tetano
Editor, Senior Moderator
Clin Infect Dis. 2019 Dec 12. pii: ciz1034. doi: 10.1093/cid/ciz1034. [Epub ahead of print] [h=1]Comparative Immunogenicity of Several Enhanced Influenza Vaccine Options for Older Adults: A Randomized, Controlled Trial.[/h]
Cowling BJ[SUP]1[/SUP], Perera RAPM[SUP]1[/SUP], Valkenburg SA[SUP]1,[/SUP][SUP]2[/SUP], Leung NHL[SUP]1[/SUP], Iuliano AD[SUP]3[/SUP], Tam YH[SUP]1[/SUP], Wong JHF[SUP]1[/SUP], Fang VJ[SUP]1[/SUP], Li APY[SUP]1,[/SUP][SUP]2[/SUP], So HC[SUP]1[/SUP], Ip DKM[SUP]1[/SUP], Azziz-Baumgartner E[SUP]3[/SUP], Fry AM[SUP]3[/SUP], Levine MZ[SUP]3[/SUP], Gangappa S[SUP]3[/SUP], Sambhara S[SUP]3[/SUP], Barr IG[SUP]4,[/SUP][SUP]5[/SUP], Skowronski DM[SUP]6,[/SUP][SUP]7[/SUP], Peiris JSM[SUP]1[/SUP], Thompson MG[SUP]3[/SUP].
[h=3]Author information[/h] 1 World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China. 2 The University of Hong Kong-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China. 3 Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 4 World Health Organization Collaborating Centre for Reference and Research, Melbourne, Victoria, Australia. 5 Department of Microbiology and Immunology, University of Melbourne, Victoria, Australia. 6 British Columbia Centre for Disease Control, Vancouver, Canada. 7 University of British Columbia, Vancouver, Canada.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Enhanced influenza vaccines may improve protection for older adults, but comparative immunogenicity data are limited. Our objective was to examine immune responses to enhanced influenza vaccines, compared to standard-dose vaccines, in community-dwelling older adults.
[h=4]METHODS:[/h] Community-dwelling older adults aged 65-82 years in Hong Kong were randomly allocated (October 2017-January 2018) to receive 2017-2018 Northern hemisphere formulations of a standard-dose quadrivalent vaccine, MF59-adjuvanted trivalent vaccine, high-dose trivalent vaccine, or recombinant-hemagglutinin (rHA) quadrivalent vaccine. Sera collected from 200 recipients of each vaccine before and at 30-days postvaccination were assessed for antibodies to egg-propagated vaccine strains by hemagglutination inhibition (HAI) and to cell-propagated A/Hong Kong/4801/2014(H3N2) virus by microneutralization (MN). Influenza-specific CD4+ and CD8+ T cell responses were assessed in 20 participants per group.
[h=4]RESULTS:[/h] Mean fold rises (MFR) in HAI titers to egg-propagated A(H1N1) and A(H3N2) and the MFR in MN to cell-propagated A(H3N2) were statistically significantly higher in the enhanced vaccine groups, compared to the standard-dose vaccine. The MFR in MN to cell-propagated A(H3N2) was highest among rHA recipients (4.7), followed by high-dose (3.4) and MF59-adjuvanted (2.9) recipients, compared to standard-dose recipients (2.3). Similarly, the ratio of postvaccination MN titers among rHA recipients to cell-propagated A(H3N2) recipients was 2.57-fold higher than the standard-dose vaccine, which was statistically higher than the high-dose (1.33-fold) and MF59-adjuvanted (1.43-fold) recipient ratios. Enhanced vaccines also resulted in the boosting of T-cell responses.
[h=4]CONCLUSIONS:[/h] In this head-to-head comparison, older adults receiving enhanced vaccines showed improved humoral and cell-mediated immune responses, compared to standard-dose vaccine recipients.
[h=4]CLINICAL TRIALS REGISTRATION:[/h] NCT03330132.
Published by Oxford University Press for the Infectious Diseases Society of America 2019.
[h=4]KEYWORDS:[/h] influenza; public health; vaccination
PMID: 31828291 DOI: 10.1093/cid/ciz1034
Cowling BJ[SUP]1[/SUP], Perera RAPM[SUP]1[/SUP], Valkenburg SA[SUP]1,[/SUP][SUP]2[/SUP], Leung NHL[SUP]1[/SUP], Iuliano AD[SUP]3[/SUP], Tam YH[SUP]1[/SUP], Wong JHF[SUP]1[/SUP], Fang VJ[SUP]1[/SUP], Li APY[SUP]1,[/SUP][SUP]2[/SUP], So HC[SUP]1[/SUP], Ip DKM[SUP]1[/SUP], Azziz-Baumgartner E[SUP]3[/SUP], Fry AM[SUP]3[/SUP], Levine MZ[SUP]3[/SUP], Gangappa S[SUP]3[/SUP], Sambhara S[SUP]3[/SUP], Barr IG[SUP]4,[/SUP][SUP]5[/SUP], Skowronski DM[SUP]6,[/SUP][SUP]7[/SUP], Peiris JSM[SUP]1[/SUP], Thompson MG[SUP]3[/SUP].
[h=3]Author information[/h] 1 World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China. 2 The University of Hong Kong-Pasteur Research Pole, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China. 3 Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. 4 World Health Organization Collaborating Centre for Reference and Research, Melbourne, Victoria, Australia. 5 Department of Microbiology and Immunology, University of Melbourne, Victoria, Australia. 6 British Columbia Centre for Disease Control, Vancouver, Canada. 7 University of British Columbia, Vancouver, Canada.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Enhanced influenza vaccines may improve protection for older adults, but comparative immunogenicity data are limited. Our objective was to examine immune responses to enhanced influenza vaccines, compared to standard-dose vaccines, in community-dwelling older adults.
[h=4]METHODS:[/h] Community-dwelling older adults aged 65-82 years in Hong Kong were randomly allocated (October 2017-January 2018) to receive 2017-2018 Northern hemisphere formulations of a standard-dose quadrivalent vaccine, MF59-adjuvanted trivalent vaccine, high-dose trivalent vaccine, or recombinant-hemagglutinin (rHA) quadrivalent vaccine. Sera collected from 200 recipients of each vaccine before and at 30-days postvaccination were assessed for antibodies to egg-propagated vaccine strains by hemagglutination inhibition (HAI) and to cell-propagated A/Hong Kong/4801/2014(H3N2) virus by microneutralization (MN). Influenza-specific CD4+ and CD8+ T cell responses were assessed in 20 participants per group.
[h=4]RESULTS:[/h] Mean fold rises (MFR) in HAI titers to egg-propagated A(H1N1) and A(H3N2) and the MFR in MN to cell-propagated A(H3N2) were statistically significantly higher in the enhanced vaccine groups, compared to the standard-dose vaccine. The MFR in MN to cell-propagated A(H3N2) was highest among rHA recipients (4.7), followed by high-dose (3.4) and MF59-adjuvanted (2.9) recipients, compared to standard-dose recipients (2.3). Similarly, the ratio of postvaccination MN titers among rHA recipients to cell-propagated A(H3N2) recipients was 2.57-fold higher than the standard-dose vaccine, which was statistically higher than the high-dose (1.33-fold) and MF59-adjuvanted (1.43-fold) recipient ratios. Enhanced vaccines also resulted in the boosting of T-cell responses.
[h=4]CONCLUSIONS:[/h] In this head-to-head comparison, older adults receiving enhanced vaccines showed improved humoral and cell-mediated immune responses, compared to standard-dose vaccine recipients.
[h=4]CLINICAL TRIALS REGISTRATION:[/h] NCT03330132.
Published by Oxford University Press for the Infectious Diseases Society of America 2019.
[h=4]KEYWORDS:[/h] influenza; public health; vaccination
PMID: 31828291 DOI: 10.1093/cid/ciz1034