Comparative Immunogenicity of Several Enhanced Influenza Vaccine Options for Older Adults: A Randomized, Controlled Trial

被引：80

作者：

Cowling, Benjamin J. ^{[1
]}

Perera, Ranawaka A. P. M. ^{[1
]}

Valkenburg, Sophie A. ^{[1
,2
]}

Leung, Nancy H. L. ^{[1
]}

Iuliano, A. Danielle ^{[3
]}

Tam, Yat Hung ^{[1
]}

Wong, Jennifer H. F. ^{[1
]}

Fang, Vicky J. ^{[1
]}

Li, Athena P. Y. ^{[1
,2
]}

So, Hau Chi ^{[1
]}

Ip, Dennis K. M. ^{[1
]}

Azziz-Baumgartner, Eduardo ^{[3
]}

Fry, Alicia M. ^{[3
]}

Levine, Min Z. ^{[3
]}

Gangappa, Shivaprakash ^{[3
]}

Sambhara, Suryaprakash ^{[3
]}

Barr, Ian G. ^{[4
,5
]}

Skowronski, Danuta M. ^{[6
,7
]}

Peiris, J. S. Malik ^{[1
]}

Thompson, Mark G. ^{[3
]}

机构：

[1] Univ Hong Kong, WHO, Sch Publ Hlth, Collaborating Ctr Infect Dis Epidemiol & Control, Hong Kong, Peoples R China

[2] Univ Hong Kong, Univ Hong Kong Pasteur Res Pole, Sch Publ Hlth, Hong Kong, Peoples R China

[3] CDCP, Influenza Div, Atlanta, GA USA

[4] WHO, Collaborating Ctr Reference & Res, Victoria, Australia

[5] Univ Melbourne, Dept Microbiol & Immunol, Melbourne, Vic, Australia

[6] British Columbia Ctr Dis Control, Vancouver, BC, Canada

[7] Univ British Columbia, Vancouver, BC, Canada

来源：

CLINICAL INFECTIOUS DISEASES | 2020年 / 71卷 / 07期

关键词：

influenza; vaccination; public health; IMMUNE-RESPONSES; METAANALYSIS; EFFICACY; SAFETY;

D O I：

10.1093/cid/ciz1034

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Enhanced influenza vaccines may improve protection for older adults, but comparative immunogenicity data are limited. Our objective was to examine immune responses to enhanced influenza vaccines, compared to standard-dose vaccines, in community-dwelling older adults. Methods. Community-dwelling older adults aged 65-82 years in Hong Kong were randomly allocated (October 2017-January 2018) to receive 2017-2018 Northern hemisphere formulations of a standard-dose quadrivalent vaccine, MF59-adjuvanted trivalent vaccine, high-dose trivalent vaccine, or recombinant-hemagglutinin (rHA) quadrivalent vaccine. Sera collected from 200 recipients of each vaccine before and at 30-days postvaccination were assessed for antibodies to egg-propagated vaccine strains by hemagglutination inhibition (HAI) and to cell-propagated A/Hong Kong/4801/2014(H3N2) virus by microneutralization (MN). Influenza-specific CD4(+) and CD8(+) T cell responses were assessed in 20 participants per group. Results. Mean fold rises (MFR) in HAI titers to egg-propagated A(H1N1) and A(H3N2) and the MFR in MN to cell-propagated A(H3N2) were statistically significantly higher in the enhanced vaccine groups, compared to the standard-dose vaccine. The MFR in MN to cell-propagated A(H3N2) was highest among rHA recipients (4.7), followed by high-dose (3.4) and MF59-adjuvanted (2.9) recipients, compared to standard-dose recipients (2.3). Similarly, the ratio of postvaccination MN titers among rHA recipients to cell-propagated A(H3N2) recipients was 2.57-fold higher than the standard-dose vaccine, which was statistically higher than the high-dose (1.33-fold) and MF59-adjuvanted (1.43-fold) recipient ratios. Enhanced vaccines also resulted in the boosting of T-cell responses. Conclusions. In this head-to-head comparison, older adults receiving enhanced vaccines showed improved humoral and cell-mediated immune responses, compared to standard-dose vaccine recipients.

引用

页码：1704 / 1714

页数：11

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