Giuseppe
Emeritus
Response after One Dose of a Monovalent Influenza A (H1N1) 2009 Vaccine ?Preliminary Report (NEJM, abstract, edited)
[Source Full Free Document: LINK. EDITED.]
Response after One Dose of a Monovalent Influenza A (H1N1) 2009 Vaccine ?Preliminary Report
Michael E. Greenberg, M.D., M.P.H., Michael H. Lai, B.Med.Sc., M.B., B.S., M.Med.Sc., Gunter F. Hartel, M.S., Ph.D., Christine H. Wichems, Ph.D., Charmaine Gittleson, B.Sc., M.B., B.Ch., Jillian Bennet, M.Sc., M.P.H., Gail Dawson, B.Pharm., Wilson Hu, M.D., M.B.A., Connie Leggio, B.Sc., Diane Washington, M.D., and Russell L. Basser, M.B., B.S., M.D., F.R.A.C.P.
From Clinical Research and Development, CSL, Parkville, VIC, Australia.
Address reprint requests to Dr. Greenberg at VaccinesClinical Research and Development, CSL, 45 Poplar Rd., Parkville, VIC 3052, Australia, or at michael.greenberg@csl.com.au.
This article (10.1056/NEJMoa0907413) was published on September 10, 2009, at NEJM.org.
N Engl J Med 2009;361.
Copyright ? 2009 Massachusetts Medical Society.
Abstract
Background
A novel influenza A (H1N1) 2009 virus is responsible for the first influenza pandemic in 41 years. A safe and effective vaccine is urgently needed. A randomized, observer-blind, parallel-group trial evaluating two doses of an inactivated, splitvirus 2009 H1N1 vaccine in healthy adults between the ages of 18 and 64 years is ongoing at a single site in Australia.
Methods
This preliminary report evaluates the immunogenicity and safety of the vaccine 21 days after the first of two scheduled doses. A total of 240 subjects, equally divided into two age groups (<50 years and ≥50 years), were enrolled and underwent randomization to receive either 15 μg or 30 μg of hemagglutinin antigen by intramuscular injection. We measured antibody titers using hemagglutination-inhibition and microneutralization assays at baseline and 21 days after vaccination. The coprimary immunogenicity end points were the proportion of subjects with antibody titers of 1:40 or more on hemagglutination-inhibition assay, the proportion of subjects with either seroconversion or a significant increase in antibody titer, and the factor increase in the geometric mean titer.
Results
By day 21 after vaccination, antibody titers of 1:40 or more were observed in 116 of 120 subjects (96.7%) who received the 15-μg dose and in 112 of 120 subjects (93.3%) who received the 30-μg dose. No deaths, serious adverse events, or adverse events of special interest were reported. Local discomfort (e.g., injection-site tenderness or pain) was reported by 46.3% of subjects, and systemic symptoms (e.g., headache) by 45.0% of subjects. Nearly all events were mild to moderate in intensity.
Conclusions
A single 15-μg dose of 2009 H1N1 vaccine was immunogenic in adults, with mild to-moderate vaccine-associated reactions. (ClinicalTrials.gov number, NCT00938639.)
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[Source Full Free Document: LINK. EDITED.]
Response after One Dose of a Monovalent Influenza A (H1N1) 2009 Vaccine ?Preliminary Report
Michael E. Greenberg, M.D., M.P.H., Michael H. Lai, B.Med.Sc., M.B., B.S., M.Med.Sc., Gunter F. Hartel, M.S., Ph.D., Christine H. Wichems, Ph.D., Charmaine Gittleson, B.Sc., M.B., B.Ch., Jillian Bennet, M.Sc., M.P.H., Gail Dawson, B.Pharm., Wilson Hu, M.D., M.B.A., Connie Leggio, B.Sc., Diane Washington, M.D., and Russell L. Basser, M.B., B.S., M.D., F.R.A.C.P.
From Clinical Research and Development, CSL, Parkville, VIC, Australia.
Address reprint requests to Dr. Greenberg at VaccinesClinical Research and Development, CSL, 45 Poplar Rd., Parkville, VIC 3052, Australia, or at michael.greenberg@csl.com.au.
This article (10.1056/NEJMoa0907413) was published on September 10, 2009, at NEJM.org.
N Engl J Med 2009;361.
Copyright ? 2009 Massachusetts Medical Society.
Abstract
Background
A novel influenza A (H1N1) 2009 virus is responsible for the first influenza pandemic in 41 years. A safe and effective vaccine is urgently needed. A randomized, observer-blind, parallel-group trial evaluating two doses of an inactivated, splitvirus 2009 H1N1 vaccine in healthy adults between the ages of 18 and 64 years is ongoing at a single site in Australia.
Methods
This preliminary report evaluates the immunogenicity and safety of the vaccine 21 days after the first of two scheduled doses. A total of 240 subjects, equally divided into two age groups (<50 years and ≥50 years), were enrolled and underwent randomization to receive either 15 μg or 30 μg of hemagglutinin antigen by intramuscular injection. We measured antibody titers using hemagglutination-inhibition and microneutralization assays at baseline and 21 days after vaccination. The coprimary immunogenicity end points were the proportion of subjects with antibody titers of 1:40 or more on hemagglutination-inhibition assay, the proportion of subjects with either seroconversion or a significant increase in antibody titer, and the factor increase in the geometric mean titer.
Results
By day 21 after vaccination, antibody titers of 1:40 or more were observed in 116 of 120 subjects (96.7%) who received the 15-μg dose and in 112 of 120 subjects (93.3%) who received the 30-μg dose. No deaths, serious adverse events, or adverse events of special interest were reported. Local discomfort (e.g., injection-site tenderness or pain) was reported by 46.3% of subjects, and systemic symptoms (e.g., headache) by 45.0% of subjects. Nearly all events were mild to moderate in intensity.
Conclusions
A single 15-μg dose of 2009 H1N1 vaccine was immunogenic in adults, with mild to-moderate vaccine-associated reactions. (ClinicalTrials.gov number, NCT00938639.)
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