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Vaccine . A randomized controlled trial of antibody response to 2019-20 cell-based inactivated and egg-based live attenuated influenza vaccines in c

tetano

Editor, Senior Moderator
Vaccine


. 2021 Dec 21;S0264-410X(21)01643-1.
doi: 10.1016/j.vaccine.2021.12.034. Online ahead of print.
A randomized controlled trial of antibody response to 2019-20 cell-based inactivated and egg-based live attenuated influenza vaccines in children and young adults


Katherine V Williams[SUP] 1 [/SUP], Bo Zhai[SUP] 2 [/SUP], John F Alcorn[SUP] 3 [/SUP], Mary Patricia Nowalk[SUP] 4 [/SUP], Min Z Levine[SUP] 5 [/SUP], Sara S Kim[SUP] 6 [/SUP], Brendan Flannery[SUP] 7 [/SUP], Krissy Moehling Geffel[SUP] 8 [/SUP], Amanda Jaber Merranko[SUP] 9 [/SUP], Jennifer P Nagg[SUP] 10 [/SUP], Mark Collins[SUP] 11 [/SUP], Michael Susick[SUP] 12 [/SUP], Karen S Clarke[SUP] 13 [/SUP], Richard K Zimmerman[SUP] 14 [/SUP], Judith M Martin[SUP] 15 [/SUP]



Affiliations

Abstract

Background: Hemagglutination inhibition (HAI) titers to the live-attenuated influenza vaccine (LAIV4) are typically lower than its counterpart egg-based inactivated influenza vaccines (IIV). Similar comparisons have not been made between LAIV4 and the 4-strain, cell-culture inactivated influenza vaccine (ccIIV4). We compared healthy children's and young adults' HAI titers against the 2019-2020 LAIV4 and ccIIV4.
Methods: Participants aged 4-21 years were randomized 1:1 to receive ccIIV4 (n = 100) or LAIV4 (n = 98). Blood was drawn prevaccination and on day 28 (21-35) post vaccination. HAI assays against egg-grown A/H1N1, A/H3N2, both vaccine B strains and cell-grown A/H3N2 antigens were conducted. Primary outcomes were geometric mean titers (GMT) and geometric mean fold rise (GMFR) in titers.
Results: GMTs to A/H1N1, A/H3N2 and B/Victoria increased following both ccIIV and LAIV and to B/Yamagata following ccIIV (p < 0.05). The GMFR range was 2.4-3.0 times higher for ccIIV4 than for LAIV4 (p < 0.001). Within vaccine types, egg-grown A/H3N2 GMTs were higher (p < 0.05) than cell-grown GMTs [ccIIV4 day 28: egg = 205 (95% CI: 178-237); cell = 136 (95% CI:113-165); LAIV4 day 28: egg = 96 (95% CI: 83-112); cell = 63 (95% CI: 58-74)]. The GMFR to A/H3N2 cell-grown and egg-grown antigens were similar. Pre-vaccination titers inversely predicted GMFR.
Conclusion: The HAI response to ccIIV4 was greater than LAIV4 in this study of mostly older children, and day 0 HAI titers inversely predicted GMFR for both vaccines. Lower prevaccination titers were associated with greater GMFR in both vaccine groups.

Keywords: Cell-culture-based inactivated influenza vaccine; Egg-based live attenuated influenza vaccine; Hemagglutination inhibition assay; Influenza; Influenza vaccine; Randomized controlled trial.
 
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