tetano
Editor, Senior Moderator
Clin Microbiol Infect. 2018 May 18. pii: S1198-743X(18)30407-5. doi: 10.1016/j.cmi.2018.05.002. [Epub ahead of print]
[h=1]Immunogenicity and Reactogenicity of High- Versus Standard-Dose Trivalent Inactivated Influenza Vaccine in Healthcare Workers: a Pilot Randomized Controlled Trial.[/h] Volling C[SUP]1[/SUP], Coleman BL[SUP]2[/SUP], Katz K[SUP]3[/SUP], Simor AE[SUP]4[/SUP], Muller M[SUP]5[/SUP], Powis J[SUP]6[/SUP], McElhaney J[SUP]7[/SUP], McGeer A[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] To compare immunogenicity, reactogenicity and acceptability of high- and standard-dose trivalent inactivated influenza vaccine (HDTIV, SDTIV) in 18-64 year olds.
[h=4]METHODS:[/h] We randomized 18-64-year-olds to HDTIV or SDTIV in two consecutive years. We collected serum on Days 0 and 21, measured hemagglutination inhibition (HAI) titers, and compared seroconversion, Day 21 titers, seroprotection, reactogenicity, acceptability.
[h=4]RESULTS:[/h] Immunogenicity was evaluable in 42 of 47 2014 participants, all 33 both year participants, and 87 of 90 2015-only participants. First-dose HDTIV recipients seroconverted more frequently than SDTIV recipients to A(H3N2) in 2014 (13/21, 62% versus 4/21, 19%, P=0.01) and to all vaccine strains in 2015: (A(H1N1): 24/42, 57% versus 15/59, 25%; A(H3N2): 42/42, 100% versus 47/59, 80%; B: 25/42, 60% versus 13/59, 22%; all P<0.01). Day 21 HAI titers were higher in first and two sequential-year HDTIV versus SDTIV recipients: A(H1N1): GMT 749 and 768 versus 384 (P<.001, P=.002); A(H3N2): 1238 and 956 versus 633 (P=.0003, P=0.1); B: 1113 and 1086 versus 556 (P=.0002, P=0.02). HDTIV was more reactogenic (local pain score 3 versus 1 of 10 on day 0/1, P=.0003), but recipients were equally willing to be re-vaccinated (HDTIV: 76/83, 92%; SDTIV: 76/80 (95%), P=.54). The ratios of Day 21 GMT in SDTIV recipients vaccinated in 0-4 prior years to those in SDTIV and HDTIV recipients vaccinated in 15 or more prior years were A(H1N1): 3.73 and 1.38; A(H3N2) 3.07 and 1.16; B: 2.01 and 1.21.
[h=4]CONCLUSIONS:[/h] HDTIV is more immunogenic and reactogenic and as acceptable as SDTIV in 18-64 year olds.
Copyright ? 2018. Published by Elsevier Ltd.
PMID: 29783025 DOI: 10.1016/j.cmi.2018.05.002
[h=1]Immunogenicity and Reactogenicity of High- Versus Standard-Dose Trivalent Inactivated Influenza Vaccine in Healthcare Workers: a Pilot Randomized Controlled Trial.[/h] Volling C[SUP]1[/SUP], Coleman BL[SUP]2[/SUP], Katz K[SUP]3[/SUP], Simor AE[SUP]4[/SUP], Muller M[SUP]5[/SUP], Powis J[SUP]6[/SUP], McElhaney J[SUP]7[/SUP], McGeer A[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] To compare immunogenicity, reactogenicity and acceptability of high- and standard-dose trivalent inactivated influenza vaccine (HDTIV, SDTIV) in 18-64 year olds.
[h=4]METHODS:[/h] We randomized 18-64-year-olds to HDTIV or SDTIV in two consecutive years. We collected serum on Days 0 and 21, measured hemagglutination inhibition (HAI) titers, and compared seroconversion, Day 21 titers, seroprotection, reactogenicity, acceptability.
[h=4]RESULTS:[/h] Immunogenicity was evaluable in 42 of 47 2014 participants, all 33 both year participants, and 87 of 90 2015-only participants. First-dose HDTIV recipients seroconverted more frequently than SDTIV recipients to A(H3N2) in 2014 (13/21, 62% versus 4/21, 19%, P=0.01) and to all vaccine strains in 2015: (A(H1N1): 24/42, 57% versus 15/59, 25%; A(H3N2): 42/42, 100% versus 47/59, 80%; B: 25/42, 60% versus 13/59, 22%; all P<0.01). Day 21 HAI titers were higher in first and two sequential-year HDTIV versus SDTIV recipients: A(H1N1): GMT 749 and 768 versus 384 (P<.001, P=.002); A(H3N2): 1238 and 956 versus 633 (P=.0003, P=0.1); B: 1113 and 1086 versus 556 (P=.0002, P=0.02). HDTIV was more reactogenic (local pain score 3 versus 1 of 10 on day 0/1, P=.0003), but recipients were equally willing to be re-vaccinated (HDTIV: 76/83, 92%; SDTIV: 76/80 (95%), P=.54). The ratios of Day 21 GMT in SDTIV recipients vaccinated in 0-4 prior years to those in SDTIV and HDTIV recipients vaccinated in 15 or more prior years were A(H1N1): 3.73 and 1.38; A(H3N2) 3.07 and 1.16; B: 2.01 and 1.21.
[h=4]CONCLUSIONS:[/h] HDTIV is more immunogenic and reactogenic and as acceptable as SDTIV in 18-64 year olds.
Copyright ? 2018. Published by Elsevier Ltd.
PMID: 29783025 DOI: 10.1016/j.cmi.2018.05.002