Antibody response to influenza vaccination in the elderly: A quantitative review
Abstract
We performed a quantitative review of 31 vaccine antibody response studies conducted from 1986 to 2002 and compared antibody responses to influenza vaccine in groups of elderly versus younger adults. We did a weighted analysis of the probability of vaccine response (measured as seroconversion and seroprotection) for each vaccine component (H1, H3 and B antigens). Using a multiple regression model, we adjusted for factors that might affect the vaccine response. The adjusted odds-ratio (OR) of responses in elderly versus young adults ranged from 0.24 to 0.59 in terms of seroconversion and seroprotection to all three antigens. The CDC estimates of 70-90% clinical vaccine efficacy in young adults and these estimates suggest a corresponding clinical efficacy in the elderly of 17-53% depending on circulating viruses. We conclude that the antibody response in the elderly is considerably lower than in younger adults. This highlights the need for more immunogenic vaccine formulations for the elderly.
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Ageing is associated with high morbidity and mortality from various infections and with substantially lower vaccine efficacy.
“ageing is associated with high morbidity and mortality rates for various infections and significant reductions in vaccine efficacy1-6”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [2]
The immune system changes with age in nearly every aspect, generally leading to weaker pathogen immunity.
“The immune system changes with age in nearly every aspect, generally resulting in a decline in pathogen immunity with increased age.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [2]
A meta-analysis of more than 30 studies found lower seroconversion and seroprotection odds in elderly versus young adults for influenza vaccine antigens.
“A meta-analysis of more than 30 studies demonstrated unadjusted odds ratios (OR) of 0.48 (95% CI: 0.41–0.55 for H1N1 Ag); 0.63 (0.55–0.73; H3N2 Ag) and 0.38 (0.33–0.44; B Ag) for seroconversion (HAI titer increase 4-fold) and 0.47 (0.40–0.55; H1N1 Ag), 0.53 (0.45–0.63; H2N3 Ag), and 0.58 (0.50–0.67; B Ag) for seroprotection (HAI ≥40) in a comparison of elderly versus young adults [150].”
From Aging of the immune system: Focus on inflammation and vaccination (2016) · cites this paper as [150]
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- Authors
- GOODWIN, K., VIBOUD, C., & SIMONSEN, L.
- Affiliations
- National Institute of Allergy and Infectious Diseases (US)
- National Institutes of Health (US)
- Corresponding author
- SIMONSEN, L
- Venue
- Vaccine
- Publisher
- Elsevier BV
- Published
- 2006-02-20
- Volume
- 24
- Issue
- 8
- Pages
- 1159-1169
- ISSN
- 0264-410X (ISSN-L)
- OpenAlex
- W2095069717
- Cited by
- 1,064
- References
- 54
- Citations by year
- 2026: 29 · 2025: 34 · 2024: 29 · 2023: 45 · 2022: 62 · 2021: 93 · 2020: 57 · 2019: 55 · 2018: 54 · 2017: 66 · 2016: 46 · 2015: 40 · 2014: 58 · 2013: 58 · 2012: 78
- FWCI
- 17.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Vaccine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Keywords
- influenza vaccination, antibody response, older adults, seroconversion, seroprotection, B antigen, vaccine immunogenicity, vaccine efficacy, age differences
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Aging, Antibodies, Viral, Humans, Influenza Vaccines, Middle Aged, Regression Analysis, Vaccination, Multivariate Analysis, Odds Ratio
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