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J Infect Dis . 202 Hemagglutination Inhibition Antibody Titers as Mediators of Influenza Vaccine Efficacy Against Symptomatic Influenza A(H1N1), A(H

tetano

Editor, Senior Moderator
J Infect Dis


. 2024 Jul 25;230(1):152-160.
doi: 10.1093/infdis/jiae122. Hemagglutination Inhibition Antibody Titers as Mediators of Influenza Vaccine Efficacy Against Symptomatic Influenza A(H1N1), A(H3N2), and B/Victoria Virus Infections

Wey Wen Lim[SUP] 1 2 [/SUP], Shuo Feng[SUP] 3 [/SUP], Sook-San Wong[SUP] 1 4 [/SUP], Sheena G Sullivan[SUP] 5 6 [/SUP], Benjamin J Cowling[SUP] 1 2 [/SUP]



Affiliations
Abstract

Background: The hemagglutination inhibition antibody (HAI) titer contributes only a part of vaccine-induced protection against influenza virus infections. Using causal mediation analysis, we quantified the proportion of vaccine efficacy mediated by postvaccination HAI titers.
Methods: We conducted causal mediation analyses using data from a randomized, active-comparator controlled, phase III, trial of an inactivated, split-virion seasonal quadrivalent influenza vaccine in children conducted from October 2010 to December 2011 in 8 countries. Vaccine efficacy was estimated using a weighted Cox proportional hazards model. Estimates were decomposed into the direct and indirect effects mediated by postvaccination HAI titers.
Results: The proportions of vaccine efficacy mediated by postvaccination HAI titers were estimated to be 22% (95% confidence interval, 18%--47%) for influenza A(H1N1), 20% (16%-39%) for influenza A(H3N2), and 37% (26%-85%) for influenza B/Victoria.
Conclusions: HAI titers partially mediate influenza vaccine efficacy against influenza A(H1N1), A(H3N2), and B/Victoria. Our estimates were lower than in previous studies, possibly reflecting expected heterogeneity in antigenic similarity between vaccine and circulating viruses across seasons.

Keywords: correlates of protection; hemagglutination inhibition; influenza; vaccination; vaccine.

 
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