tetano
Editor, Senior Moderator
Vaccine. 2019 Nov 14. pii: S0264-410X(19)31433-1. doi: 10.1016/j.vaccine.2019.10.053. [Epub ahead of print] [h=1]Priming with MF59 adjuvanted versus nonadjuvanted seasonal influenza vaccines in children - A systematic review and a meta-analysis.[/h]
Patel MM[SUP]1[/SUP], Davis W[SUP]2[/SUP], Beacham L[SUP]2[/SUP], Spencer S[SUP]2[/SUP], Campbell AP[SUP]2[/SUP], Lafond K[SUP]2[/SUP], Rolfes M[SUP]2[/SUP], Levine MZ[SUP]2[/SUP], Azziz-Baumgartner E[SUP]2[/SUP], Thompson MG[SUP]2[/SUP], Fry AM[SUP]2[/SUP].
[h=3]Author information[/h] 1 Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: aul3@cdc.gov. 2 Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Identifying optimal priming strategies for children <2 years could substantially improve the public health benefits of influenza vaccines. Adjuvanted seasonal influenza vaccines were designed to promote a better immune response among young vaccine-na?ve children.
[h=4]METHODS:[/h] We systematically reviewed randomized trials to assess hemagglutination inhibition (HAI) antibody response to MF59-adjuvanted inactivated influenza vaccine (aIIV) versus nonadjuvanted IIV among children. We estimated pooled ratios of post-vaccination HAI geometric mean titer (GMT) for aIIV versus IIV and confidence intervals (CIs) using the pooled variances derived from reported CIs.
[h=4]RESULTS:[/h] Mean age was 28 months (range, 6-72 months). Children received vaccines with either 7.5 μg (6-35 months) or 15 μg (≥36 months) hemagglutinin of each strain depending on age. Seven of eight trials administered trivalent vaccines and one used quadrivalent vaccine. Pooled post-vaccination GMT ratios against the three influenza vaccine strains were 2.5-3.5 fold higher after 2-dose-aIIV versus 2-dose-IIV among children 6-72 months, and point estimates were higher among children 6-35 months compared with older children. When comparing 1-dose-aIIV to 2-dose-IIV doses, pooled GMT ratios were not significantly different against A/H1N1 (1.0; 95% CI: 0.5-1.8; p = 0.90) and A/H3N2 viruses (1.0; 95% CI: 0.7-1.5; p = 0.81) and were significantly lower against B viruses (0.6; 95% CI: 0.4-0.8; p < 0.001) for both age groups. Notably, GMT ratios for vaccine-mismatched heterologous viruses after 2-dose-aIIV compared with 2-dose-IIV were higher against A/H1N1 (2.0; 95% CI: 1.1-3.4), A/H3N2 (2.9; 95% CI: 1.9-4.2), and B-lineage viruses (2.1; 95% CI: 1.8-2.6).
[h=4]CONCLUSIONS:[/h] Two doses of adjuvanted IIV consistently induced better humoral immune responses against Type A and B influenza viruses compared with nonadjuvanted IIVs in young children, particularly among those 6-35 months. One adjuvanted IIV dose had a similar response to two nonadjuvanted IIV doses against Type A influenza viruses. Longer-term benefits from imprinting and cell-mediated immunity, including trials of clinical efficacy, are gaps that warrant investigation.
Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Adjuvants; Children; Immunogenicity; Inactivated influenza vaccine; Influenza
PMID: 31735505 DOI: 10.1016/j.vaccine.2019.10.053
Patel MM[SUP]1[/SUP], Davis W[SUP]2[/SUP], Beacham L[SUP]2[/SUP], Spencer S[SUP]2[/SUP], Campbell AP[SUP]2[/SUP], Lafond K[SUP]2[/SUP], Rolfes M[SUP]2[/SUP], Levine MZ[SUP]2[/SUP], Azziz-Baumgartner E[SUP]2[/SUP], Thompson MG[SUP]2[/SUP], Fry AM[SUP]2[/SUP].
[h=3]Author information[/h] 1 Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: aul3@cdc.gov. 2 Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Identifying optimal priming strategies for children <2 years could substantially improve the public health benefits of influenza vaccines. Adjuvanted seasonal influenza vaccines were designed to promote a better immune response among young vaccine-na?ve children.
[h=4]METHODS:[/h] We systematically reviewed randomized trials to assess hemagglutination inhibition (HAI) antibody response to MF59-adjuvanted inactivated influenza vaccine (aIIV) versus nonadjuvanted IIV among children. We estimated pooled ratios of post-vaccination HAI geometric mean titer (GMT) for aIIV versus IIV and confidence intervals (CIs) using the pooled variances derived from reported CIs.
[h=4]RESULTS:[/h] Mean age was 28 months (range, 6-72 months). Children received vaccines with either 7.5 μg (6-35 months) or 15 μg (≥36 months) hemagglutinin of each strain depending on age. Seven of eight trials administered trivalent vaccines and one used quadrivalent vaccine. Pooled post-vaccination GMT ratios against the three influenza vaccine strains were 2.5-3.5 fold higher after 2-dose-aIIV versus 2-dose-IIV among children 6-72 months, and point estimates were higher among children 6-35 months compared with older children. When comparing 1-dose-aIIV to 2-dose-IIV doses, pooled GMT ratios were not significantly different against A/H1N1 (1.0; 95% CI: 0.5-1.8; p = 0.90) and A/H3N2 viruses (1.0; 95% CI: 0.7-1.5; p = 0.81) and were significantly lower against B viruses (0.6; 95% CI: 0.4-0.8; p < 0.001) for both age groups. Notably, GMT ratios for vaccine-mismatched heterologous viruses after 2-dose-aIIV compared with 2-dose-IIV were higher against A/H1N1 (2.0; 95% CI: 1.1-3.4), A/H3N2 (2.9; 95% CI: 1.9-4.2), and B-lineage viruses (2.1; 95% CI: 1.8-2.6).
[h=4]CONCLUSIONS:[/h] Two doses of adjuvanted IIV consistently induced better humoral immune responses against Type A and B influenza viruses compared with nonadjuvanted IIVs in young children, particularly among those 6-35 months. One adjuvanted IIV dose had a similar response to two nonadjuvanted IIV doses against Type A influenza viruses. Longer-term benefits from imprinting and cell-mediated immunity, including trials of clinical efficacy, are gaps that warrant investigation.
Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Adjuvants; Children; Immunogenicity; Inactivated influenza vaccine; Influenza
PMID: 31735505 DOI: 10.1016/j.vaccine.2019.10.053