pandemic situations, as cell supply can be accelerated with the use of high cell density
frozen seed stocks, unlike the longer timelines for egg supply [41,42]. Indeed, egg
supply was shown to be a major bottleneck for vaccine production for a significant part
of active manufacturers [17]. However, in order to encourage influenza vaccine pro-
ducers to shift from the cost-effective and well-established egg-based system to cell-
culture platforms, a number of challenges have yet to be overcome: i) the screening and
development of new host cell lines, with characteristics such as high cell density
suspension growth and the ability to grow in media free from animal-based supple-
ments; ii) the development of cost-effective and scalable high cell density processes,
that maximize productivities; iii) the improvement of culture media and media sup-
plementation specific for virus production; iv) the development of online monitoring
techniques to increase product quality and minimize product losses. Cell-culture pro-
cesses for influenza vaccine manufacturing, as well as its challenges and opportunities
have been reviewed elsewhere [32].
9.4.2
LIVE ATTENUATED INFLUENZA VACCINES (LAIVS)
LAIVs represent around 5% of total influenza vaccine production, being made from a
cold adapted (ca), temperature sensitive (ts), or attenuated (att) virus backbone
containing the relevant antigenic proteins (HA and NA) from recommended seasonal
strains. The resulting viruses are incapable of replicating in the warmer temperatures
of the lower respiratory tract and, being restricted to the nasal passage, stimulate local
humoral and cellular immune responses [19,28,43]. The vaccine, administered in-
tranasally, have shown to be effective in young children but, because of the presence
of live viruses, is not recommended for immunosuppressed individuals [28]. Vaccine
strains are generated either by reassortment in eggs or, more recently, by reverse
genetics recapitulating ca, ts, and att mutations [19]. LAIV antigen content is defined
as 6.5–7.5 log fluorescent focus units (FFUs) for vaccines containing the Ann Arbor
TABLE 9.3
Licensed cell-culture−based IIVs
Commercial
name
Manufacturer
Composition
Cell
platform
Approval
Current
production
status
Preflucel
Baxter
trivalent
Vero
EU
No longer in
production
Celvapan
Baxter
monovalent (H1N1)
Vero
EU
No longer in
production
Flucelvax
Seqirus
trivalent and
quadrivalent
MDCK
FDA/EU
In production
Audenz
Seqirus
monovalent (H5N1)
MDCK
FDA
Not in production
SKYCellflu
SK Bioscience quadrivalent
MDCK
MFDS
In production
Source: Adapted from Silva, et al. [ 32].
230
Bioprocessing of Viral Vaccines