
What Goes Into Making Our Seasonal Flu Jab? – Expert Q+A
Press Release – Science Media Centre
As most seasonal influenza vaccines are made using chicken eggs, the SMC asked experts for background on seasonal flu vaccine manufacture and alternatives to the standard jab.
How are the eggs to make traditional seasonal flu vaccines procured and kept safe from other pathogens, like avian influenza? Why do seasonal flu vaccines work better some years than others? And what other kinds of flu jabs are there?
Most seasonal influenza vaccines are made using chicken eggs.
The SMC asked experts for background on seasonal flu vaccine manufacture and alternatives to the standard jab.
Dr Mary Nowlan, Senior Advisor, Immunisation Advisory Centre (IMAC), comments:
Where do the eggs come from to make the seasonal influenza vaccine?
'Egg-based influenza vaccine manufacture is a well-established process, with chicken eggs being the preferred medium to grow viruses since the 1950s.
'Large quantities of eggs are produced in specific pathogen-free chicken colonies. These are controlled environments in which the hens and the eggs are closely monitored, which means that every step is taken to ensure that these animals are not at risk of being infected by bird influenza strains (including H5N1).'
Why do influenza vaccines work better some years than others?
'Predicting and matching exact influenza strains is an imperfect science, and vaccines that are developed are not always a perfect match for the circulating virus.
'Growing enough virus for millions of doses of vaccine is a slow process, particularly in eggs. As the virus grows in eggs, small changes occur in the virus – known as 'egg-adaption'. This can mean that the virus produced does not completely match the circulating virus, thereby potentially reducing the effectiveness of the vaccine.
'Another reason that the vaccine effectiveness can alter each year is that the wild virus strains have also mutated over the six months since they were selected for the vaccine and a mismatch can also occur. Advances in technology to analyse the circulating strains may have mitigated that risk to some degree, but the unpredictability of influenza virus evolution means mismatches still occur.'
How is it decided which strains are covered by the flu vaccines for the upcoming flu season?
'As the influenza virus continually mutates, vaccine production must take this into account and adjust the virus strains for the following influenza season.
'The Global Influenza Surveillance and Response System collates data from the WHO Collaborating Centres, who in turn receive data from the National Influenza Centres (ESR in New Zealand).
'This provides data for both the Southern and the Northern Hemispheres to help to predict which influenza strains are likely to circulate during their respective flu seasons each year.
'At around six months before the next influenza season, the WHO holds a meeting (in October and April – one for each hemisphere) to decide on the composition of upcoming influenza virus vaccines. Once this has happened, production of the next year's vaccine begins.
'The reason that influenza vaccine is recommended annually is due the constant changes in the influenza virus strains, and therefore the vaccine needs to alter in response. Protection only lasts for a short time.'
What are the alternatives to the standard flu vaccine?
'All the current seasonal influenza vaccines rely on recommendation from the WHO as to which influenza strains are included. Vaccines available in New Zealand include a cell-based vaccine, in which the virus is grown in cell culture rather than eggs, and an 'adjuvanted' vaccine, in which a naturally occurring compound (squalene) is added to induce a stronger immune response in older people who may have a weaker immune response than young adults.
'Further vaccines available internationally but not New Zealand include recombinant influenza vaccines, in which the surface proteins of the virus are produced artificially rather than being isolated from whole viruses. Also available in the Northern Hemisphere is a live attenuated influenza vaccine that is given through a nasal spray, usually to children.'
Why should we be concerned about bird flu in New Zealand?
'Birds, particularly wading birds, carry influenza virus in their guts. Usually this does not make the birds sick. However, some forms of avian flu have become deadly. Highly pathogenic avian influenza (HPAI) is of significant concern, not only for the risk of spread to humans but for wild and domestic birds and other animals such as livestock. H5N1 is just one strain of avian influenza that can mutate to make animals sick. It has also infected humans who were exposed to sick animals.
'As well as concerns about infection in birds, livestock, and marine mammals in New Zealand, a big concern in humans would be if a HPAI infected someone who is also infected with the seasonal influenza virus. The risk is that the influenza viruses would combine into a strain that is transmissible between humans. This has the potential to cause a pandemic. People who work with animals are encouraged to receive the seasonal influenza vaccine each year to reduce this risk.'
No conflicts declared.
Dr Lisa Connor, Programme Leader, Infection and Vaccinology Group, Malaghan Institute of Medical Research, comments:
Could the ongoing impact of the H5N1 avian flu pandemic on raised chickens overseas have flow-on effects on influenza vaccine availability in NZ?
'One widely used influenza vaccine in New Zealand is the Tetra Fluvac, which provides protection against four different flu virus variants. This vaccine is produced using eggs and is available for free to eligible New Zealanders, making it an accessible and effective option.
'However, it is important to note that there are also other flu vaccines available on the market that do not rely on egg-based production. These vaccines are made using cell cultures and, while not currently funded by the NZ government, they are an alternative for those who require or prefer them. These non-egg-based vaccines are available in New Zealand but are typically more expensive, as they are not covered by the public funding system.
'H5N1, the avian influenza strain, is a significant concern, especially for our bird population, including chickens. Thus, there is the potential to disrupt egg production and, consequently, vaccine production. Fortunately, the availability of cell culture-based vaccines ensures that there are safe, effective, and approved alternatives on the market that do not depend on eggs. This flexibility is reassuring, as it means that if egg production were to be impacted by H5N1 or other factors, we have viable options to ensure continued vaccine supply.
'Overall, the current flu vaccines, including the egg-based Tetra Fluvac can lower the risk of infection and reduce severity of disease from influenza, and many New Zealanders are eligible for free vaccination. Should the situation evolve and potential shortages arise, the availability of mammalian cell culture-based vaccines offers a solid backup. We are fortunate that there are multiple, effective vaccine options in New Zealand, ensuring that the public remains well-prepared to limit infection from influenza, regardless of future challenges.'
No conflicts of interest.
Natalie Netzler PhD, Senior Lecturer, Faculty of Medical and Health Sciences, University of Auckland, comments:
'The current egg-based vaccines are produced in a manufacturing system that is over 70 years old. However, there is a lengthy lead time needed to secure the eggs required to make the egg-based flu vaccine.
'Following the 2009 influenza pandemic we had a shortage of egg-based vaccines due to a number of issues including slow virus growth of the pandemic strain in eggs and a very high demand coupled with the slow manufacturing process.
'Given that our Indigenous populations all over the world face higher rates of severe influenza compared to non-indigenous groups in the same regions, it is important that we have sufficient vaccine supplies to protect our unique Māori and Pacific communities here in Aotearoa NZ.
'The development of cell-based influenza vaccines is gaining traction. While there are some challenges posed by these newer flu vaccines including higher costs of production, and limited global availability, there are several advantages of cell-based vaccines over egg-based flu shots. These include faster and more predictable rates of production and being able to offer an egg-free option.
'Although our current influenza vaccines are not perfect in that they don't always stop you getting the flu altogether, they do offer protection against severe flu and are highly recommended for those at risk of severe disease, no matter which type of flu vaccine you get.'
Conflict of interest statement: 'I work with several Pacific and Māori organisations and health providers to support our communities to make informed decisions on immunisation.'
Sue Huang, Director, WHO National Influenza Centre, Institute of Environmental Science and Research (ESR), comments:
What strains are covered in this year's flu vaccines?
'The southern hemisphere influenza vaccines to be used in NZ in 2025:
Egg-based vaccines:
• an A/Victoria/4897/2022 (H1N1)pdm09-like virus;
• an A/Croatia/10136RV/2023 (H3N2)-like virus; and
• a B/Austria/1359417/2021 (B/Victoria lineage)-like virus.
Cell culture-, recombinant protein- or nucleic acid-based vaccines
• an A/Wisconsin/67/2022 (H1N1)pdm09-like virus;
• an A/District of Columbia/27/2023 (H3N2)-like virus; and
• a B/Austria/1359417/2021 (B/Victoria lineage)-like virus.
The recommendation for the B/Yamagata lineage component of quadrivalent influenza vaccines remains unchanged from previous recommendations:
• a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.
'Interestingly, the influenza vaccine strains recommended by WHO in February 2025 for the use for northern hemisphere countries in 2025-2026 are the same as the NZ's vaccine strains to be used in 2025. This suggests that our vaccine strains match well with the current circulating viruses which would give us optimal protection. Influenza vaccination is the primary tool to protection us against influenza, particularly for those vulnerable groups (elderly, and individuals with underlying conditions).
'At the moment, influenza activity is still at a low level. Influenza A(H1N1)pdm09 is the predominant strain followed by influenza B and A(H3N2). For details, see here.'
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By expanding beyond traditional targets, we reach the genotypes that matter more in our populations for cervical cancer elimination. This means earlier intervention, fewer missed cases, and better outcomes,' said Dr Sachdeva. Truenat HPV-HR Plus offers the best of both worlds – critical genotype coverage and real-world deploy-ability. What does it mean to eliminate cervical cancer by 2030? To eliminate cervical cancer, all countries must reach and maintain an incidence rate of below 4 per 100,000 women. Achieving that goal rests on three key pillars and their corresponding targets: vaccination: 90% of all eligible young people must be fully vaccinated with the HPV vaccine by the age of 15. screening: 70% of women should be screened using a high-performance test by the age of 35, and again by the age of 45; treatment: 90% of women with pre-cancer treated and 90% of women with invasive cancer managed. No other cancer but cervical cancer is fully preventable and curable if detected and managed early. Even one death from it is a death too many. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here


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As cervical cancer is the only cancer that can be eliminated, the WHO Director General had called upon the governments in 2018 to eliminate it. All governments globally committed to do so by 2030 (by endorsing the global strategy to eliminate cervical cancer by 2030 at the World Health Assembly 2020). But despite some progress, the world is way off the mark from the elimination goal in 2025. Where cervical cancer burden is greatest, access to lifesaving services is most broken Cervical cancer reflects the global inequities between the Global North and the Global South: The highest rates of cervical cancer incidence and mortality are in low- and middle-income countries. In fact, 94% of the cervical cancer deaths in 2022 took place in these countries where access to health services is appalling. This reflects major health inequities which are driven by lack of access to vaccination, cervical cancer screening and treatment services. Prophylactic vaccination against human papilloma virus (HPV) - which is one of the most common sexually transmitted infections and which causes cervical cancer - and screening, and treatment of pre-cancer lesions are very cost-effective strategies to prevent cervical cancer. WHO's call to deliver on #HealthForAll dates to the 1970s, but even now gaping health inequities and injustices plague the health systems – especially in the Global South. Vaccines against HPV have existed since almost 20 years now. No surprise for guessing that both Cervarix (made by Glaxo) and Gardasil (made by Merck) were made in the rich nations – and their rollout in the Global South has been far from ideal. In 2022, India-based Serum Institute in collaboration with the Department of Biotechnology of the government of India developed India's first indigenously produced HPV vaccine called Cervavac. So, now there is a vaccine developed in the Global South too. But its rollout is far from ideal as of now. It is still not a part of India's public health programme, for instance. Same inequities block access to HPV screening in the Global South "Almost all cervical cancers (~95%) are caused by persistent HPV infection. Women living with HIV are 6 times more likely to develop cervical cancer compared to the general population, and an estimated 5% of all cervical cancer cases are attributable to HIV,' said Dr Kuldeep Singh Sachdeva, former head of Indian government's national TB and HIV programmes. Dr Sachdeva was speaking at the National Dialogue and stakeholder meet organised by National Coalition of People living with HIV in India (NCPI Plus) bringing together over 100 community leaders from almost all states of India. Dr Sachdeva currently leads Molbio Diagnostics as President and Chief Medical Officer. He was speaking ahead of 10th Asia-Pacific AIDS & Co-Infections Conference (APACC 2025), Japan; 2nd Asia Pacific Conference on Point of Care Diagnostics for Infectious Diseases (POC 2025), Thailand; and 13th International AIDS Society Conference on HIV Science (IAS 2025), Rwanda. Cervical cancer screening efforts in most settings of the Global South have long been hampered by reliance on outdated methods like pap smears and visual inspection with acetic acid (VIA) test, both of which suffer from poor sensitivity, high subjectivity, and dependence on specialised infrastructure. Advanced molecular HPV tests developed by the Global North, while highly accurate than pap smear and VIA, remain inaccessible for most women living in peripheral, rural, and resource-limited settings, especially of the Global South. India's first point-of-care HPV test that can be deployed at point-of-need in the Global South In April 2025, India's first ever indigenously developed RT-PCR molecular test for HPV on Truenat (called HPV-HR Plus) got an independent multi-centric validation done by Government of India's Department of Biotechnology, Biotechnology Industry Research Assistance Council (BIRAC) and Grand Challenges India. Truenat HPV-HR Plus test is made by Molbio Diagnostics in India. This independent validation of Truenat HPV-HR Plus was conducted under the study 'Validating Indigenous Human Papilloma Virus (HPV) Tests for Cervical Cancer Screening in India.' The study involved leading Indian government's research institutes, including All India Institute of Medical Sciences (AIIMS) Delhi, ICMR National Institute for Cancer Prevention and Research (NICPR) Noida, and ICMR National Institute for Research in Reproductive and Child Health (NIRRCH) Mumbai, in collaboration with WHO's International Agency for Research on Cancer (IARC). There are over 200 genotypes of HPV but those that put the infected person at risk of developing cervical cancer are few. Truenat HPV-HR Plus molecular test enables detection for 8 HPV high-risk genotypes – which account for over 96% cervical cancer cases worldwide. These HPV high-risk genotypes include 16, 18, 31, 33, 35, 45, 52 and 58. Out of these, 16 and 18 high-risk genotypes dominate globally as 77% of invasive cervical cancer cases are associated with them. These high-risk genotypes can also cause cancer of the anus, penis, vagina, vulva, and oropharynx (throat). Raising cervical cancer awareness and health literacy among people with HIV As women living with HIV are 6 times more at risk of cervical cancer, communities and networks of people with HIV must come forward to find ways to integrate cervical cancer screening as well as for other cancers (such as breast cancer) programmatically and in people-centred manner, said Daxa Patel, co-founder of National Coalition of People living with HIV in India (NCPI Plus) and its former President. Agrees Pooja Mishra, Secretary of NCPI Plus that it is unacceptable when cervical cancer, which is preventable and curable - and the only cancer which can be eliminated - still kills 350,000 women worldwide. We also need to raise awareness, health and treatment literacy among the young people, said Mishra. That is why NCPI Plus took leadership in organising a national dialogue and stakeholder consultation on preventing cancers among people with HIV, especially women. Truenat HPV-HR Plus test is critical for closing the screening gap, particularly for asymptomatic women and women who are at higher risk for persistent HPV infection. By shifting HPV screening closer to the most-at-risk people and communities, this test ensures early detection, better triaging, and timely treatment - especially in historically underserved populations. Over 10,000 Truenat RT-PCR molecular test machines are already deployed globally in over 85 countries (mostly for TB), and mostly in the Global South nations in remote settings. Truenat is a battery operated (with solar power charging), laboratory independent, de-centralised and point-of-care test that provides highly accurate diagnosis for over 30 diseases (including TB, HPV, HCV, HBV, STIs, COVID-19, etc) within an hour – thus enabling same day test and treat, counselling and follow-up. Superiority of Truenat HPV-HR Plus test Older Pap smear test detects precancerous or cancerous cervical cancer cells whereas Truenat HPV-HR Plus test detects the presence of high-risk HPV DNA (8 genotypes). Pap smear is a cytological screening test and depends on the observing medical expert's skill and slide quality, whereas Truenat is a PCR-based nuclear acid amplification test with very high sensitivity and specificity. False negative reports are higher and false positive reports are also moderate when pap smear is used whereas both are low with Truenat HPV-HR Plus. The most recent validation of Truenat HPV-HR Plus showed 100% specificity and 100% sensitivity. Truenat HPV-HR is designed to work with cervical swab samples collected by a clinician (self-collection of samples is still under evaluation), and it gives highly accurate results in just 60 minutes. Whereas, a pap smear results may take 3-7 days as these are laboratory dependent. Easy to use and with high stability at room temperature, Truenat HPV-HR Plus requires minimal biosafety and is optimised for use at both the laboratory and near-patient settings. This test overcomes shortcomings of current diagnostic methods, including variable sensitivity and specificity, high costs, complex workflows, and dependence on advanced equipment, said Dr Sachdeva. Highlighting the importance of developing health technologies in the Global South, Rajesh S Gokhale, Secretary, Department of Biotechnology, Ministry of Science and Technology, Government of India said, 'Truenat HPV-HR Plus represents the kind of diagnostic innovation we need - dependable, scientifically rigorous, locally developed, and built to serve our public health system. It is a huge step forward in strengthening cervical cancer screening across India.' "HPV infection is common. However, persistence of HPV infection could be deadly. Studies show that nearly half of persistent HPV infections do not resolve by 24 months. These silent carriers drive the progression to high-grade pre-cancerous lesions and cancer. That's why extended HPV genotype detection is crucial," shared Dr Sachdeva. HPV also causes oropharyngeal cancers Oropharyngeal cancers related to HPV vary from 28% to 68% in the richer nations. Indian studies also show alarming numbers though, more research is needed for science-informed responses towards eliminating HPV related cancers in our population, said Dr Ishwar Gilada, President Emeritus of AIDS Society of India (ASI) and Governing Council member of International AIDS Society (IAS). 'While there is increasing evidence of HPV-associated oropharyngeal cancer in both men and women globally, there still remain gaps in gender-neutral HPV vaccination policies globally,' said Dr Sachdeva. Community leaders like Manoj Pardeshi, who is among the co-founders and inspiring lights of NCPI Plus, said that regardless of gender, all those eligible and at risk of HPV related cancers, must be vaccinated against HPV. Programme addressing cervical cancer elimination should expand to eliminate all HPV related cancers in people-centred ways, regardless of gender. HPV is transmitted through: - Sexual contact: Transmission mode is through vaginal, anal, or oral sex with an infected person. - Skin-to-skin contact: Transmitted through non-penetrative sexual activities involving skin-to-skin contact. The WHO Guidelines recommend HPV detection via molecular test after age of 30 (and every 5 years thereafter). Vaccination against HPV is highly recommended for younger people under the age of 15 or before the initiation of sexual activity. Do not leave equity behind 'Truenat HPV-HR Plus test is about equity in detection. By expanding beyond traditional targets, we reach the genotypes that matter more in our populations for cervical cancer elimination. This means earlier intervention, fewer missed cases, and better outcomes,' said Dr Sachdeva. Truenat HPV-HR Plus offers the best of both worlds - critical genotype coverage and real-world deploy-ability. What does it mean to eliminate cervical cancer by 2030? To eliminate cervical cancer, all countries must reach and maintain an incidence rate of below 4 per 100,000 women. Achieving that goal rests on three key pillars and their corresponding targets: vaccination: 90% of all eligible young people must be fully vaccinated with the HPV vaccine by the age of 15. screening: 70% of women should be screened using a high-performance test by the age of 35, and again by the age of 45; treatment: 90% of women with pre-cancer treated and 90% of women with invasive cancer managed. No other cancer but cervical cancer is fully preventable and curable if detected and managed early. Even one death from it is a death too many. Shobha Shukla – CNS (Citizen News Service) (Shobha Shukla is the award-winning founding Managing Editor and Executive Director of CNS (Citizen News Service) and is a feminist, health and development justice advocate. She is a former senior Physics faculty of prestigious Loreto Convent College and current Coordinator of Asia Pacific Regional Media Alliance for Health and Development (APCAT Media) and Chairperson of Global AMR Media Alliance (GAMA received AMR One Health Emerging Leaders and Outstanding Talents Award 2024). She also coordinates SHE & Rights initiative (Sexual health with equity & rights). Follow her on Twitter @shobha1shukla or read her writings here