, Mould-Quevedo JF. The value of influenza vaccination in the older adult population. A stochastic model estimation of the benefit of vaccination to prevent the severe outcomes in the U.S. Poster presented at: IDWeek 2023; October 11-15; Boston, MA.
2. Pelton SI, Mould-Quevedo JF, Nguyen VH. The impact of adjuvanted influenza vaccine on disease severity in the US: a stochastic model. Vaccines. 2023;11:1525.
3. McGovern I, Chastek B, Bancroft T, et al. Relative vaccine effectiveness of MF59-adjuvanted vs high-dose trivalent inactivated influenza vaccines for prevention of test-confirmed influenza hospitalizations during the 2017-2020 influenza seasons. Int J Infect Dis. …

Host: Mary Katherine Cheeley, PharmD, BCPS, CLS, FNLA

Guest: Leigh Anne Cantrell, MD, MSPH

The updated ASCCP guidelines now address the use of dual-stain technology for cervical cancer management. CINtec PLUS Cytology is a test for the co-expression of p16 and Ki67 and confirms the presence of a transforming HPV infection and defines patients with high-risk cervical disease. To learn more about these guidelines and how to apply them in practice, join Dr. Leigh Cantrell, Medical Physician and Fellow in the American College of Obstetrics and Gynecology.

COBAS and CINTEC are trademarks of Roche.
All other product names and trademarks are the property of their respective owners. 07/24

Guest: Stephen I. Pelton, MD

Influenza disproportionately affects adults 65 and older as a result of increased frequency of comorbidities and immunosenescence.1,2 It is also linked to neurologic, cardiovascular, and respiratory complications in high-risk groups, while potentially exacerbating underlying chronic medical conditions.1,2 So how can adjuvanted vaccines help patients who are affected? Dive in to learn more with Dr. Stephen Pelton, Professor of Pediatrics at Boston University Chobanian and Avedisian School of Medicine.

References:

1. Pelton SI, Nguyen VH, Mould-Quevedo JF. The value of influenza vaccination in the older adult population. A stochastic model estimation of the benefit of vaccination to prevent the severe outcomes in the U.S. Poster presented at: IDWeek 2023; October 11-15; Boston, MA.
2. Pelton SI, Mould-Quevedo JF, Nguyen VH. The impact of adjuvanted influenza vaccine on disease severity in the US: a stochastic model. Vaccines. 2023; 11(10):1525. https://doi.org/10.3390/vaccines11101525

USA-FLUD-24-0039 08/24

Host: Jennifer Caudle, DO

Guest: Victoria A. Statler, MD, MSc

Test-confirmed influenza outcomes provide a specific measure of influenza vaccine effectiveness (VE) and has helped to illustrate the potential benefit of cell-based versus egg-based vaccines.1 So what data support improved VE from cell-based flu vaccines versus egg-based vaccines? To learn more, join Dr. Jennifer Caudle as she speaks with Dr. Victoria A. Statler, Associate Professor of Pediatrics at the University of Louisville and the Director of the Pediatric Transplant and Immunocompromised Host service at Norton Children’s Hospital.

Reference:

1. Stein AN, Mills C, McGovern, et al. Superior effectiveness of cell-based versus egg-based quadrivalent influenza vaccines against test-confirmed influenza over three consecutive seasons in the United States. Paper presented at: The Ninth European Scientific Working Group Influenza (ESWI) Influenza Conference; September 17-20, 2023: Valencia, Spain.

USA-FCV-24-0055 08/24

Host: Charles Turck, PharmD, BCPS, BCCCP

Guest: Wendy Wright, DNP

Guest: Elias Chahine, PharmD, FCCP, FASCP

While the flu may seem benign to some, it may result in up to 710,000 hospitalizations and up to 52,000 deaths every year.1 So how are current and concerning trends in declining flu vaccinations being addressed? To hear the latest updates and recommendations, join Dr. Charles Turck as he speaks with Dr. Wendy Wright, Owner and Family Nurse Practitioner at Wright & Associates Family Healthcare in New Hampshire, and Dr. Elias Chahine, Professor of Pharmacy Practice at Palm Beach Atlantic University in West Palm Beach, Florida and Clinical Pharmacy Specialist at Wellington Regional Medical Center.

Reference:

1. Disease Burden of Influenza. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/burden/index.html. Updated October 4, 2022. Accessed November 28, 2023.

USA-CRP-23-0043 01/24