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Repeated vaccination is required to optimise seroprotection against H1N1 in the immunocompromised host

tetano

Editor, Senior Moderator
Haematologica. 2010 Oct 22. [Epub ahead of print]
Repeated vaccination is required to optimise seroprotection against H1N1 in the immunocompromised host.

de Lavallade H, Garland P, Sekine T, Hoschler K, Marin D, Stringaris K, Loucaides E, Howe K, Szydlo R, Kanfer E, McDonald D, Kelleher P, Cooper N, Khoder A, Gabriel I, Milojkovic D, Pavlu J, Goldman JM, Apperley JF, Rezvani K.

Imperial College London, UK;
Abstract

Background. In 2009 the declaration by the WHO of a global pandemic of influenza-H1N1 virus led to a vaccination campaign to ensure protection for immunocompromised patients. The goal of this study was to determine the efficacy of the 2009 H1N1 vaccine in patients with haematological malignancies. Design and Methods. We evaluated humoral and cellular immune responses to 2009 H1N1 vaccine in 97 adults with haematological malignancies compared to 25 adult controls. Patients received two injections of vaccine 21 days apart and controls received one dose. Antibody titres were measured using a haemagglutination-inhibition assay on days 0, 21 and 49 after injection of the first dose. Cellular immune responses to H1N1 were determined on days 0 and 49. Results. By day 21 post-vaccination, protective antibody titres of "d1:32 were seen in 100% of controls compared to 39% of patients with B-cell malignancies (p<0.001), 46% of allogeneic stem cell transplant recipients (allo-SCT, p<0.001) and 85% of chronic myeloid leukaemia (CML) patients (p=0.086). After a second dose, seroprotection rates increased to 68%, (p=0.008), 73%, (p=0.031), and 95% (p=0.5) in patients with B-cell malignancies, after allo-SCT and with CML respectively. On the other hand, T-cell responses to H1N1-vaccine were not significantly different between patients and controls. Conclusions. These data demonstrate the efficacy of H1N1 vaccine in most patients with haematological malignancies and support the recommendation for the administration of 2 vaccine doses in immunocompromised patients. These results may contribute towards the development of evidence-based guidelines for influenza vaccination in such patients in the future.

PMID: 20971824 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/20971824
 
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