Effect of Repeat Vaccination on Immunogenicity of Quadrivalent Cell-Culture and Recombinant Influenza Vaccines Among Healthcare Personnel Aged 18–64 Years: A Randomized, Open-Label Trial. (29th August 2022)

• Record Type: Journal Article
• Authors: Gaglani, Manjusha; Kim, Sara S; Naleway, Allison L; Levine, Min Z; Edwards, Laura; Murthy, Kempapura; Dunnigan, Kayan; Zunie, Tnelda; Groom, Holly; Ball, Sarah; Jeddy, Zuha; Hunt, Danielle; Wesley, Meredith G; Sambhara, Suryaprakash; Gangappa, Shivaprakash; Grant, Lauren; Cao, Weiping; Gross, F Liaini; Mishina, Margarita; Fry, Alicia M; Thompson, Mark G; Dawood, Fatimah S; Flannery, Brendan
• Is Part Of: Clinical infectious diseases. Volume 76:Number 3(2023)
• Page Start: e1168
• Page End: e1176
• Publication Date: 2022-08-29
• Subjects: influenza vaccines -- immunogenicity -- healthcare personnel -- Flucelvax Quadrivalent -- Flublok Quadrivalent; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciac683
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Antibody responses to non–egg-based standard-dose cell-culture influenza vaccine (containing 15 µg hemagglutinin [HA]/component) and recombinant vaccine (containing 45 µg HA/component) during consecutive seasons have not been studied in the United States. Methods: In a randomized trial of immunogenicity of quadrivalent influenza vaccines among healthcare personnel (HCP) aged 18–64 years over 2 consecutive seasons, HCP who received recombinant-HA influenza vaccine (RIV) or cell culture–based inactivated influenza vaccine (ccIIV) during the first season (year 1) were re-randomized the second season of 2019–2020 (year 2 [Y2]) to receive ccIIV or RIV, resulting in 4 ccIIV/RIV combinations. In Y2, hemagglutination inhibition antibody titers against reference cell–grown vaccine viruses were compared in each ccIIV/RIV group with titers among HCP randomized both seasons to receive egg-based, standard-dose inactivated influenza vaccine (IIV) using geometric mean titer (GMT) ratios of Y2 post-vaccination titers. Results: Y2 data from 414 HCP were analyzed per protocol. Compared with 60 IIV/IIV recipients, 74 RIV/RIV and 106 ccIIV/RIV recipients showed significantly elevated GMT ratios (Bonferroni corrected P < .007) against all components except A(H3N2). Post-vaccination GMT ratios for ccIIV/ccIIV and RIV/ccIIV were not significantly elevated compared with IIV/IIV except for RIV/ccIIV against A(H1N1)pdm09. Conclusions: In adult HCP, receipt of RIV in 2 consecutive seasons or the second season was more immunogenic than consecutive egg-based IIV for 3 of the 4 components of quadrivalent vaccine. Immunogenicity of ccIIV/ccIIV was similar to that of IIV/IIV. Differences in HA antigen content may play a role in immunogenicity of influenza vaccination in consecutive seasons. Clinical Trials Registration: NCT03722589. Abstract : Healthcare personnel aged 18–64 years who received 2 consecutive seasons of quadrivalent recombinant-hemagglutinin influenza vaccine showed higher post-vaccination hemagglutination-inhibition antibodies against 3 components compared with those who received egg-based inactivated vaccine; those who received the cell-culture vaccines did not.