Humoral and Cell-Mediated Immune Responses to Monovalent 2009 Influenza A/H1N1 and Seasonal Trivalent Influenza Vaccines in High-Risk Children

Abstract

Objective Humoral and cell-mediated immune responses to monovalent H1N1/2009 and seasonal trivalent influenza (TIV) vaccines were evaluated in healthy children and those with asthma, sickle cell disease (SCD), systemic lupus erythematosus (SLE), and solid organ transplantation (SOT). Study design Blood was collected from 112 subjects at the time of H1N1/2009 vaccination and 46±15 days later for hemagglutination inhibition (HI) titers and IFNγ ELISPOT responses to H1N1/2009 vaccine and TIV; unvaccinated children also received TIV at enrollment. Results A significant increase in the percentage of subjects with seroprotective HI titers to both vaccines was observed in all high risk groups. Children with asthma and SCD were most likely to achieve seroprotective titers to H1N1/2009, whereas fewer than 50% of subjects with SOT and SLE mounted a seroprotective response. The latter also had lower rates of seroprotection following TIV, and subjects with SLE had the lowest ELISPOT responses to both vaccines. Overall, 73% of healthy children exhibited protective responses to TIV; only 35% achieved seroprotection for H1N1/2009. Conclusions This evaluation of immune responses to H1N1/2009 in high risk children suggests suboptimal responses for SOT and SLE, but not subjects with SCD or asthma. Higher antigen dose and/or additional dose regimens for immunocompromised children warrant further investigation.

Preventive Care Delivery to Young Children With Sickle Cell Disease

“…3,4 The mechanism underlying this enhanced risk is incompletely understood, but may involve influenza: 1) compromising respiratory tract mucosal immunity; 36 2) causing acute chest syndrome; 37 and 3) provoking fever which results in precautionary admission to rule out bacterial sepsis. Fortunately, influenza immunization is both safe 38,39 and immunogenic 39,40 in children with SCD, and is efficacious in children generally. 8 Influenza immunization has been recommended for children with SCD by the Advisory Committee on Immunization Practices of the CDC since 1978, 41 and is now recommended for all children over 6 months of age.…”

Saccharomyces cerevisiae -derived virus-like particle parvovirus B19 vaccine elicits binding and neutralizing antibodies in a mouse model for sickle cell disease

“…[17], who showed that children with SCD respond well to an influenza virus vaccine. The animal model results are also consistent with our own observations that children with SCD respond well immunologically to parvovirus B19 antigens after a natural infection, and that parvovirus sero-prevalence is similar between children with SCD and their unaffected counterparts [18].…”

Antibody and cell-mediated immune response to whole virion and split virion influenza vaccine in patients with inflammatory bowel disease on maintenance immunosuppressive and biological therapy

“…They also found that this diminished cell-mediated response may reflect the effects of concomitant use of immunosuppressive drugs [17]. The study of Long et al also found a diminished humoral and cell-mediated immune response to monovalent 2009 pandemic influenza A (H1N1/2009) and seasonal trivalent influenza vaccines in subjects with SLE but not with sickle cell disease or asthma, presumably due to the different immunocompromised status of these children [18].…”