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Vaccine
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doi:10.1016/j.vaccine.2011.04.077 | How to Cite or Link Using DOI
Copyright ? 2011 Published by Elsevier Ltd.
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Frailty is associated with impairment of vaccine-induced antibody response and increase in post-vaccination influenza infection in community-dwelling older adults
References and further reading may be available for this article. To view references and further reading you must purchase this article.
Xu Yaoa, Robert G. Hamiltonb, Nan-ping Wengd, Qian-Li Xuea, Jay H. Breamc, Huifen Lia, Jing Tiana, Shu-Hui Yehg, Barbara Resnicke, Xiyan Xuf, Jeremy Walstona, Linda P. Friedh and Sean X. Lenga, Corresponding Author Contact Information, E-mail The Corresponding Author
a Divisions of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
b Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
c Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
d Laboratory of Molecular Biology and Immunology, National Institute on Aging, Baltimore, MD, USA
e University of Maryland School of Nursing, Baltimore, MD, USA
f Influenza Division, Center for Disease Control and Prevention, Atlanta, GA, USA
g Chang Gung Institute of Technology, Taiwan
h Columbia University Mailman School of Public Health, New York, NY, USA
Received 18 January 2011;
revised 12 April 2011;
accepted 21 April 2011.
Available online 10 May 2011.
Abstract
Annual immunization with a trivalent inactivated vaccine (TIV) is considered efficacious for prevention of seasonal influenza in older adults. However, significant controversy exists in the current literature regarding the clinical effectiveness of TIV immunization in this highly heterogeneous population. Frailty is an important geriatric syndrome characterized by decreased physiologic reserve and increased vulnerability to stressors. Using a validated set of frailty criteria, we conducted a prospective observational study to evaluate TIV-induced strain-specific hemagglutination inhibition (HI) antibody titers and post-vaccination rates of influenza-like illness (ILI) and infection in frail and nonfrail older adults. The results indicate that frailty was associated with significant impairment in TIV-induced strain-specific HI titers and increased rates of ILI and laboratory-confirmed influenza infection. These findings suggest that assessing frailty status in the elderly may identify those who are less likely to respond to TIV immunization and be at higher risk for seasonal influenza and its complications.
http://www.sciencedirect.com/scienc...dc9cb96bdbe09c4022f2dd15f2d32649&searchtype=a
Article in Press, Uncorrected Proof - Note to users
doi:10.1016/j.vaccine.2011.04.077 | How to Cite or Link Using DOI
Copyright ? 2011 Published by Elsevier Ltd.
Permissions & Reprints
Frailty is associated with impairment of vaccine-induced antibody response and increase in post-vaccination influenza infection in community-dwelling older adults
References and further reading may be available for this article. To view references and further reading you must purchase this article.
Xu Yaoa, Robert G. Hamiltonb, Nan-ping Wengd, Qian-Li Xuea, Jay H. Breamc, Huifen Lia, Jing Tiana, Shu-Hui Yehg, Barbara Resnicke, Xiyan Xuf, Jeremy Walstona, Linda P. Friedh and Sean X. Lenga, Corresponding Author Contact Information, E-mail The Corresponding Author
a Divisions of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
b Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
c Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
d Laboratory of Molecular Biology and Immunology, National Institute on Aging, Baltimore, MD, USA
e University of Maryland School of Nursing, Baltimore, MD, USA
f Influenza Division, Center for Disease Control and Prevention, Atlanta, GA, USA
g Chang Gung Institute of Technology, Taiwan
h Columbia University Mailman School of Public Health, New York, NY, USA
Received 18 January 2011;
revised 12 April 2011;
accepted 21 April 2011.
Available online 10 May 2011.
Abstract
Annual immunization with a trivalent inactivated vaccine (TIV) is considered efficacious for prevention of seasonal influenza in older adults. However, significant controversy exists in the current literature regarding the clinical effectiveness of TIV immunization in this highly heterogeneous population. Frailty is an important geriatric syndrome characterized by decreased physiologic reserve and increased vulnerability to stressors. Using a validated set of frailty criteria, we conducted a prospective observational study to evaluate TIV-induced strain-specific hemagglutination inhibition (HI) antibody titers and post-vaccination rates of influenza-like illness (ILI) and infection in frail and nonfrail older adults. The results indicate that frailty was associated with significant impairment in TIV-induced strain-specific HI titers and increased rates of ILI and laboratory-confirmed influenza infection. These findings suggest that assessing frailty status in the elderly may identify those who are less likely to respond to TIV immunization and be at higher risk for seasonal influenza and its complications.
http://www.sciencedirect.com/scienc...dc9cb96bdbe09c4022f2dd15f2d32649&searchtype=a