Immunization of Elderly People with High Doses of Influenza Vaccine

Abstract

Healthy ambulatory elderly were immunized with increasing doses of the 1984-1985 influenza vaccine formulation. Two types of vaccines, split-product vaccine (SPV) and whole virus vaccine (WVV), were used. Three different doses, 0.5 mL (the standard volume, 1X), or 1.0 mL (2X), and 1.5 mL (3X) of each of the two vaccines were compared. The size of each of the six groups was between 23 and 26 subjects. The mean ages in each of the groups ranged from 71 to 74 years. No difference in local or systemic reaction was noted among the six groups. A dose-response effect was observed for the SPV recipients to the influenza A/Chile/83 (H1N1) strain. The geometric mean hemagglutination inhibition (HI)titer (GMT) was 1:76 after the 3X dose vs 1:38 after the 1X dose (P less than 0.025). To the influenza A/Philippines/82 (H3N2) strain the GMT was 1:70 after the 3X dose vs 1:43 after the 1X dose. A similar trend was noted for the influenza B/USSR/83 strain. A (HI) titer of greater than or equal to 1:40 for all the strains was seen in greater than 70% of the split product vaccine recipients only after the 3X dose. For the WVV recipients, increasing doses did not result in increasing GMT for any of the three vaccine strains. In addition, HI titers greater than or equal to 1:40 were not uniformly seen in greater than 70% of the vaccine recipients at any of the three whole virus vaccine doses.(ABSTRACT TRUNCATED AT 250 WORDS)

Influenza Vaccination and Risk of Incident Myocardial Infarction

“…Subjects were classified as exposed to vaccine if they had received that season's influenza vaccine at least 14 days prior to the index date to allow for the lag between vaccination and attainment of protective antibody levels. [22][23][24] The association between influenza vaccination and incident MI was evaluated for subjects with index dates during months when influenza activity is expected to be high (November-March) and during months when influenza activity is uncommon (AprilSeptember). In additional analyses, we restricted our evaluation to the subset of weeks during that period in which at least 50 respiratory specimens from Washington State were tested for influenza virus and in which influenza was isolated from ≥10% of the specimens in order to obtain a more specific definition of influenza season.…”

Immunization and the Prevention of Influenza and Pneumococcal Disease in People With Diabetes

“…Because immunity from influenza vaccination declines in the year after vaccination, yearly vaccination is recommended. Although antibody responses to repeat immunization have been reported to be greater in some people with diabetes, repeated immunization within the same season is not recommended (3). The ACIP does recommend two doses of influenza vaccine administered at least 1 month apart (the last administered before December) for children Ͻ9 years of age who have never been vaccinated (2).…”

Vaccine-Induced Antibody Responses as Parameters of the Influence of Endogenous and Environmental Factors

“…The efficacy of influenza vaccine has been estimated to be 70-90% in young adults, but it is lower in elderly nursing home patients (51)(52)(53)(54)(55). The diminished efficacy has been attributed to lower rates of protective antibody responses against the influenza strains.…”

“…Hemagglutinin inhibition antibody titers of > 40 are generally considered protective. Yet, several studies indicate that at least 25% of the elderly do not develop hemagglutinin inhibition antibody titers after vaccination (52,56,57).…”