Comparative Immunogenicity of Several Enhanced Influenza Vaccine Options for Older Adults: A Randomized, Controlled Trial
Comparative Immunogenicity of Several Enhanced Influenza Vaccine Options for Older Adults: A Randomized, Controlled Trial
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DOI：
10.1093/cid/ciz1034
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发表时间：
2020-10-01
影响因子：
11.8
通讯作者：
Thompson, Mark G.
中科院分区：
文献类型：
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作者：
Cowling, Benjamin J.;Perera, Ranawaka A. P. M.;Thompson, Mark G.
背景增强型流感疫苗可能会提高对老年人的保护，但比较免疫原性的数据有限。我们的目的是检查增强流感疫苗的免疫应答，与标准剂量疫苗相比，在社区居住的老年人。随机分配（2017年10月至2018年1月）香港65-82岁的社区居住老年人，接受2017-2018年北方标准剂量四价疫苗、MF 59佐剂三价疫苗、高剂量三价疫苗或重组血凝素（rHA）四价疫苗。在接种前和接种后30天，从每种疫苗的200名接种者中收集血清，通过血凝抑制（HAI）评估鸡蛋繁殖疫苗株的抗体，并通过微量中和（MN）评估细胞繁殖A/Hong Kong/4801/2014（H3 N2）病毒的抗体。每组20名参与者评估流感特异性CD 4（+）和CD 8（+）T细胞应答。与标准剂量疫苗相比，在增强疫苗组中，对鸡蛋传播的A（H1N1）和A（H3 N2）的HAI滴度的平均倍数上升（MFR）以及MN对细胞传播的A（H3 N2）的MFR在统计学上显著更高。与标准剂量受体（2.3）相比，rHA受体（4.7）中MN对细胞传播的A（H3 N2）的MFR最高，其次是高剂量（3.4）和MF 59佐剂（2.9）受体。类似地，rHA受体与细胞繁殖的A（H3 N2）受体之间的疫苗接种后MN滴度的比率比标准剂量疫苗高2.57倍，这在统计学上高于高剂量（1.33倍）和MF 59佐剂（1.43倍）受体比率。增强型疫苗也导致T细胞应答的增强。在这种头对头比较中，与标准剂量疫苗接种者相比，接受增强型疫苗的老年人显示出改善的体液和细胞介导的免疫应答。
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.