Sex-specific effects of age and body mass index on antibody responses to seasonal influenza vaccines in healthcare workers

Kuo, Helen; Shapiro, Janna R.; Dhakal, Santosh; Morgan, Rosemary; Fink, Ashley L.; Lui, Hsuan; Westerbeck, Jason W.; Sylvia, Kristyn E.; Park, Han Sol; Ursin, Rebecca L.; Shea, Patrick; Shaw-Saliba, Kathryn; Fenstermacher, Katherine; Rothman, Richard E.; Pekosz, Andrew; Klein, Sabra L.

doi:10.1016/j.vaccine.2021.02.047

Cited by 23 publications

(23 citation statements)

References 20 publications

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“…Another recent study reported that human females mounted higher Ab and IL-6 responses after H1N1 vaccination [ 282 ]. A study of vaccinated healthcare workers within Johns Hopkins Hospital ( n = 274) did not observe overall significant differences in neutralizing Ab titers between males and females when all age groups were merged [ 283 ]. Females in older age groups had higher titers than males.…”

Section: The Effect Of Sex On Infections With Influenza Viruses and Potential Implications For Vaccinationmentioning

confidence: 99%

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Review of Influenza Virus Vaccines: The Qualitative Nature of Immune Responses to Infection and Vaccination Is a Critical Consideration

Chan

Alizadeh

et al. 2021

Vaccines

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Influenza viruses have affected the world for over a century, causing multiple pandemics. Throughout the years, many prophylactic vaccines have been developed for influenza; however, these viruses are still a global issue and take many lives. In this paper, we review influenza viruses, associated immunological mechanisms, current influenza vaccine platforms, and influenza infection, in the context of immunocompromised populations. This review focuses on the qualitative nature of immune responses against influenza viruses, with an emphasis on trained immunity and an assessment of the characteristics of the host–pathogen that compromise the effectiveness of immunization. We also highlight innovative immunological concepts that are important considerations for the development of the next generation of vaccines against influenza viruses.

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Section: The Effect Of Sex On Infections With Influenza Viruses and Potential Implications For Vaccinationmentioning

confidence: 99%

“…Females in older age groups had higher titers than males. Elevated female body mass index resulted in reduced Ab responses; males did not exhibit the same trend [ 283 ].…”

Section: The Effect Of Sex On Infections With Influenza Viruses and Potential Implications For Vaccinationmentioning

confidence: 99%

Review of Influenza Virus Vaccines: The Qualitative Nature of Immune Responses to Infection and Vaccination Is a Critical Consideration

Chan

Alizadeh

et al. 2021

Vaccines

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“…Conversely, ratiobased outcomes (i.e., fold rise and seroconversion) were negatively associated with prevaccination titers, since, by definition, large denominators (pre-vaccination titers) result in smaller ratios. We recently reported a similar effect in younger adult healthcare workers, where mandatory vaccination policies result in exceptionally high rates of immunization 49 . While some argue that high levels of pre-existing antibodies interfere with the generation of de novo immune responses 24,27 , others suggest that ratio-based measures simply do not appropriately control for imbalances in levels of pre-existing humoral immunity 50 .…”

Section: Discussionmentioning

confidence: 55%

Sex-specific effects of aging on the humoral immune response to repeat vaccination with the high-dose seasonal influenza vaccine in older adults

Shapiro

Morgan

et al. 2021

Preprint

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Older adults (≥65 years of age) bear a significant burden of severe disease and mortality associated with influenza, despite relatively high annual vaccination coverage and substantial pre-existing immunity to influenza. To test the hypothesis that host factors, including age and sex, play a role in determining the effect of repeat vaccination and levels of pre-existing humoral immunity to influenza, we evaluated pre- and post-vaccination strain-specific hemagglutination inhibition (HAI) titers in adults over 75 years of age who received a high-dose influenza vaccine in at least four out of six influenza seasons (NCT02200276). Neither age, sex, body mass index, frailty, nor repeat vaccination were significantly associated with post-vaccination HAI titer outcomes. Pre-vaccination titers, however, were significantly predictive of post-vaccination outcomes. Pre-vaccination titers to H1N1 remained constant with age, while those to H3N2 and influenza B decreased substantially with age in males but not in females. Our findings highlight the importance of pre-existing immunity in this highly vaccinated older adult population and suggest that older males are particularly vulnerable to reduced pre-existing humoral immunity to influenza from previous annual vaccination.

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“…For S1 IgG there was a similar but less pronounced pattern and for RBD pan-Ig antibodies females “caught up” during observation period, starting with lower antibody concentrations shortly after infection and finally slightly higher levels than males. Apparently, the more immune dominant antigens are driving a longer lasting immunity in females as described for influenza [ 23 ] and other anti-viral responses, only transiently however [ 26 ]. How this evolves long-term for SARS-CoV‑2 remains to be seen.…”

Section: Discussionmentioning

confidence: 99%

“…Sex differences with respect to antibody responses have been reported in different contexts [23][24][25] with somewhat conflicting results. Often, differential kinetics of titres were not considered.…”

Section: Original Articlementioning

confidence: 99%

12-month SARS-CoV-2 antibody persistency in a Tyrolean COVID-19 cohort

Deisenhammer

Bauer

Kavelar

et al. 2021

Wien Klin Wochenschr

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Summary Background Short-term antibody response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown previously. The further development remains to be determined. Methods We prospectively followed 29 coronavirus disease 2019 cases, mean age 44 ± 13.2 years. Except for one participant in whom rheumatoid arthritis existed, all other cases were previously healthy. We determined anti-viral binding antibodies at 2–10 weeks, 3 months, 6 months, and 12 months after disease onset as well as neutralizing antibodies (NAb) against wild type at 6 and 12 months and the B.1.1.7 and B.1.351 variants at month 12. Three binding antibody assays were used, targeting the nucleocapsid protein (NCP), the S1 subunit of the spike protein, and the receptor binding domain (RBD). Results Antibodies to the RBD persisted for 12 months in all cases with increasing concentrations, whereas antibodies to S1 dropped below cut-off point in 7 participants and NCP antibodies were above cut-off point in only 5 subjects at month 12. The NAb against wild type were detected in all but 2 samples at 12 months of follow-up but clearly less frequently when targeting the variants. In 5 participants who were vaccinated against COVID-19 there was a strong increase of antibodies against S1 and RBD as well as an increase of NAb titres against wild type and the variants. Conclusion There was a persisting antibody response against SARS-CoV‑2 up to 12 months after COVID-19 with declining concentrations except for RBD and a strong increase of all antibody concentrations after vaccination.

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Sex-specific effects of age and body mass index on antibody responses to seasonal influenza vaccines in healthcare workers

Cited by 23 publications

References 20 publications

Review of Influenza Virus Vaccines: The Qualitative Nature of Immune Responses to Infection and Vaccination Is a Critical Consideration

Review of Influenza Virus Vaccines: The Qualitative Nature of Immune Responses to Infection and Vaccination Is a Critical Consideration

Sex-specific effects of aging on the humoral immune response to repeat vaccination with the high-dose seasonal influenza vaccine in older adults

12-month SARS-CoV-2 antibody persistency in a Tyrolean COVID-19 cohort

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