Immunogenicity of Three Different Influenza Vaccines against Homologous and Heterologous Strains in Nursing Home Elderly Residents

We studied whether MF59-adjuvanted influenza vaccine improves immunity against drifted influenza strains in institutionalised elderly with underling chronic health conditions. Sera from a randomized study, comparing MF59-adjuvanted (Sub/MF59, n = 72), virosomal (SVV, n = 39), and split (n = 88) vaccines, were retested using a hemagglutination inhibition (HI) assay against homologous (Northern Hemisphere [NH] 1998/99) and drifted (NH 2006/07) strains. Corrected postvaccination HI antibody titres were significantly higher with Sub/MF59 than SVV for all strains; GMTs against homologous A/H3N2 and B and both drifted A strains were significantly higher for Sub/MF59 than split. Seroprotection rates and mean-fold titer increases were generally higher with Sub/MF59 for all A influenza strains. MF59-adjuvanted influenza vaccine induced greater and broader immune responses in elderly people with chronic conditions, than conventional virosomal and split vaccines, particularly for A/H1 and A/H3 strains, potentially giving clinical benefit in seasons where antigenic mismatch occurs.

[1]  R. van Strik,et al.  Impact of influenza on mortality in relation to age and underlying disease, 1967-1989. , 1993, International journal of epidemiology.

[2]  A. Osterhaus,et al.  On the relationship between mean antibody level, seroprotection and clinical protection from influenza. , 2009, Biologicals : journal of the International Association of Biological Standardization.

[3]  R. Rappuoli,et al.  An MF59-adjuvanted inactivated influenza vaccine containing A/Panama/1999 (H3N2) induced broader serological protection against heterovariant influenza virus strain A/Fujian/2002 than a subunit and a split influenza vaccine. , 2006, Vaccine.

[4]  J. McElhaney,et al.  The unmet need in the elderly: designing new influenza vaccines for older adults. , 2005, Vaccine.

[5]  J. Treanor.  Influenza vaccine--outmaneuvering antigenic shift and drift. , 2004, The New England journal of medicine.

[6]  T. A. Bektemirov,et al.  [Inactivated influenza vaccines]. , 1978, Voprosy virusologii.

[7]  M. Nei,et al.  MEGA4: Molecular Evolutionary Genetics Analysis (MEGA) software version 4.0. , 2007, Molecular biology and evolution.

[8]  V. Baldo,et al.  Influenza vaccines: Antibody responses to split virus and MF59-adjuvanted subunit virus in an adult population , 1999, European Journal of Epidemiology.

[9]  K. Nichol,et al.  The efficacy, effectiveness and cost-effectiveness of inactivated influenza virus vaccines. , 2003, Vaccine.

[10]  L. Ferrucci,et al.  Hospital diagnoses, Medicare charges, and nursing home admissions in the year when older persons become severely disabled. , 1997, JAMA.

[11]  J. S. Stevenson,et al.  Older Adults , 1980, Suicide Prevention.

[12]  Keiji Fukuda,et al.  Influenza-associated hospitalizations in the United States. , 2004, JAMA.

[13]  V. Prikazsky,et al.  Immunogenicity of an inactivated split influenza vaccine in institutionalized elderly patients. , 1996, Gerontology.

[14]  A. Floreani,et al.  Comparison of three different influenza vaccines in institutionalised elderly. , 2001, Vaccine.

[15]  Mark A. Miller,et al.  Influenza and the winter increase in mortality in the United States, 1959-1999. , 2004, American journal of epidemiology.

[16]  D. Weiskopf,et al.  Biology of immune responses to vaccines in elderly persons. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[17]  Keiji Fukuda,et al.  Mortality associated with influenza and respiratory syncytial virus in the United States. , 2003, JAMA.

[18]  A. Osterhaus,et al.  Mismatch between the 1997/1998 influenza vaccine and the major epidemic A(H3N2) virus strain as the cause of an inadequate vaccine‐induced antibody response to this strain in the elderly , 2000, Journal of medical virology.

[19]  N. Cox,et al.  Global epidemiology of influenza: past and present. , 2000, Annual review of medicine.

[20]  L. Sticchi,et al.  Neutralizing and Hemagglutination-Inhibiting Activities of Antibodies Elicited by the 2004-2005 Influenza Vaccine against Drifted Viruses , 2006, Clinical and Vaccine Immunology.

[21]  W. Gruber,et al.  Correlation of Cellular Immune Responses with Protection against Culture-Confirmed Influenza Virus in Young Children , 2008, Clinical and Vaccine Immunology.

[22]  A. Tzankov,et al.  Age‐related loss of naïve T cells and dysregulation of T‐cell/B‐cell interactions in human lymph nodes , 2005, Immunology.

[23]  Y. Kanegae,et al.  Evolutionary pattern of the hemagglutinin gene of influenza B viruses isolated in Japan: cocirculating lineages in the same epidemic season , 1990, Journal of virology.

[24]  W. Parson,et al.  CD25-Expressing CD8+ T Cells Are Potent Memory Cells in Old Age1 , 2005, The Journal of Immunology.

[25]  T. Kase,et al.  Cross-reactivity of influenza A (H3N2) hemagglutination-inhibition antibodies induced by an inactivated influenza vaccine. , 2006, Vaccine.

[26]  K. Nichol,et al.  Influenza vaccine effectiveness in preventing hospitalizations and deaths in persons 65 years or older in Minnesota, New York, and Oregon: data from 3 health plans. , 2001, The Journal of infectious diseases.

[27]  G. Lüchters,et al.  Seroprotection rate, mean fold increase, seroconversion rate: which parameter adequately expresses seroresponse to influenza vaccination? , 2004, Virus research.

[28]  L. Sticchi,et al.  Cross-protection by MF59-adjuvanted influenza vaccine: neutralizing and haemagglutination-inhibiting antibody activity against A(H3N2) drifted influenza viruses. , 2008, Vaccine.

[29]  T. Cate,et al.  Clinical manifestations and consequences of influenza. , 1987, The American journal of medicine.

[30]  A. Monto.  Epidemiology and Virology of Influenza Illness , 2000 .

[31]  A. Monto,et al.  Effect of neuraminidase antibody on Hong Kong influenza. , 1973, Lancet.