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COVID-19 UPDATE

stated the following: “The combination combination vaccine may be preferred References
qNIV/CoV2373 vaccine produces high titer since it is more convenient to receive one 1. “CDC COVID Data Tracker.” Centers
influenza hemagglutination inhibiting combined shot rather than two individ- for Disease Control and Prevention, Centers
(HAI) and neutralizing antibodies against ual shots. for Disease Control and Prevention,
influenza A and B strains. The combination covid.cdc.gov/covid-data-tracker/#cases_to-
vaccine also elicited antibodies that block 2. Patients who get the influenza vaccine talcases.
SARS-CoV-2 spike protein binding to the yearly will continue to receive the in- 2. “Combination Vaccines – Fewer Shots
human angiotensin converting enzyme-2 fluenza vaccine but may refuse the Same Protection.” Centers for Disease Con-
(hACE2) receptor. Significantly, hamsters COVID vaccine due to hesitation to re- trol and Prevention, Centers for Disease
immunized with qNIV/CoV2373 vaccine ceive a newly synthesized vaccine or the Control and Prevention, 1 Aug. 2019,
and challenged with SARS-CoV-2 were pro- inconvenience of returning for a re- www.cdc.gov/vaccines/parents/why-vacci-
tected against…and were free of replicating quired second COVID vaccine dose, de- nate/combination-vaccines.html.
SARS-CoV-2 in the upper and lower respira- pending on the type of vaccine first 3. Kim, Jerome H., et al. “Looking beyond
tory tract with no evidence of viral pneumo- administered. COVID-19 Vaccine Phase 3 Trials.” Nature
nia. This study supports evaluation of Medicine, vol. 27, no. 2, 2021, pp. 205–211.,
qNIV/CoV2373 combination vaccine as a 3. Patients who decline both vaccines be- doi:10.1038/s41591-021-01230-y.
preventive measure for seasonal influenza and cause of anti-vaccination sentiments, vac- 4. Massare, Michael J, et al. “Combination
4
COVID-19.” And while this early data is cine hesitations, lack of health care access Respiratory Vaccine Containing Recombi-
promising, human-based clinical trial studies or any number of barriers to health care. nant SARS-CoV-2 Spike and Quadrivalent
of the combination vaccine are still impera- Seasonal Influenza Hemagglutinin Nanopar-
tive for the Novavax study. 4. Patients who choose only to receive the ticles with Matrix-M Adjuvant.” 2021,
As vaccine research continues to develop COVID vaccine because of pre-existing doi:10.1101/2021.05.05.442782.
and trials increase in number, an immuniza- hesitations from past influenza vaccine 5. Shinde, Vivek, et al. “Efficacy of NVX-
tion action plan needs to be considered. In experience (i.e., those who believe “the CoV2373 Covid-19 Vaccine against the
addition, the cost and burden of individual last time I received the influenza vaccine, B.1.351 Variant.” New England Journal of
shots as opposed to a combination vaccine re- I got the flu”). Medicine, vol. 384, no. 20, 2021, pp. 1899–
quires evaluation, while also keeping in mind 1909., doi:10.1056/nejmoa2103055.
that citizens in rural areas and underserved Taken together, ongoing research is sug- 6. Uyeki, Timothy M., et al. “Influenza Ac-
populations would likely benefit from a com- gesting that influenza and SARS-CoV-2 tivity in the US During the 2020-2021 Sea-
bination vaccine due to its convenience and present with many similarities. Both respira- son.” JAMA, 2021, doi:10.1001/
enhanced protection against both SARS- tory viruses demonstrate the need for a yearly jama.2021.6125.
CoV-2 and influenza viruses. vaccine based on variations in viral strains 7. “Weekly U.S. Influenza Surveillance Re-
from past strains. They also manifest paral- port.” Centers for Disease Control and Pre-
What would the future look like? lelism in symptoms, transmission and popu- vention, Centers for Disease Control and
The future of any novel COVID/influenza lations that are particularly vulnerable. Prevention, 28 May 2021, www.cdc.gov/flu/
combination vaccine is still undetermined; Therefore, a combination vaccine presents weekly/index.htm.
nevertheless, we can analyze past vaccination the optimal solution to curbing both infec-
trends to predict future ones. Multiple sce- tions. While research is newly emerging re- Alvin Boyd Newman-Caro is a
narios can be proposed regarding a patient’s garding a combination vaccine, past Fourth Year Medical Student at the
choice for vaccination: infection and vaccination trends also show a University of Incarnate Word School
promising future for a combined influenza of Osteopathic Medicine. He plans to specialize
1. Patients who get the influenza vaccine and SARS-CoV-2 vaccine. For these reasons, in General Surgery.
yearly will continue to receive the in- public health officials and members of the
fluenza vaccine and will more than likely health care community should consider Rebecca L. Sanchez, PhD is an
also opt to receive the COVID vaccine. starting a conversation now around combi- Assistant Professor of Microbiology
In this scenario, the COVID/influenza nation vaccine implementation. at the UIWSOM.

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