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Immunogenicity and safety of a quadrivalent inactivated influenza vaccine in pregnant women: a randomized, observer-blind trial

tetano

Editor, Senior Moderator
Hum Vaccin Immunother. 2019 Sep 17. doi: 10.1080/21645515.2019.1667202. [Epub ahead of print]
[h=1]Immunogenicity and safety of a quadrivalent inactivated influenza vaccine in pregnant women: a randomized, observer-blind trial.[/h] Vesikari T[SUP]1[/SUP], Virta M[SUP]2[/SUP], Heinonen S[SUP]3,[/SUP][SUP]4[/SUP], Eymin C[SUP]5[/SUP], Lavis N[SUP]5[/SUP], Chabanon AL[SUP]6[/SUP], Gresset-Bourgeois V[SUP]6[/SUP].
[h=3]Author information[/h] 1 Vaccine Research Center, Tampere University , Tampere , Finland . 2 Tampere Vaccine Research Clinic, Vaccine Research Center, Tampere University , Tampere , Finland . 3 Department of Obstetrics and Gynecology, Helsinki University Hospital , Helsinki , Finland. 4 University of Helsinki , Helsinki , Finland . 5 Medical Operations, Sanofi Pasteur, Campus Sanofi Lyon , 14 Espace Henry Vallee, 69007 Lyon , France . 6 Global Medical Strategy, Sanofi Pasteur , Campus Sanofi Lyon, 14 Espace Henry Vallee, 69007 Lyon , France .

[h=3]Abstract[/h] Vaccination against influenza during pregnancy provides direct protection to pregnant women and indirect protection to their infants. Trivalent inactivated influenza vaccines (IIV3s) are safe and effective during pregnancy, but quadrivalent inactivated influenza vaccines (IIV4s) have not been evaluated in pregnant women and their infants. Here, we report the results of a randomized phase IV study to evaluate the immunogenicity and safety of IIV4 vs. IIV3 in pregnant women. Participants aged ≥18 years at weeks 20 to 32 of gestation were randomly assigned in a 2:1 ratio to receive a single dose of IIV4 (n=230) or IIV3 (n=116). Between baseline and 21 days after vaccination, hemagglutination inhibition (HAI) antibody titers increased in both groups by similar magnitudes for the two influenza A strains and single B strain common to IIV4 and IIV3. For the additional B strain in IIV4, HAI titers were higher in IIV4 recipients than IIV3 recipients (post-/pre-vaccination geometric mean titer ratio, 6.3 [95% CI: 5.1-7.7] vs. 3.4 [95% CI: 2.7-4.3]). At delivery, in both groups, HAI antibody titers for all strains were 1.5-1.9-fold higher in umbilical cord blood than in maternal blood, confirming active transplacental antibody transfer. Rates of solicited and unsolicited vaccine-related adverse events in mothers were similar between the two groups. Live births were reported for all participants and there were no vaccine-related adverse events in newborns. These results suggest IIV4 is as safe and immunogenic as IIV3 in pregnant women, and that maternal immunization with IIV4 should protect newborns against influenza via passively acquired antibodies.


[h=4]KEYWORDS:[/h] Immunization; influenza vaccines; newborn infant; pregnancy; safety; seasonal influenza; transplacental antibody transfer; vaccination

PMID: 31526225 DOI: 10.1080/21645515.2019.1667202
 
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