Clinical and serological responses to an inactivated influenza vaccine in adults with HIV infection, diabetes, obstructive airways disease, elderly adults and healthy volunteers

Abstract

To investigate the clinical and serological responses to an inactivated influenza vaccine (split-virion A/Singapore/6/86-like strains H1N1 (15 ug HA), A/Beijing/353/89-like H3N2 (15 ug HA) and B/Yamagata/16/88-like strain (15 ug HA): MFV-JECT, Merieux, UK) in persons with HIV infection, diabetes, obstructive lung diseases, elderly adults and healthy volunteers. Forty-nine HIV-infected persons received 2 doses of the vaccine at one-month intervals; 34 healthy volunteers, 30 elderly persons, 29 with insulin and non-insulin diabetes and 14 with obstructive airways diseases were vaccinated with one single dose between October 1992 to January 1993. Serological testing of antibody responses was done using haemagglutination assay. Beta2-microglobulin in HIV-infected persons was measured using radioimmunodiffusion between 1st and 2nd dose. Fructosamine levels in diabetic persons were assessed for diabetic control and peak expiratory flow rate (PEFR) was self monitored in persons with lung diseases. All groups apart from the elderly filled in a symptom score chart for the first 5 days following vaccination. A 4-fold rise in titre equal to or more than 1:64 to all the 3 antigens occurred in 20 (58.8%) of healthy volunteers compared with 13 (44.8%) diabetics, 5 (35.7%) with lung diseases, 10 (33.3%) elderly and 13 (26.5%) with HIV infection. A significant correlation of serological response to number of CD4 count in persons with HIV infection was noted (H1N1 P=0.0013, H3N2 P=0.025, BYAM P=0.0018). Mean beta2-microglobulin levels did not change significantly post 1st and 2nd vaccination. Mean fructosamine level did not change significantly. There was no significant change in PEFR. The vaccine was well tolerated. Persons with HIV infection and low CD4 count do not serologically respond well to influenza vaccine even with 2 doses compared to the other 4 groups. The other 4 groups had adequate protective serologic responses. The vaccine was well tolerated in all groups.

A Vaccination Model for Transmission Dynamics of Influenza

“…Redistribution subject to SIAM license or copyright; see http://www.siam.org/journals/ojsa.php [13,17,25]. Although vaccination has been an effective strategy against influenza infection [5,12,17,26,28,34,40], current preventive vaccines consisting of inactivated virions do not protect all vaccine recipients equally. The vaccine-based protection is dependent on the immune status of the recipient (see [18,35] for general references).…”

“…The vaccine-based protection is dependent on the immune status of the recipient (see [18,35] for general references). Typically, influenza vaccines protect 70%-90% of the recipients among healthy young adults and as low as 30%-40% of the elderly and others with weakened immune systems (such as HIV-infected or immunosuppressed transplant patients) [5,12,15,26]. Furthermore, due to the seasonal drift in the viral genome, annual vaccination against the influenza virus strains anticipated to be in circulation during the upcoming season is necessary to prevent new infections and subsequent outbreaks.…”

Cocoon Strategy of Vaccinations: Benefits and Limitations

“…During the occurrence of an inluenza outbreak in a facility whose residents were at the age of above 65 years, the percentage of infected patients in an epidemic season was very high and it could reach even 60% [68]. The facts that inluenza vaccinations in the elderly are not as efective as vaccinations in a younger population (30-40% vs 70-90%), and that inluenza epidemics occurred in the populations of the residents of nursing homes, where inluenza immunization was very high and reached even 90%, prove that it is necessary to perform vaccinations in healthcare professionals in order to protect the patients [69,70].…”

Szczepienia Przeciwko Grypie U Personelu Medycznego

“…Opisano, że w sezonie epidemicznym, w czasie wystąpienia ogniska zachorowań na grypę w placówce, której pensjonariuszami były osoby w wieku powyżej 65 lat, odsetek zakażonych był bardzo wysoki i sięgał nawet 60% (20). Ponieważ szczepienia przeciwko grypie osób w wieku podeszłym nie są tak efektywne jak u osób młodszych (30-40% vs 70-90%) i opisywano epidemie grypy w populacjach pensjonariuszy domów opieki, gdzie wyszczepialność była bardzo wysoka i sięgała nawet 90%, konieczne jest w celu ochrony pacjentów wykonywanie szczepień personelu medycznego (21,22).…”