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Virologie

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Le vaccin antigrippal d'aujourd'hui et de demain Volume 1, issue 2, Mars - Avril 1997

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Institut Pasteur 18, villa Prévost 92120 Montrouge

Influenza vaccines were used since 1943 in the USA and since 1950 in France : they contained purified and concentrated egg-grown virus which was inactivated by formalin. Improvements have been developed and modern vaccines contain whole virions, split virus or purified active sub-units. In subjects 60 year-old and older, decompensation of chronic affections by influenza constitutes a risk factor for severe consequences and justifies vaccination. Vaccine efficacy has been repeatedly demonstrated and is greater against severe forms and hospitalization. Strategy for the optimal use of vaccine includes priority protection for high risk subjects and vaccine is provided at no charge to these patients in France. The only contra-indication is true allergy to egg proteins. Local and general reactions are unfrequent, mild and short. The main trends for future developments are either specific of influenza or belong to general lines concerning all viral vaccines. In the first category, cell culture-grown vaccines are being tested, or new modes of administration are tried (oral, nasal). The general methods include adjuvant research, preparation of sub-units by genetic engineering or chemical synthesis and the evaluation of the advantages of DNA vaccines adapted to the problems of influenza. Simpler and cheaper vaccines could contribute to extend the indications of influenza vaccination and help to change the strategies for influenza control.