Comparable humoral response after two doses of adjuvanted influenza A/H1N1pdm2009 vaccine or natural infection in allogeneic stem cell transplant recipients.

Abstract

BACKGROUND:

The present study evaluated immunogenicity and tolerance of two-dose influenza A/H1N1pdm09 vaccination in allogeneic hematopoietic stem cell transplantation (HSCT) recipients, and compared the vaccine-induced humoral response to that triggered by natural infection in another group of HSCT patients.

METHODS:

Adult allogeneic HSCT recipients vaccinated with two doses of influenza A/H1N1pdm09 vaccine, separated by 3 weeks, and patients with proven influenza A/H1N1pdm09 infection were included. Antibody responses were measured by hemagglutination-inhibition assay 1) on days 0, 21, 42 and 6 months after the first vaccine injection in vaccinated patients and 2) before pandemic and after influenza A/H1N1pdm09 infection, in patients presented natural infection.

RESULTS:

At baseline, 3% of 59 recipients of adjuvanted vaccine and 0% of 20 infected patients were seroprotected (antibody titer≥1/40). Seroprotection rate observed 42 days after vaccination was not different from that observed after natural infection (66% and 60% respectively, p=0.78). In vaccinated patients, seroprotection rate increased significantly from 54% to 66% between day 21 and 42 (p=0.015). Moreover, after 6 months, seroprotection rate in 21 vaccinated patients was similar to that observed in 10 infected patients evaluated at least 76 days after infection (D76-217) (60% and 81% respectively, p=0.2). In multivariate analysis, no immunosuppressive treatment or chronic graft-versus-host disease (GVHD) and longer time between transplantation and vaccination/infection were associated with a stronger humoral response. The adjuvanted vaccine was safe with low rate of GVHD worsening.

CONCLUSION:

In HSCT recipients, two doses of influenza A/H1N1pdm09 adjuvanted vaccine were safe and induced a humoral response comparable to that triggered by natural infection in these patients.

• Authors: Nathalie Dhédin, Anne Krivine, Nicole Le Corre, Alain Mallet, Bruno Lioure, Jacques-Olivier Bay, Marie-Thérèse Rubio, Philippe Agape, Anne Thiébaut, Jérôme Le Goff, Brigitte Autran, Patricia Ribaud
• Journal: Vaccine (Vaccine) Vol. 32 Issue 5 Pg. 585-91 (Jan 23 2014) ISSN: 1873-2518 [Electronic] Netherlands
• PMID: 24333120 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.

Chemical References

• Adjuvants, Immunologic
• Antibodies, Viral
• Influenza Vaccines

Topics

• Adjuvants, Immunologic (administration & dosage)
• Adult
• Aged
• Antibodies, Viral (blood)
• Antibody Formation
• Female
• Graft vs Host Disease
• Hematopoietic Stem Cell Transplantation
• Humans
• Immunization Schedule
• Influenza A Virus, H1N1 Subtype
• Influenza Vaccines (administration & dosage, immunology)
• Influenza, Human (immunology, prevention & control)
• Male
• Middle Aged
• Prospective Studies
• Young Adult