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NPJ Vaccines . Hemagglutination-inhibition and microneutralization antibody titers as mediators of protection for cell-based and recombinant influen

tetano

Editor, Senior Moderator
NPJ Vaccines


. 2026 Jul 9.
doi: 10.1038/s41541-026-01521-w. Online ahead of print.
Hemagglutination-inhibition and microneutralization antibody titers as mediators of protection for cell-based and recombinant influenza vaccines

Shuyi Zhong[SUP] #[/SUP][SUP] 1 [/SUP], Wey Wen Lim[SUP] #[/SUP][SUP] 2 [/SUP], Faith Ho[SUP] 1 [/SUP], Manjusha Gaglani[SUP] 3 4 5 [/SUP], Allison L Naleway[SUP] 5 [/SUP], Fatimah S Dawood[SUP] 6 [/SUP], Min Z Levine[SUP] 6 [/SUP], Kelsey Sumner[SUP] 6 [/SUP], Brendan Flannery[SUP] 6 [/SUP], Benjamin J Cowling[SUP] 7 [/SUP]


Affiliations
Free article Abstract

The proportion of relative influenza vaccine efficacy (rVE) mediated by post-vaccination hemagglutination inhibition (HAI) and microneutralization (MN) antibody titers has not been evaluated. We compared rVE by influenza vaccine type and HAI and MN antibody titer against symptomatic influenza A(H3N2) infection in a randomized immunogenicity trial of quadrivalent cell culture-based (ccIIV4), recombinant (RIV4), and egg-based (eIIV4) influenza vaccines in US healthcare personnel, and estimated proportions of rVE mediated by antibody titers using causal mediation analysis. Cumulative influenza A(H3N2) incidence was 3.2%, 1.3% and 1% among ccIIV, eIIV4 and RIV4 recipients, respectively. Age-adjusted rVE estimates were not statistically significant. Higher MN and HAI titers against A(H3N2) vaccine and circulating viruses explained 97.9% and 15.8%, respectively, of rVE for RIV4 compared with ccIIV4, versus 1.7% and 12.6% of rVE for eIIV4 compared with ccIIV4, indicating MN titers to be used as correlates of protection against A(H3N2) for comparisons between cell-based influenza vaccines.


 
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