Quality and Quantity of the Humoral Immune Response in Healthy Elderly and Young Subjects after Annually Repeated Influenza Vaccination

Abstract

Doubt about the serologic efficacy of annually repeated influenza vaccination prompted investigations into the course of hemagglutination-inhibiting (HI), IgG, and IgA antibody titers and the IgG and IgA avidity index to influenza A/Taiwan/1/86 and A/Beijing/353/89 after annual vaccination. Fifty-four healthy elderly persons >70 years of age and 24 healthy young adults <30 years of age received standard influenza vaccine during 3 consecutive years. On average, prevaccination HI, IgG, and IgA titers to both influenza virus strains increased >=4 fold between the first and the third vaccination (analysis of variance, P<.001). The postvaccination HI and IgG titers remained unchanged after annual vaccination. The avidity index of IgG and IgA antibodies increased somewhat after annual vaccination, although the increase was statistically significant only in the young subjects. These data indicate that annual influenza vaccination of healthy elderly and young subjects results in an overall increase in protective antibodies.

Safety, immunogenicity, and tolerability of three influenza vaccines in older adults

“…In contrast, most subjects in the present study had received the study vaccine strain in both pre-study years and, as annual vaccine recipients, could have received B/Victoria lineage strains in 4 of 5 prestudy years. As others have reported, 15,16,24 repeated vaccination of seniors with the same or similar antigens causes titers to approach maximal levels. Our observations of high baseline B/Brisbane titers and limited further responses to vaccination are consistent with this phenomenon, although subjects had also received A/H1N1/California/2009 antigen in both pre-study years without a similar increase in baseline titers.…”

“…13 This study benefitted from a high degree of similarity among the study groups, effectively controlling for a range of potential influences on responses to vaccination including age, 19 sex, prior influenza vaccination, 15,16 frailty, 20 chronic health conditions, obesity, 21 moderate exercise 22 and probiotic use. 23 Similarity of baseline antibody titers among the study groups avoided the need for adjustment of observed responses.…”

“…To B/Brisbane, IDV recipients had a higher post-immunization GMT compared with TIV recipients but this observation was confounded by the high pre-immunization titers in both groups. A recent meta-analysis 37 of 4 trials that compared immunogenicity of IDV 15 and TIV in seniors concluded that no substantial differences were evident in seroprotection rate ratios or GMT ratios with A or B virus antigens. Van Damme et al 13 reported non-inferior immune responses in adults ≥ 65 y of age after IDV compared with ADV with all 3 vaccine antigens based on SRH assay data.…”

“…Seniors who receive annual influenza vaccination often develop progressively higher antibody titers, 15,16 a situation that can complicate assessment of vaccine responses and potentially blunt differences between vaccine formulations. Nevertheless, we chose to recruit seniors with a history of annual influenza vaccination because most (~70%) of this age group receives TIV vaccine in Canada 17 and any advantages of a new formulation would need to be evident in this context to support program policy decisions.…”

Studies of cell‐mediated immune responses to influenza vaccination in systemic lupus erythematosus

“…Influenza vaccination in the previous year was associated with a lower seroconversion rate to A/H1N1; both vaccines contained the same A/H1N1 strain. The effects of previous influenza vaccination on antibody responses remain subject to discussion, because some studies demonstrated decreased antibody responses (34)(35)(36), whereas others showed similar (37)(38)(39) or improved responses (40).…”