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. Issue 5 (31st January 2022)

• Record Type: Journal Article
• Authors: Williams, Katherine V.; Zhai, Bo; Alcorn, John F.; Patricia Nowalk, Mary; Levine, Min Z.; Kim, Sara S.; Flannery, Brendan; Moehling Geffel, Krissy; Jaber Merranko, Amanda; Nagg, Jennifer P.; Collins, Mark; Susick, Michael; Clarke, Karen S.; Zimmerman, Richard K.; Martin, Judith M.
• Is Part Of: Vaccine. Volume 40:Issue 5(2022)
• Page Start: 780
• Page End: 788
• Publication Date: 2022-01-31
• Subjects: Influenza -- Influenza vaccine -- Hemagglutination inhibition assay -- Cell-culture-based inactivated influenza vaccine -- Egg-based live attenuated influenza vaccine -- Randomized controlled trial; HAI hemagglutination inhibition assay -- IIV inactivated influenza vaccine -- ccIIV4 cell-culture-based inactivated influenza vaccine quadrivalent -- LAIV4 Egg-based live attenuated influenza vaccine quadrivalent -- EMR Electronic medical record -- RDE Receptor-destroying enzyme -- PBS Phosphate-buffered saline -- CDC Centers for Disease Control and Prevention -- FDA Food and Drug Administration -- GMT Geometric mean titers -- GMFR Geometric mean fold rise -- ACIP Advisory Committee on Immunization Practice -- PA-SIIS Pennsylvania Statewide Immunization Information System; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2021.12.034
• Languages: English
• ISSNs: 0264-410X

Abstract

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.