de Jonge J, van Dijken H, de Heij F, Spijkers S, Mouthaan J, de Jong R, Roholl P, Adami EA, Akamatsu MA, Ho PL, Brunner L, Collin N, Friede M, Ferreira JA, and Luytjes W
Until universal influenza vaccines become available, pandemic preparedness should include developing classical vaccines against potential pandemic influenza subtypes. We here show that addition of SWE adjuvant, a squalene-in-water emulsion, to H7N9 split influenza vaccine clearly enhanced functional antibody responses in ferrets. These were cross-reactive against H7N9 strains from different lineages and newly emerged H7N9 variants. Both vaccine formulations protected in almost all cases against severe pneumonia induced by intratracheal infection of ferrets with H7N9 influenza; however, the SWE adjuvant enhanced protection against virus replication and disease. Correlation analysis and curve fitting showed that both VN- and NI-titers were better predictors for protection than HI-titers. Moreover, we show that novel algorithms can assist in better interpretation of large data sets generated in preclinical studies. Cluster analysis showed that the adjuvanted vaccine results in robust immunity and protection, whereas the response to the non-adjuvanted vaccine is heterogeneous, such that the protection balance may be more easily tipped toward severe disease. Finally, cluster analysis indicated that the dose-sparing capacity of the adjuvant is at least a factor six, which greatly increases vaccine availability in a pandemic situation., Competing Interests: Competing interestsJ.J., H.D., F.H., S.P., J.M., R.J., J.F., P.R., E.A.A., M.P.A., P.L.H., L.B., N.C., and W.L. declare no competing interests. M.F. is affiliated with the World Health Organization, that funded the study. He declares he was only involved in the design of the study, but he had no influence on the planning, protocol, and conduction of the study nor on the analysis and interpretation of the data., (© The Author(s) 2020.)