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J Infect Dis . High dose inactivated influenza vaccine inconsistently improves heterologous antibody responses in an elderly human cohort

tetano

Editor, Senior Moderator
J Infect Dis


. 2025 Jan 8:jiaf003.
doi: 10.1093/infdis/jiaf003. Online ahead of print. High dose inactivated influenza vaccine inconsistently improves heterologous antibody responses in an elderly human cohort

W Zane Billings[SUP] 1 2 [/SUP], Yang Ge[SUP] 3 [/SUP], Jessica H Knight[SUP] 1 [/SUP], Hayley Hemme[SUP] 1 2 [/SUP], Savannah M Hammerton[SUP] 1 2 [/SUP], Amanda L Skarlupka[SUP] 4 [/SUP], Wangnan Cao[SUP] 5 [/SUP], Ye Shen[SUP] 1 [/SUP], Justin Bahl[SUP] 1 2 6 7 [/SUP], Paul G Thomas[SUP] 8 [/SUP], Ted M Ross[SUP] 9 10 [/SUP], Andreas Handel[SUP] 1 2 [/SUP]



Affiliations
Abstract

Background: Older adults often mount a weak immune response to standard inactivated influenza vaccines. To induce a stronger response and better protection, a high-dose (HD) version of the inactivated Fluzone vaccine is recommended for individuals >65 years of age. While better immunogenicity and protection against the vaccine strain has been shown, it is not known if the HD vaccine also induces a robust antibody response to heterologous strains.
Methods: We fit bayesian multilevel regression models to hemagglutination inhibition (HAI) antibody data from an influenza vaccine cohort spanning the 2013/14-2021/22 influenza seasons. We used this model to estimate the average causal effect (ACE) of obtaining the HD vaccine, relative to the SD vaccine.
Results: We show that while there is generally a benefit derived from the HD vaccine, the impact is small and inconsistent. For some strains, the HD vaccine might even result in less robust heterologous responses.
Conclusions: We suggest that further increases in dose might be worth investigating to help induce a stronger broad response.

Keywords: cohort study; elderly population; heterologous responses; high-dose influenza vaccine; humoral immunity; influenza; secondary data analysis; vaccine dose; vaccines.

 
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