Frailty is associated with impairment of vaccine-induced antibody response and increase in post-vaccination influenza infection in community-dwelling older adults
Open accessAbstract
Annual immunization with a trivalent inactivated vaccine (TIV) is considered efficacious for prevention of seasonal influenza in older adults. However, significant controversy exists in the current literature regarding the clinical effectiveness of TIV immunization in this highly heterogeneous population. Frailty is an important geriatric syndrome characterized by decreased physiologic reserve and increased vulnerability to stressors. Using a validated set of frailty criteria, we conducted a prospective observational study to evaluate TIV-induced strain-specific hemagglutination inhibition (HI) antibody titers and post-vaccination rates of influenza-like illness (ILI) and infection in frail and nonfrail older adults. The results indicate that frailty was associated with significant impairment in TIV-induced strain-specific HI titers and increased rates of ILI and laboratory-confirmed influenza infection. These findings suggest that assessing frailty status in the elderly may identify those who are less likely to respond to TIV immunization and be at higher risk for seasonal influenza and its complications.
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Frailty is linked to weaker antibody responses to influenza and pneumococcal vaccines, which may explain why vaccination benefits older people only modestly.
“Furthermore, frailty is associated with an impaired antibody response to influenza (63) and pneumococcal vaccine (64), which helps explain the observation that vaccination in older people is associated with only relatively modest clinical effectiveness (65).”
From Frailty in elderly people (2013) · cites this paper as [63]
Frailty impacts susceptibility to influenza and responsiveness to influenza vaccine in elderly patients.
“In elderly patients, frailty, a multifactorial syndrome characterized by reduced stress resistance and physiological reserve [151, 152], and associated with increased serum levels of IL-6 [153], has been shown to impact susceptibility to influenza and responsiveness to influenza vaccine [154].”
From Aging of the immune system: Focus on inflammation and vaccination (2016) · cites this paper as [154]
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References 46 · Cited by 189
Research works printed but not linked: 1
- [19]Fried LP Walston J Halter JB Frailty Hazzard’s principles of geriatric medicine and gerontology 2007 6th ed. Anne Arbor McGraw-Hill
- Authors
- Yao, X., Hamilton, R. G., Weng, N.-P., Xue, Q.-L., Bream, J. H., Li, H., Tian, J., Yeh, S.-H., Resnick, B., Xu, X., Walston, J., Fried, L. P., & Leng, S. X.
- Affiliations
- Johns Hopkins University (US)
- National Institute on Aging (US)
- University of Maryland, Baltimore (US)
- Centers for Disease Control and Prevention (US)
- Columbia University (US)
- Corresponding author
- Leng, Sean X.
- ORCID
- Venue
- Vaccine
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 29
- Issue
- 31
- Pages
- 5015-5021
- ISSN
- 0264-410X (ISSN-L)
- PMC
- PMC3129421
- OpenAlex
- W2073120237
- Cited by
- 189
- References
- 46
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 6 · 2023: 13 · 2022: 17 · 2021: 29 · 2020: 20 · 2019: 18 · 2018: 9 · 2017: 8 · 2016: 15 · 2015: 7 · 2014: 9 · 2013: 14 · 2012: 8
- FWCI
- 7.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Vaccine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- John A. Hartford Foundation
- Johns Hopkins University
- Starr Foundation
- National Institutes of Health (5r37ag019905-10)
- National Institute on Aging (R37-AG019905, K23AG028963, P30AG021334)
- National Institute of Allergy and Infectious Diseases (R01AI070594)
- Topics
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Keywords
- frailty, seasonal influenza vaccine, trivalent inactivated vaccine, antibody response, hemagglutination inhibition titers, influenza-like illness, influenza, older adults, vaccine response, geriatric syndromes
- MeSH terms
- Aged, Aged, 80 and over, Antibodies, Viral, Female, Hemagglutination Inhibition Tests, Humans, Influenza, Human, Influenza Vaccines, Male, Prospective Studies, Vaccines, Inactivated, Incidence, Frail Elderly
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