In adults and even the elderly, choice of which of these strain candidates to include in the final vaccine is less critical, as it has been noted that each provides some measure of immunity to the others.
But this is not the case in children, making proper prediction of which strain will predominate far more critical, especially as B virus outbreaks have been known to cause pediatric deaths.
Advisory panel members who specialize in the care of children, including Philip S. LaRussa, M.D., professor of clinical pediatrics, Columbia University, New York, and Gary D. Overturf, M.D., professor of pediatrics and pathology, University of New Mexico, Albuquerque, questioned if it would be possible for the panel to propose the development of a pediatric vaccine which would combine both types of B viruses in a single formulation. In discussion, the consensus was that such a formulation would need clinical testing, and initiating such testing did not fall under the authority of the panel, nor even of the FDA. Any such new vaccine would have to be initiated by a manufacturer and brought to the FDA through channels.
If necessary, it would be appropriate to recommend a monovalent vaccine with the alternative B strain to be given in addition to the trivalent standard for pediatric patients. It is well known that such vaccines are effective, Dr. Levandowski said.