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Clin Infect Dis
. 2021 Jul 10;ciab566.
doi: 10.1093/cid/ciab566. Online ahead of print.
Comparison of the Immunogenicity of Cell Culture-Based and Recombinant Quadrivalent Influenza Vaccines to Conventional Egg-Based Quadrivalent Influenza Vaccines among Healthcare Personnel Aged 18-64 Years: A Randomized Open-Label Trial
Fatimah S Dawood 1 , Allison L Naleway 2 , Brendan Flannery 1 , Min Z Levine 1 , Kempapura Murthy 3 , Suryaprakash Sambhara 1 , Shivaprakash Gangappa 1 , Laura Edwards 4 , Sarah Ball 4 5 , Lauren Beacham 1 , Edward Belongia 6 , Kelsey Bounds 3 , Weiping Cao 1 , F Liaini Gross 1 , Holly Groom 2 , Alicia M Fry 1 , Danielle Hunt 4 , Zuha Jeddy 4 , Margarita Mishina 1 , Sara S Kim 1 , Meredith G Wesley 1 4 , Sarah Spencer 1 , Mark G Thompson 1 , Manjusha Gaglani 3
Affiliations
- PMID: 34245243
- DOI: 10.1093/cid/ciab566
Abstract
Background: RIV4 and cell-culture based inactivated influenza vaccine (ccIIV4) have not been compared to egg-based IIV4 in healthcare personnel, a population with frequent influenza vaccination that may blunt vaccine immune responses over time. We conducted a randomized trial among HCP aged 18-64 years to compare humoral immune responses to ccIIV4 and RIV4 to IIV4.
Methods: During the 2018-2019 season, participants were randomized to receive ccIIV4, RIV4, or IIV4 and had sera collected pre-vaccination, 1 and 6 months post-vaccination. Sera were tested by hemagglutination inhibition (HI) for influenza A/H1N1, B/Yamagata, and B/Victoria and microneutralization (MN) for A/H3N2 against cell-grown vaccine reference viruses. Primary outcomes at 1 month were seroconversion rate (SCR), geometric mean titers (GMT), GMT ratio, and mean fold rise (MFR) in the intention-to-treat population.
Results: 727 participants were included (283 ccIIV4, 202 RIV4, and 242 IIV4). At 1 month, responses to ccIIV4 were similar to IIV4 by SCR, GMT, GMT ratio, and MFR. RIV4 induced higher SCRs, GMTs, and MFRs than IIV4 against A/H1N1, A/H3N2, and B/Yamagata. The GMT ratio of RIV4 to egg-based vaccines was 1.5 (95%CI 1.2-1.9) for A/H1N1, 3.0 (95%CI 2.4-3.7) for A/H3N2, 1.1 (95%CI 0.9-1.4) for B/Yamagata, and 1.1 (95%CI 0.9-1.3) for B/Victoria. At 6 months, ccIIV4 recipients had similar GMTs to IIV4, whereas RIV4 recipients had higher GMTs against A/H3N2 and B/Yamagata.
Conclusion: RIV4 resulted in improved antibody responses by HI and MN compared to egg-based vaccines against three of four cell-grown vaccine strains 1 month post-vaccination, suggesting a possible additional benefit from RIV4.
Keywords: Influenza vaccines; healthcare personnel; immunogenicity.