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Cited by 110Influenza Virus Research StudiesBacterial Infections and VaccinesRespiratory viral infections research

Comparative Immunogenicity of Several Enhanced Influenza Vaccine Options for Older Adults: A Randomized, Controlled Trial

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Cowling, Benjamin J, Perera, Ranawaka A P M, Valkenburg, Sophie A, Leung, Nancy H L, Iuliano, A Danielle, Tam, Yat Hung, Wong, Jennifer H F, Fang, Vicky J +12 more·2020·Clinical Infectious Diseases
DOI 10.1093/cid/ciz1034PMC PMC7289658
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Abstract

Background: Enhanced influenza vaccines may improve protection for older adults, but comparative immunogenicity data are limited. Our objective was to examine immune responses to enhanced influenza vaccines, compared to standard-dose vaccines, in community-dwelling older adults. Methods: Community-dwelling older adults aged 65–82 years in Hong Kong were randomly allocated (October 2017–January 2018) to receive 2017–2018 Northern hemisphere formulations of a standard-dose quadrivalent vaccine, MF59-adjuvanted trivalent vaccine, high-dose trivalent vaccine, or recombinant-hemagglutinin (rHA) quadrivalent vaccine. Sera collected from 200 recipients of each vaccine before and at 30-days postvaccination were assessed for antibodies to egg-propagated vaccine strains by hemagglutination inhibition (HAI) and to cell-propagated A/Hong Kong/4801/2014(H3N2) virus by microneutralization (MN). Influenza-specific CD4+ and CD8+ T cell responses were assessed in 20 participants per group. Results: Mean fold rises (MFR) in HAI titers to egg-propagated A(H1N1) and A(H3N2) and the MFR in MN to cell-propagated A(H3N2) were statistically significantly higher in the enhanced vaccine groups, compared to the standard-dose vaccine. The MFR in MN to cell-propagated A(H3N2) was highest among rHA recipients (4.7), followed by high-dose (3.4) and MF59-adjuvanted (2.9) recipients, compared to standard-dose recipients (2.3). Similarly, the ratio of postvaccination MN titers among rHA recipients to cell-propagated A(H3N2) recipients was 2.57-fold higher than the standard-dose vaccine, which was statistically higher than the high-dose (1.33-fold) and MF59-adjuvanted (1.43-fold) recipient ratios. Enhanced vaccines also resulted in the boosting of T-cell responses. Conclusions: In this head-to-head comparison, older adults receiving enhanced vaccines showed improved humoral and cell-mediated immune responses, compared to standard-dose vaccine recipients. Clinical Trials Registration: NCT03330132.

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  • The rate of severe fatigue in BNT162b2 recipients is higher than that observed in recipients of some vaccines recommended for older adults.

    “Severe fatigue was observed in approximately 4% of BNT162b2 recipients, which is higher than that observed in recipients of some vaccines recommended for older adults.12”

    From Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine (2020) · cites this paper as [12]

    The Results section reports local reactions and serious adverse events after influenza vaccination, but gives no rate of severe fatigue. Searches for severe fatigue and systemic reactions found no passage in our copy that supports the comparison with BNT162b2 recipients. (LLM, conf=0.72)

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Authors
Cowling, B. J., Perera, R. A. P. M., Valkenburg, S. A., Leung, N. H. L., Iuliano, A. D., Tam, Y. H., Wong, J. H. F., Fang, V. J., Li, A. P. Y., So, H. C., Ip, D. K. M., Azziz-Baumgartner, E., Fry, A. M., Levine, M. Z., Gangappa, S., Sambhara, S., Barr, I. G., Skowronski, D. M., Peiris, J. S. M., & Thompson, M. G.
Affiliations
  • University of Hong Kong (HK)
  • Centers for Disease Control and Prevention (US)
  • World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
  • Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  • The University of Melbourne (AU)
  • University of British Columbia (CA)
Corresponding author
Cowling, Benjamin J
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2019-12-12
Volume
71
Issue
7
Pages
1704-1714
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/cid/ciz1034
PMC
PMC7289658
OpenAlex
W2994612945
Cited by
110
References
3
Citations by year
2026: 10 · 2025: 12 · 2024: 18 · 2023: 16 · 2022: 22 · 2021: 18 · 2020: 14
FWCI
10.27
Type
journal article
Language
en
Open access
Locations
  • Clinical Infectious Diseases (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
Centers for Disease Control and Prevention (IP001064-02)
Topics
  • Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
Keywords
high-dose influenza vaccine, quadrivalent influenza vaccine, immunogenicity, older adults, humoral immune response, T cell response, hemagglutination inhibition, microneutralization
MeSH terms
Immunogenicity, Vaccine, Adjuvants, Immunologic, Aged, Aged, 80 and over, Antibodies, Viral, Hemagglutination Inhibition Tests, Humans, Influenza, Human, Influenza Vaccines, Squalene, Influenza A Virus, H1N1 Subtype, Influenza A Virus, H3N2 Subtype

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