Influenza is caused by a rapidly mutating viruse that consists of 2 types, namely type A with the H1N1 and H3N2 genotypes and type B. Influenza caused global mortality with 250,000-500,000 death in 2009. The effectiveness of vaccines also changes regarding the mutation of influenza viruses, however, in the development and utilization of influenza vaccines should be supported by the economic status of a country. Up to now, there are many countries that have not prioritized the utilization of influenza vaccines. The target of influenza vaccination are children and adults (> 60 years old). The purpose of this review was to determine the effectiveness of influenza vaccines from various countries and categorized based on their income. This review used Medline, Elsevier, and BMC Public Health as the database with the keywords "Effectiveness" and "Influenza vaccine". Then, the articles are selected based on inclusion and exclusion criteria. Based on the initial search there are 784 articles that match the keywords, and only 13 articles met the criteria. These articles are classified based on the center of the study in order to classify based on their national income; 5 studies in high income countries, 5 studies in upper-middle income countries, 3 studies in lower-middle income countries, and 1 study in low income countries. The results showed that the administration of influenza vaccine in high income and upper-middle income countries is quite effective for type A H1N1 genotypes, where as H3N2 is less effective. In the lower-middle income countries, the utilization of vaccines with type A H3N2 genotypes was effective, however, in the low-income countries, the effectiveness of vaccines has not been justified due to the limited study of type of influenza and the administration of influenza vaccines in those countries.
192. Development of the Oral Universal Type A Influenza Vaccine Using Bifidobacterium Displaying Influenza-M2e Protein
