Immunogenicity and safety of high-dose trivalent inactivated influenza vaccine compared to standard-dose vaccine in children and young adults with cancer or HIV infection. Issue 27 (8th June 2016)

• Record Type: Journal Article
• Authors: Hakim, Hana; Allison, Kim J.; Van de Velde, Lee-Ann; Tang, Li; Sun, Yilun; Flynn, Patricia M.; McCullers, Jonathan A.
• Is Part Of: Vaccine. Volume 34:Issue 27(2016)
• Page Start: 3141
• Page End: 3148
• Publication Date: 2016-06-08
• Subjects: Influenza vaccine -- High dose -- Cancer -- HIV -- Immune response -- Safety; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2016.04.053
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: High dose influenza vaccine was more immunogenic than standard dose influenza vaccine in children and young adults with leukemia or solid tumor, but not with HIV. High dose influenza vaccine was safe and well-tolerated in children and young adults with leukemia, solid tumor, or HIV. Two doses of influenza vaccine were more immunogenic than one dose, especially against H1 and B antigens, in children and young adults with leukemia or solid tumor, but not with HIV. Abstract: Background: Approaches to improve the immune response of immunocompromised patients to influenza vaccination are needed. Methods: Children and young adults (3–21 years) with cancer or HIV infection were randomized to receive 2 doses of high-dose (HD) trivalent influenza vaccine (TIV) or of standard-dose (SD) TIV. Hemagglutination inhibition (HAI) antibody titers were measured against H1, H3, and B antigens after each dose and 9 months later. Seroconversion was defined as ≥4-fold rise in HAI titer comparing pre- and post-vaccine sera. Seroprotection was defined as a post-vaccine HAI titer ≥1:40. Reactogenicity events (RE) were solicited using a structured questionnaire 7 and 14 days after each dose of vaccine, and adverse events by medical record review for 21 days after each dose of vaccine. Results: Eighty-five participants were enrolled in the study; 27 with leukemia, 17 with solid tumor (ST), and 41 with HIV. Recipients of HD TIV had significantly greater fold increase in HAI titers to B antigen in leukemia group and to H1 antigen in ST group compared to SD TIV recipients. This increase was not documented in HIV group. There were no differences in seroconversion or seroprotection between HD TIV and SD TIV in all groups. There was no difference in the percentage of solicited RE in recipients of HD TIV (54% after dose 1 and 38% after dose 2) compared to SD TIV (40% after dose 1 and 20% after dose 2, p = 0.27 and 0.09 after dose 1 and 2, respectively). Conclusion: HD TIV was more immunogenic than SD TIV in children and young adults with leukemia or ST, but not with HIV. HD TIV was safe and well-tolerated in children and young adults with leukemia, ST, or HIV.