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Shahri MS, Sadeghi S, Hazegh Fetratjoo D, Hosseini H, Amin Ghobadi M, Afshani SM, Mirhassani R, Gohari K, Havasi F, Abdolghaffari A, Hedayatjoo B, Ghanei M. Immunogenicity and safety evaluation of a newly manufactured recombinant Baculovirus-Expressed quadrivalent influenza vaccine in adults 18 years old and Above: An Open-Label, phase III extension study. Int Immunopharmacol 2024; 136:112214. [PMID: 38823176 DOI: 10.1016/j.intimp.2024.112214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/26/2024] [Accepted: 05/03/2024] [Indexed: 06/03/2024]
Abstract
In the face of global health threats, there is a growing demand for vaccines that can be manufactured on a large scale within compressed timeline. This study responds to this imperative by delving into the evaluation of FluGuard, a novel recombinant influenza vaccine developed by Nivad Pharmed Salamat Company in Iran. Positioned as a phase 3 extension, the research aimed to evaluate the safety and immunogenicity of FluGuard in volunteers aged 18 and above. The study was conducted as a single-center, open-label clinical trial. All eligible volunteers received FluGuard (2021-2022 Formula) on day 0. Safety assessments occurred at days 1, 4, 7, 14, 28 and 42 post-vaccination. Immunogenicity was measured through seroconversion, seroprotection, and geometric mean titer fold increase in subgroups of 250 volunteers. Among the 4,260 volunteers were screened and assessed for eligibility, 1000 were enrolled. At day 28 post-vaccination, seroconversion rates for A/H1N1, A/H3N2, B/Yamagata, B/Victoria were 53.4 % [95 %CI: 46.7-60], 57.7 % [95 %CI: 51.1-64.3], 54.3 % [95 %CI: 47.7-60.9], and 36.2 % [95 %CI: 29.8-42.6], respectively in volunteers 18 years and above. The most common solicited adverse events were pain at the injection site, malaise, and headache. No suspected unexpected adverse events and adverse events of special interest occurred during the study period. Our findings suggested that FluGuard® exhibits a desirable safety profile and provides sufficient immunogenicity against influenza virus types A and B. However, extended studies are warranted to assess the long-term protective efficacy. Trial Registration: The study protocol was accepted by Iranian registry of clinical trial; https://www.irct.ir; IRCT20201104049265N2.
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Affiliation(s)
| | - Setayesh Sadeghi
- Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamed Hosseini
- Clinical Trial Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Reihaneh Mirhassani
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran; Nivad Pharmed Salamat, Biotechnology Research Center, Tehran, Iran
| | - Kimiya Gohari
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Forugh Havasi
- Nivad Pharmed Salamat, Biotechnology Research Center, Tehran, Iran; Department of Chemistry, Faculty of Sciences, University of Kurdistan, Sanandaj, Iran
| | - Amirhossein Abdolghaffari
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Gastrointestinal Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | | | - Mostafa Ghanei
- Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Veroniki AA, Thirugnanasampanthar SS, Konstantinidis M, Dourka J, Ghassemi M, Neupane D, Khan P, Nincic V, Corry M, Robson R, Parker A, Soobiah C, Sinilaite A, Doyon-Plourde P, Gil A, Siu W, Moqueet N, Stevens A, English K, Florez ID, Yepes-Nuñez JJ, Hutton B, Muller M, Moja L, Straus S, Tricco AC. Trivalent and quadrivalent seasonal influenza vaccine in adults aged 60 and older: a systematic review and network meta-analysis. BMJ Evid Based Med 2024; 29:239-254. [PMID: 38604619 PMCID: PMC11287607 DOI: 10.1136/bmjebm-2023-112767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES To compare the efficacy of influenza vaccines of any valency for adults 60 years and older. DESIGN AND SETTING Systematic review with network meta-analysis (NMA) of randomised controlled trials (RCTs). MEDLINE, EMBASE, JBI Evidence-Based Practice (EBP) Database, PsycINFO, and Cochrane Evidence -Based Medicine database were searched from inception to 20 June 20, 2022. Two reviewers screened, abstracted, and appraised articles (Cochrane Risk of Bias (ROB) 2.0 tool) independently. We assessed certainty of findings using Confidence in Network Meta-Analysis and Grading of Recommendations, Assessment, Development and Evaluations approaches. We performed random-effects meta-analysis and network meta-analysis (NMA), and estimated odds ratios (ORs) for dichotomous outcomes and incidence rate ratios (IRRs) for count outcomes along with their corresponding 95% confidence intervals (CIs) and prediction intervals. PARTICIPANTS Older adults (≥60 years old) receiving an influenza vaccine licensed in Canada or the USA (vs placebo, no vaccine, or any other licensed vaccine), at any dose. MAIN OUTCOME MEASURES Laboratory-confirmed influenza (LCI) and influenza-like illness (ILI). Secondary outcomes were the number of vascular adverse events, hospitalisation for acute respiratory infection (ARI) and ILI, inpatient hospitalisation, emergency room (ER) visit for ILI, outpatient visit, and mortality, among others. RESULTS We included 41 RCTs and 15 companion reports comprising 8 vaccine types and 206 032 participants. Vaccines may prevent LCI compared with placebo, with high-dose trivalent inactivated influenza vaccine (IIV3-HD) (NMA: 9 RCTs, 52 202 participants, OR 0.23, 95% confidence interval (CI) (0.11 to 0.51), low certainty of evidence) and recombinant influenza vaccine (RIV) (OR 0.25, 95%CI (0.08 to 0.73), low certainty of evidence) among the most efficacious vaccines. Standard dose trivalent IIV3 (IIV3-SD) may prevent ILI compared with placebo, but the result was imprecise (meta-analysis: 2 RCTs, 854 participants, OR 0.39, 95%CI (0.15 to 1.02), low certainty of evidence). Any HD was associated with prevention of ILI compared with placebo (NMA: 9 RCTs, 65 658 participants, OR 0.38, 95%CI (0.15 to 0.93)). Adjuvanted quadrivalent IIV (IIV4-Adj) may be associated with the least vascular adverse events, but the results were very uncertain (NMA: eight 8 RCTs, 57 677 participants, IRR 0.18, 95%CI (0.07 to 0.43), very low certainty of evidence). RIV on all-cause mortality may be comparable to placebo (NMA: 20 RCTs, 140 577 participants, OR 1.01, 95%CI (0.23 to 4.49), low certainty of evidence). CONCLUSIONS This systematic review demonstrated efficacy associated with IIV3-HD and RIV vaccines in protecting older persons against LCI. RIV vaccine may reduce all-cause mortality when compared with other vaccines, but the evidence is uncertain. Differences in efficacy between influenza vaccines remain uncertain with very low to moderate certainty of evidence. PROSPERO REGISTRATION NUMBER CRD42020177357.
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Affiliation(s)
- Areti Angeliki Veroniki
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Sai Surabi Thirugnanasampanthar
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Menelaos Konstantinidis
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jasmeen Dourka
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Marco Ghassemi
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Dipika Neupane
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Paul Khan
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Vera Nincic
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Margarita Corry
- Trinity College Dublin School of Nursing and Midwifery, Dublin, Ireland
| | - Reid Robson
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Amanda Parker
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Charlene Soobiah
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | | | - Anabel Gil
- Public Health Agency, Ottawa, Ontario, Canada
| | - Winnie Siu
- Public Health Agency, Ottawa, Ontario, Canada
| | | | | | - Kelly English
- Patient Partner, Strategy for Patient Oriented-Research Evidence Alliance (SPOR EA), St Michael's Hospital, Toronto, Ontario, Canada
| | - Ivan D Florez
- Department of Pediatrics, University of Antioquia Faculty of Medicine, Medellin, Colombia
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- Pediatric Intensive Care Unit, Clinica Las Américas-AUNA, Medellin, Colombia
| | - Juan J Yepes-Nuñez
- University of los Andes Faculty of Medicine, Bogota, Cundinamarca, Colombia
- Pulmonology Service, Internal Medicine Section, University Hospital of the Fundacion Santa Fe de Bogota, Bogota, Colombia
| | - Brian Hutton
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Matthew Muller
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Lorenzo Moja
- Department of Biomedical Sciences and Technologies, University of Milan, Milano, Lombardia, Italy
| | - Sharon Straus
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Andrea C Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Epidemiology Division & Institute of Health Policy, Management, and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
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Garg N, Tellier G, Vale N, Kluge J, Portman JL, Markowska A, Tussey L. Phase 1, randomized, rater and participant blinded placebo-controlled study of the safety, reactogenicity, tolerability and immunogenicity of H1N1 influenza vaccine delivered by VX-103 (a MIMIX microneedle patch [MAP] system) in healthy adults. PLoS One 2024; 19:e0303450. [PMID: 38843267 PMCID: PMC11156369 DOI: 10.1371/journal.pone.0303450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/19/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The MIMIX platform is a novel microneedle array patch (MAP) characterized by slowly dissolving microneedle tips that deploy into the dermis following patch application. We describe safety, reactogenicity, tolerability and immunogenicity for MIMIX MAP vaccination against influenza. METHODOLOGY The trial was a Phase 1, exploratory, first-in-human, parallel randomized, rater, participant, study analyst-blinded, placebo-controlled study in Canada. Forty-five healthy participants (18 to 39 years of age, inclusive) were randomized in a 1:1:1 ratio to receive either 15 μg or 7.5 μg of an H1N1 influenza vaccine, or placebo delivered via MIMIX MAP to the volar forearm. A statistician used a computer program to create a randomization scheme with a block size of 3. Post-treatment follow-up was approximately 180 days. Primary safety outcomes included the incidence of study product related serious adverse events and unsolicited events within 180 days, solicited application site and systemic reactogenicity through 7 days after administration and solicited application site erythema and/or pigmentation 14, 28, 56 and 180 days after administration. Immunogenicity outcomes included antibody titers and percentage of seroconversion (SCR) and seroprotection (SPR) rates determined by the hemagglutination inhibition (HAI) assay. Exploratory outcomes included virus microneutralization (MN) titers, durability and breadth of the immune response. The trial was registered with ClinicalTrials.gov, number NCT06125717. FINDINGS Between July 7, 2022 and March 13, 2023 45 participants were randomized to a treatment group. One participant was lost to follow up in the 15 μg group and 1 participant withdrew from the 7.5 μg dose group. Safety analyses included n = 15 per group, immunogenicity analyses included n = 14 for the 15 μg and 7.5 μg treatment groups and n = 15 for the placebo group. No SAEs were reported in any of the treatment groups. All treatment groups reported solicited local events within 7 days after vaccination, with mild (Grade 1) erythema being the most frequent symptom reported. Other local symptoms reported included mostly mild (Grade 1) induration/swelling, itching, pigmentation, skin flaking, and tenderness. Within 7 days after vaccination, 2 participants (4.4%) reported moderate (Grade 2) erythema, 1 participant (2.2%) reported moderate (Grade 2) induration/swelling, and 1 participant (2.2%) reported moderate (Grade 2) itching. There was an overall reduction in erythema and pigmentation reported on Days 15, 29, 57, and 180 among all treatment groups. Systemic symptoms reported within 7 days after vaccination, included mild (Grade 1) fatigue reported among all treatment groups, and mild (Grade 1) headache reported by 1 participant in the 7.5 μg treatment group. No study drug related severe symptoms were reported in the study. Group mean fold rises in HAI titers ranged between 8.7 and 12-fold, SCRs were >76% and SPRs were >92% for both VX-103 dose groups thereby fulfilling serological criteria established by the EMA and FDA for seasonal influenza vaccines. Longitudinal assessments demonstrate persistence of the immune response through at least Day 180. CONCLUSIONS The MIMIX MAP platform is safe, well tolerated and elicits robust antibody responses.
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Affiliation(s)
- Naveen Garg
- Centricity Research-Montreal, Point-Claire, Québec, Canada
| | - Guy Tellier
- Centricity Research-Mirabel, Mirabel, Québec, Canada
| | - Noah Vale
- Centricity Research-Toronto, Toronto, Ontario, Canada
| | - Jon Kluge
- Research and Development, Vaxess Technologies, Cambridge, Massachusetts, United States of America
| | - Jonathan L. Portman
- Research and Development, Vaxess Technologies, Cambridge, Massachusetts, United States of America
| | - Anna Markowska
- Research and Development, Vaxess Technologies, Cambridge, Massachusetts, United States of America
| | - Lynda Tussey
- Development and MAP Production, Vaxess Technologies, Woburn, Massachusetts, United States of America
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Kiely M, Tadount F, Lo E, Sadarangani M, Wei SQ, Rafferty E, Quach C, MacDonald SE. Sex differences in adverse events following seasonal influenza vaccines: a meta-analysis of randomised controlled trials. J Epidemiol Community Health 2023; 77:791-801. [PMID: 37734937 PMCID: PMC10646905 DOI: 10.1136/jech-2023-220781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/20/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Despite being a vaccine-preventable disease, influenza remains a major public health threat with vaccine safety concerns reducing vaccine acceptability. Immune responses to vaccines and adverse events may differ between males and females, but most studies do not report results by sex. Using data from clinical trials, we explored sex differences in adverse events following seasonal influenza vaccines. METHODS We obtained data for phase III randomised controlled trials identified through a systematic review and clinical trials registries, and performed a two-stage meta-analysis. Risk ratios (RR) and 95% confidence intervals (95% CI) comparing solicited reactions in females versus males were pooled using the Mantel-Haenszel method and a random-effects model. We used the ROBINS-I tool to assess risk of bias and the I2 statistic for heterogeneity. Main analysis was stratified by age: 18-64 years and ≥65 years. RESULTS The dataset for this analysis included 34 343 adults from 18 studies (12 with individual-level data and 6 with aggregate data). There was a higher risk of injection site reactions in females compared with males for both younger and older participants, with RRs of 1.29 (95% CI 1.21 to 1.37) and 1.43 (95% CI 1.28 to 1.60), respectively. Higher risk in females was also observed for systemic reactions, with RRs of 1.25 (95% CI 1.20 to 1.31) and 1.27 (95% CI 1.20 to 1.34) for younger and older participants, respectively. We also observed elevated risks of severe reactions in females, with a higher RR in younger versus older participants for systemic reactions (RRs 2.12 and 1.48, p=0.03, I2=79.7%). RRs were not found to vary between quadrivalent and trivalent vaccines. CONCLUSION This meta-analysis suggested a higher risk of solicited reactions following influenza vaccines for females compared with males, irrespective of age and vaccine type. Transparent communication of this risk could increase the trust in vaccines and limit vaccine hesitancy. Future studies should report results stratified by sex and explore the role of gender in the occurrence of adverse events.
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Affiliation(s)
- Marilou Kiely
- Department of Microbiology, Infectiology, immunology & Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - Fazia Tadount
- Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
| | - Ernest Lo
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Institut national de santé publique du Québec, Quebec, Quebec, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Department of Pediatrics, University if British Columbia, Vancouver, British Columbia, Canada
| | - Shu Qin Wei
- Institut national de santé publique du Québec, Quebec, Quebec, Canada
| | | | - Caroline Quach
- Department of Microbiology, Infectiology, immunology & Pediatrics, University of Montreal, Montreal, Quebec, Canada
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Ramsay JA, Jones M, Vande More AM, Hunt SL, Williams PCM, Messer M, Wood N, Macartney K, Lee FJ, Britton WJ, Snelling TL, Caterson ID. A single blinded, phase IV, adaptive randomised control trial to evaluate the safety of coadministration of seasonal influenza and COVID-19 vaccines (The FluVID study). Vaccine 2023; 41:7250-7258. [PMID: 37903680 DOI: 10.1016/j.vaccine.2023.10.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 11/01/2023]
Abstract
OBJECTIVES We evaluated the frequency of moderate and severe adverse events following coadministration of seasonal influenza vaccine (SIV) versus placebo with COVID-19 vaccines among adults to support practice guidelines. METHODS FluVID is a participant-blinded, phase IV, randomised control trial. On the same day as the participant's scheduled COVID-19 vaccine, participants were randomised to receive SIV or saline placebo; those assigned placebo at visit one then received SIV a week later, and vice versa. Self-reported adverse events were collected daily for seven days following each visit. The primary endpoint was any solicited adverse event of at least moderate severity occurring up to seven days following receipt of SIV or placebo. This was modelled using a Bayesian logistic regression model. Analyses were performed by COVID-19 vaccine type and dose number. RESULTS Overall, 248 participants were enrolled; of these, 195 had received BNT162b2 and 53 had received mRNA1273 COVID-19 vaccines according to national guidelines. After randomisation, 119 were assigned to receive SIV and 129 were assigned to receive placebo at visit one. Adverse events were most frequently reported as mild (grade 1) in nature. Among 142 BNT162b2 booster dose one and 43 BNT162b2 booster dose two recipients, the posterior median risk difference for moderate/severe adverse events following SIV versus placebo was 13% (95% credible interval [CrI] -0.03 to 0.27) and 13% (95%CrI -0.37 to 0.12), respectively. Among 18 mRNA1273 booster dose one and 35 mRNA1273 booster dose two recipients, the posterior median risk difference of moderate/severe adverse events following influenza vaccine versus placebo was 6% (95%CrI -0.29 to 0.41) and -4% (95%CrI -0.30 to 0.23), respectively. CONCLUSION Adverse events following SIV and COVID-19 co-administration were generally mild and occurred with similar frequency to events following COVID-19 vaccine alone. We found no evidence to justify routine separation of SIV and COVID-19 vaccine doses. CLINICAL TRIAL REGISTRATION ACTRN12621001063808.
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Affiliation(s)
- J A Ramsay
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA 6009, Australia; School of Public Health, University of Sydney, NSW 2006, Australia.
| | - M Jones
- School of Public Health, University of Sydney, NSW 2006, Australia
| | - A M Vande More
- Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - S L Hunt
- Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - P C M Williams
- School of Public Health, University of Sydney, NSW 2006, Australia; Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia; National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia
| | - M Messer
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - N Wood
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, NSW 2006, Australia
| | - K Macartney
- National Centre for Immunisation Research and Surveillance, Westmead, NSW 2145, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, NSW 2006, Australia
| | - F J Lee
- Department of Clinical Immunology & Allergy, Royal Prince Alfred Hospital. Camperdown 2050, NSW, Australia; Sydney Medical School, University of Sydney, 2006 NSW, Australia
| | - W J Britton
- Department of Clinical Immunology & Allergy, Royal Prince Alfred Hospital. Camperdown 2050, NSW, Australia; Centenary Institute, University of Sydney, 2006 NSW, Australia
| | - T L Snelling
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA 6009, Australia; School of Public Health, University of Sydney, NSW 2006, Australia
| | - I D Caterson
- Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, 2050 NSW, Australia; The Boden Initiative, Charles Perkins Centre, University of Sydney, 2006 NSW, Australia
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Cocores AN, Goadsby PJ, Monteith TS. Post-vaccination headache reporting: Trends according to the Vaccine Adverse Events Reporting System. Headache 2023; 63:275-282. [PMID: 36651626 DOI: 10.1111/head.14458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To assess the characteristics and associated disability of headache as an adverse event following vaccination. BACKGROUND According to clinical trials and post-licensure surveillance, headache is a common symptom of vaccines, yet systematic investigations of post-licensure reports of this adverse event are lacking. METHODS This was a retrospective database analysis study. We searched the Vaccine Adverse Events Reporting System (VAERS) database completed from July 1990 to June 2020 (a 30-year period prior to the start of COVID-19 pandemic) to identify reports of headache. We evaluated epidemiological features, including event characteristics, patient demographics, and vaccine type. RESULTS In those aged 3 years or older, headache was the fifth most reported adverse symptom, present in 8.1% (43,218/536,120) of all reports. Of headache reports, 96.3% (41,635/43,218) included the code "headache" not further specified. Migraine was coded in 1973 cases, although almost one-third (12,467/41,808; 29.8%) of headache reports without a migraine code mention nausea or vomiting. The onset of symptoms was within 1 day of vaccination in over two-thirds of cases. The majority of reports were classified as not serious; about one-third involved emergency room or office visits. Of the 43,218 total headache reports, only a minority involved hospitalizations (2624; 6.1%) or permanent disability (1091; 2.5%), females accounted for 68.9% (29,771) and males for 29.5% (12,725), patients aged 6 to 59 years represented 67.3% (29,112), and over one-third of cases were reported after herpes zoster (8665; 20.1%) and influenza (6748; 15.6%) vaccinations. CONCLUSION In a national surveillance system, headache was a commonly reported post-vaccination adverse event; a small subset of reports was considered serious. The development of standardized vaccine-related case definitions could be useful for better evaluating headache as an adverse event during vaccine development, and may reduce vaccine hesitancy especially in headache-prone individuals.
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Affiliation(s)
- Alexandra N Cocores
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Peter J Goadsby
- NIHR King's Clinical Research Facility & Headache Group-Wolfson CARD, King's College London, London, UK.,Department of Neurology, University of California, Los Angeles, Los Angeles, California, USA
| | - Teshamae S Monteith
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
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Liu X, Park J, Xia S, Liang B, Yang S, Wang Y, Syrkina O, Lavis N, Liu S, Zhao C, Ding J, Hu J, Samson SI, de Bruijn IA, Li X, Liu Q, Luo H, Lv Q, Su M, Xie Z, Xia H, You W, Zhang W, Zheng Y, Zhu G, Zhang Z, Zhang H, Abalos K, Beyer YJ, Zhang M, Moreau C, Deng C, Salamand C, Tabar C, Ao R, Mallett Moore T, Jouve A, Frago C, A R, Jean Baria E, Camille S, Cao X, Cathcart D, Chabanon AL, Chen N, Feng H, Fontvieille AI, Hagenbach A, He H, Inamdar A, Janosczyk H, Lau A, Petit C, Philippe W, See S, Serradell-Vallejo L, Tourault A, Wu S, Yan M, Yue C, Zhang X, Zhang H, Zhu Y, Li J, Mao H, Yang H, Yang Y, Yi X, Du Z, Guo L, Wang K. Immunological non-inferiority and safety of a quadrivalent inactivated influenza vaccine versus two trivalent inactivated influenza vaccines in China: Results from two studies. Hum Vaccin Immunother 2022; 18:2132798. [PMID: 36328438 DOI: 10.1080/21645515.2022.2132798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
WHO UNIVERSAL TRIAL NUMBERS (UTNS) U1111-1174-4615 and U1111-1174-4698. CLINICALTRIALS.GOV NCT04210349 and NCT03430089.
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Affiliation(s)
- Xiaoqiang Liu
- Vaccine Clinical Research Center, Yunnan Provincial Center for Disease Control and Prevention, Kunming City, Yunnan, China
| | - Juliana Park
- Global Clinical Development, Sanofi, Sydney, Australia
| | - Shengli Xia
- Institute for Communicable Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou City, Henan, China
| | - Bin Liang
- China Medical, Sanofi, Beijing, China
| | - Shuangmin Yang
- Vaccine Clinical Research Center, Yunnan Provincial Center for Disease Control and Prevention, Kunming City, Yunnan, China
| | - Yanxia Wang
- Institute for Communicable Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou City, Henan, China
| | - Olga Syrkina
- Global Pharmacovigilance, Sanofi, Swiftwater, Pennsylvania, USA
| | | | - Shuzhen Liu
- Department of Respiratory Virus Vaccine, National Institutes for Food and Drug Control, Beijing, China
| | - Chenyan Zhao
- Department of Respiratory Virus Vaccine, National Institutes for Food and Drug Control, Beijing, China
| | - Jian Ding
- China Medical, Sanofi, Beijing, China
| | - Jieqiong Hu
- Global Clinical Development, Sanofi, Sydney, Australia
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Mannocci A, Pellacchia A, Millevolte R, Chiavarini M, de Waure C. Quadrivalent Vaccines for the Immunization of Adults against Influenza: A Systematic Review of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9425. [PMID: 35954781 PMCID: PMC9368426 DOI: 10.3390/ijerph19159425] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/10/2022]
Abstract
Vaccination is the most effective intervention to prevent influenza. Adults at risk of complications are among the targets of the vaccination campaigns and can be vaccinated with different types of quadrivalent influenza vaccines (QIVs). In the light of assessing the relative immunogenicity and efficacy of different QIVs, a systematic review was performed. Randomized controlled trials conducted in adults aged 18-64 years until 30 March 2021 were searched through three databases (Medline, Cochrane Library and Scopus). Twenty-four RCTs were eventually included. After data extraction, a network meta-analysis was not applicable due to the lack of common comparators. However, in the presence of at least two studies, single meta-analyses were performed to evaluate immunogenicity and efficacy; on the contrary, data from single studies were considered. Seroconversion rate for H1N1 was higher for standard QIVs, while for the remaining strains it was higher for low-dose adjuvanted QIVs. For seroprotection rate, the recombinant vaccine recorded the highest values for H3N2, while for the other strains, the cell-based QIVs achieved better results. In general, standard and cell-based QIVs showed an overall good immunogenicity profile. Nevertheless, as a relative comparative analysis was not possible, further research would be deserved.
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Affiliation(s)
- Alice Mannocci
- Faculty of Economics, Universitas Mercatorum, 00186 Rome, Italy;
| | - Andrea Pellacchia
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (R.M.); (M.C.); (C.d.W.)
| | - Rossella Millevolte
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (R.M.); (M.C.); (C.d.W.)
| | - Manuela Chiavarini
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (R.M.); (M.C.); (C.d.W.)
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, 06132 Perugia, Italy; (R.M.); (M.C.); (C.d.W.)
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9
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Villanueva P, Wadia U, Crawford NW, Messina NL, Kollmann TR, Lucas M, Manning L, Richmond P, Pittet LF, Curtis N. The safety of co-administration of Bacille Calmette-Guérin (BCG) and influenza vaccines. PLoS One 2022; 17:e0268042. [PMID: 35657850 PMCID: PMC9165819 DOI: 10.1371/journal.pone.0268042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/19/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND With the emergence of novel vaccines and new applications for older vaccines, co-administration is increasingly likely. The immunomodulatory effects of BCG could theoretically alter the reactogenicity of co-administered vaccines. Using active surveillance in a randomised controlled trial, we aimed to determine whether co-administration of BCG vaccination changes the safety profile of influenza vaccination. METHODS Participants who received influenza vaccine alone (Influenza group) were compared with those who also received BCG-Denmark vaccine in the contralateral arm (Influenza+BCG group). Data on the influenza vaccination site were collected using serial questionnaires and active follow-up for 3 months post vaccination. RESULTS Of 1351 participants in the Influenza+BCG group and 1418 participants in the Influenza group, 2615 (94%) provided influenza vaccine safety data. There was no significant difference in the proportion of participants with any local adverse reaction between the Influenza+BCG group and the Influenza group (918/1293 [71.0%] versus (906/1322 [68.5%], p = 0.17). The proportion of participants reporting any pain, erythema and tenderness at the influenza vaccination site were similar in both groups. Swelling was less frequent (81/1293 [6.3%] versus 119/1322 (9.0%), p = 0.01) and the maximal diameter of erythema was smaller (mean 1.8 cm [SD 2.0] versus 3.0 cm [SD 2.5], p<0.001) in the Influenza+BCG group. Sixteen participants reported serious adverse events: 9 participants in the Influenza+BCG group and 7 in the Influenza group. CONCLUSIONS Adverse events following influenza vaccination are not increased when BCG is co-administered.
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Affiliation(s)
- Paola Villanueva
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
- Department of General Medicine, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Ushma Wadia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Nigel W. Crawford
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of General Medicine, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
- Immunisation Service, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Nicole L. Messina
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
| | - Tobias R. Kollmann
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Michaela Lucas
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Department of Immunology, Sir Charles Gairdner Hospital, Perth, WA, Australia
- Departments of Immunology and General Paediatrics, Perth Children’s Hospital, Perth, WA, Australia
- Department of Immunology, Pathwest, QE2 Medical Centre, Perth, WA, Australia
| | - Laurens Manning
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Department of Infectious Diseases, Fiona Stanley Hospital, Perth, WA, Australia
| | - Peter Richmond
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- School of Medicine, University of Western Australia, Perth, WA, Australia
- Departments of Immunology and General Paediatrics, Perth Children’s Hospital, Perth, WA, Australia
| | - Laure F. Pittet
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
| | - Nigel Curtis
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Infection and Immunity, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Infectious Diseases, Royal Children’s Hospital Melbourne, Parkville, VIC, Australia
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10
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Castaldo M, Waliszewska-Prosół M, Koutsokera M, Robotti M, Straburzyński M, Apostolakopoulou L, Capizzi M, Çibuku O, Ambat FDF, Frattale I, Gadzhieva Z, Gallo E, Gryglas-Dworak A, Halili G, Jusupova A, Koperskaya Y, Leheste AR, Manzo ML, Marcinnò A, Marino A, Mikulenka P, Ong BE, Polat B, Popovic Z, Rivera-Mancilla E, Roceanu AM, Rollo E, Romozzi M, Ruscitto C, Scotto di Clemente F, Strauss S, Taranta V, Terhart M, Tychenko I, Vigneri S, Misiak B, Martelletti P, Raggi A. Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis. J Headache Pain 2022; 23:41. [PMID: 35361131 PMCID: PMC8969402 DOI: 10.1186/s10194-022-01400-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/05/2022] [Indexed: 12/15/2022] Open
Abstract
Background Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are used to reduce the risk of developing Coronavirus Disease 2019 (COVID-19). Despite the significant benefits in terms of reduced risk of hospitalization and death, different adverse events may present after vaccination: among them, headache is one of the most common, but nowadays there is no summary presentation of its incidence and no description of its main features. Methods We searched PubMed and EMBASE covering the period between January 1st 2020 and August 6th, 2021, looking for record in English and with an abstract and using three main search terms (with specific variations): COVID-19/SARS-CoV-2; Vaccination; headache/adverse events. We selected manuscript including information on subjects developing headache after injection, and such information had to be derived from a structured form (i.e. no free reporting). Pooled estimates and 95% confidence intervals were calculated. Analyses were carried out by vaccine vs. placebo, by first vs. second dose, and by mRNA-based vs. “traditional” vaccines; finally, we addressed the impact of age and gender on post-vaccine headache onset. Results Out of 9338 records, 84 papers were included in the review, accounting for 1.57 million participants, 94% of whom received BNT162b2 or ChAdOx1. Headache was generally the third most common AE: it was detected in 22% (95% CI 18–27%) of subjects after the first dose of vaccine and in 29% (95% CI 23–35%) after the second, with an extreme heterogeneity. Those receiving placebo reported headache in 10–12% of cases. No differences were detected across different vaccines or by mRNA-based vs. “traditional” ones. None of the studies reported information on headache features. A lower prevalence of headache after the first injection of BNT162b2 among older participants was shown. Conclusions Our results show that vaccines are associated to a two-fold risk of developing headache within 7 days from injection, and the lack of difference between vaccine types enable to hypothesize that headache is secondary to systemic immunological reaction than to a vaccine-type specific reaction. Some descriptions report onset within the first 24 h and that in around one-third of the cases, headache has migraine-like features with pulsating quality, phono and photophobia; in 40–60% of the cases aggravation with activity is observed. The majority of patients used some medication to treat headache, the one perceived as the most effective being acetylsalicylic acid. Supplementary Information The online version contains supplementary material available at 10.1186/s10194-022-01400-4.
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11
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OUP accepted manuscript. Lab Med 2022; 53:602-608. [DOI: 10.1093/labmed/lmac035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Ekizoglu E, Gezegen H, Yalınay Dikmen P, Orhan EK, Ertaş M, Baykan B. The characteristics of COVID-19 vaccine-related headache: Clues gathered from the healthcare personnel in the pandemic. Cephalalgia 2021; 42:366-375. [PMID: 34510919 PMCID: PMC8988457 DOI: 10.1177/03331024211042390] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction Headache is a frequent adverse event after viral vaccines. We aimed to investigate the frequency and clinical associations of COVID-19 vaccine-related headache. Methods The characteristics, associations of this headache, main comorbidities, headache history following the influenza vaccine and during COVID-19 were investigated using a web-based questionnaire. Results A total of 1819 healthcare personnel (mean age: 44.4 ± 13.4 years, 1222 females), vaccinated with inactivated virus, contributed to the survey; 209 (11.4%) had been infected with COVID-19. A total of 556 participants (30.6%) reported headache with significant female dominance (36.1% vs. 19.3%), 1.8 ± 3.5 (median: 1; IQR: 0–2) days following vaccination. One hundred and forty-four participants (25.9%) experienced headache lasting ≥3 days. Headache was mostly bilateral without accompanying phenomena, less severe, and shorter than COVID-19-related headache. The presence of primary headaches and migraine were significantly associated with COVID-19 vaccine-related headache (ORs = 2.16 [95% CI 1.74–2.68] and 1.65 [1.24–2.19], respectively). Headache during COVID-19 or following influenza vaccine also showed significant association with headache following COVID-19 vaccine (OR = 4.3 [95% CI 1.82–10.2] and OR = 4.84 [95% CI 2.84–8.23], respectively). Only thyroid diseases showed a significant association (OR = 1.54 [95% CI 1.15–2.08]) with vaccine-related headache among the common comorbidities. Conclusion Headache is observed in 30.6% of the healthcare workers following COVID-19 vaccine and mostly experienced by females with pre-existing primary headaches, thyroid disorders, headache during COVID-19, or headache related to the influenza vaccine.
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Affiliation(s)
- Esme Ekizoglu
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
| | - Haşim Gezegen
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
| | - Pınar Yalınay Dikmen
- Acıbadem Mehmet Ali Aydınlar University School of Medicine, Department of Neurology, Istanbul, Turkey
| | - Elif Kocasoy Orhan
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
| | - Mustafa Ertaş
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
| | - Betül Baykan
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 37516Istanbul University, Istanbul, Turkey
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13
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Friedman MA, Curtis JR, Winthrop KL. Impact of disease-modifying antirheumatic drugs on vaccine immunogenicity in patients with inflammatory rheumatic and musculoskeletal diseases. Ann Rheum Dis 2021; 80:1255-1265. [PMID: 34493491 DOI: 10.1136/annrheumdis-2021-221244] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/25/2021] [Indexed: 12/14/2022]
Abstract
Patients with rheumatic diseases are at increased risk of infectious complications; vaccinations are a critical component of their care. Disease-modifying antirheumatic drugs may reduce the immunogenicity of common vaccines. We will review here available data regarding the effect of these medications on influenza, pneumococcal, herpes zoster, SARS-CoV-2, hepatitis B, human papilloma virus and yellow fever vaccines. Rituximab has the most substantial impact on vaccine immunogenicity, which is most profound when vaccinations are given at shorter intervals after rituximab dosing. Methotrexate has less substantial effect but appears to adversely impact most vaccine immunogenicity. Abatacept likely decrease vaccine immunogenicity, although these studies are limited by the lack of adequate control groups. Janus kinase and tumour necrosis factor inhibitors decrease absolute antibody titres for many vaccines, but do not seem to significantly impact the proportions of patients achieving seroprotection. Other biologics (interleukin-6R (IL-6R), IL-12/IL-23 and IL-17 inhibitors) have little observed impact on vaccine immunogenicity. Data regarding the effect of these medications on the SARS-CoV-2 vaccine immunogenicity are just now emerging, and early glimpses appear similar to our experience with other vaccines. In this review, we summarise the most recent data regarding vaccine response and efficacy in this setting, particularly in light of current vaccination recommendations for immunocompromised patients.
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Affiliation(s)
| | - Jeffrey R Curtis
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham Department of Medicine, Birmingham, Alabama, USA
| | - Kevin L Winthrop
- Medicine, Oregon Health & Science University, Portland, Oregon, USA.,School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
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14
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Fan R, Huang X, Nian X, Ou Z, Zhou J, Zhang J, Zeng P, Zhao W, Deng J, Chen W, Chen S, Duan K, Chen Y, Li X, Zhang J, Yang X. Safety and immunogenicity of a quadrivalent influenza vaccine in adults aged 60 years or above: a phase III randomized controlled clinical study. Hum Vaccin Immunother 2021; 18:1-9. [PMID: 34473607 PMCID: PMC8920214 DOI: 10.1080/21645515.2021.1967041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
To control seasonal influenza epidemics in elders, a quadrivalent, inactivated, split-virion influenza vaccine (IIV4) comprising A and B lineages is produced for young individuals and adults aged ≥60 years. In this phase III, randomized, double-blind, active-controlled trial, we compared safety and immunogenicity of IIV4 with a licensed quadrivalent inactivated vaccine (IIV4-HL) produced by Hualan Biological Engineering during the 2019 influenza season. Participants were randomly assigned to receive IIV4 (n = 959) or IIV4-HL (n = 959). Compared to IIV4-HL, geometric mean titers (GMT) of hemagglutination inhibition (HAI) titers and seroconversion rate (SCR) of IIV4 demonstrated better antibody responses in A lineages (H1N1 and H3N2) (P < .01) and equivalent antibody responses in B lineages (B/Yamagata and B/Victoria) (P > .01) in both age groups. After immunization, IIV4 provided a satisfactory SCR and seroprotection rate (SPR) in elders. No discernible variation in immunogenicity was observed between the two age cohorts. In both age groups, IIV4 and IIV4-HL recipients experienced similar levels of solicited and unsolicited adverse events (AEs), and the incidence of AEs was low in both vaccine groups. Most AEs were of mild-to-moderate severity and no grade 3 AEs in IIV4 group, but AEs in adults aged 60–65 were little higher than in adults over 65 years in IIV4 and IIV4-HL groups (IIV4: 14.66% vs. 10.36%; IIV4-HL:14.67% vs. 11.43%). Totally, IIV4 was generally well tolerated and induced high antibody titers against all four influenza strains in elderly, making it a compelling alternative for the elderly aged ≥60 years. Trial registration: Clinical Trials.gov: 2015L00649-2.
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Affiliation(s)
- Renfeng Fan
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Xiaoyuan Huang
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Xuanxuan Nian
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Zhiqiang Ou
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Jian Zhou
- Gaozhou Center for Disease Control and Prevention, Gaozhou, China
| | - Jiayou Zhang
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Peiyu Zeng
- Gaozhou Center for Disease Control and Prevention, Gaozhou, China
| | - Wei Zhao
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Jinglong Deng
- Gaozhou Center for Disease Control and Prevention, Gaozhou, China
| | - Wei Chen
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Shaomin Chen
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Kai Duan
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Yingshi Chen
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Xinguo Li
- Wuhan Institute of Biological Products Co. Ltd, Wuhan, China.,National Engineering Technology Research Center of Combined Vaccines, Wuhan, China
| | - Jikai Zhang
- Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, China
| | - Xiaoming Yang
- National Engineering Technology Research Center of Combined Vaccines, Wuhan, China.,China National Biotec Group Company Limited, Beijing, China
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15
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Del Rosario JMM, da Costa KAS, Asbach B, Ferrara F, Ferrari M, Wells DA, Mann GS, Ameh VO, Sabeta CT, Banyard AC, Kinsley R, Scott SD, Wagner R, Heeney JL, Carnell GW, Temperton NJ. Exploiting Pan Influenza A and Pan Influenza B Pseudotype Libraries for Efficient Vaccine Antigen Selection. Vaccines (Basel) 2021; 9:741. [PMID: 34358157 PMCID: PMC8310092 DOI: 10.3390/vaccines9070741] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/09/2021] [Accepted: 06/21/2021] [Indexed: 12/15/2022] Open
Abstract
We developed an influenza hemagglutinin (HA) pseudotype library encompassing Influenza A subtypes HA1-18 and Influenza B subtypes (both lineages) to be employed in influenza pseudotype microneutralization (pMN) assays. The pMN is highly sensitive and specific for detecting virus-specific neutralizing antibodies against influenza viruses and can be used to assess antibody functionality in vitro. Here we show the production of these viral HA pseudotypes and their employment as substitutes for wildtype viruses in influenza neutralization assays. We demonstrate their utility in detecting serum responses to vaccination with the ability to evaluate cross-subtype neutralizing responses elicited by specific vaccinating antigens. Our findings may inform further preclinical studies involving immunization dosing regimens in mice and may help in the creation and selection of better antigens for vaccine design. These HA pseudotypes can be harnessed to meet strategic objectives that contribute to the strengthening of global influenza surveillance, expansion of seasonal influenza prevention and control policies, and strengthening pandemic preparedness and response.
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Affiliation(s)
- Joanne Marie M. Del Rosario
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham ME4 4BF, UK; (J.M.M.D.R.); (K.A.S.d.C.); (F.F.); (G.S.M.); (S.D.S.)
- Department of Physical Sciences and Mathematics, College of Arts and Sciences, University of the Philippines Manila, Manila 1000, Philippines
- DIOSynVax, Cambridge CB3 0ES, UK; (M.F.); (D.A.W.); (R.K.); (J.L.H.); (G.W.C.)
| | - Kelly A. S. da Costa
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham ME4 4BF, UK; (J.M.M.D.R.); (K.A.S.d.C.); (F.F.); (G.S.M.); (S.D.S.)
| | - Benedikt Asbach
- Institute of Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany; (B.A.); (R.W.)
| | - Francesca Ferrara
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham ME4 4BF, UK; (J.M.M.D.R.); (K.A.S.d.C.); (F.F.); (G.S.M.); (S.D.S.)
- Vector Development and Production Laboratory, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Matteo Ferrari
- DIOSynVax, Cambridge CB3 0ES, UK; (M.F.); (D.A.W.); (R.K.); (J.L.H.); (G.W.C.)
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - David A. Wells
- DIOSynVax, Cambridge CB3 0ES, UK; (M.F.); (D.A.W.); (R.K.); (J.L.H.); (G.W.C.)
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Gurdip Singh Mann
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham ME4 4BF, UK; (J.M.M.D.R.); (K.A.S.d.C.); (F.F.); (G.S.M.); (S.D.S.)
| | - Veronica O. Ameh
- Department of Veterinary Public Health and Preventive Medicine, College of Veterinary Medicine, Federal University of Agriculture Makurdi, Makurdi P.M.B. 2373, Bene State, Nigeria;
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, P. Bag X04, Onderstepoort 0110, South Africa;
| | - Claude T. Sabeta
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, P. Bag X04, Onderstepoort 0110, South Africa;
- OIE Rabies Reference Laboratory, Agricultural Research Council-Onderstepoort Veterinary Research, Onderstepoort 0110, South Africa
| | - Ashley C. Banyard
- Animal and Plant Health Agency (APHA), Department of Virology, Weybridge, Surrey KT15 3NB, UK;
| | - Rebecca Kinsley
- DIOSynVax, Cambridge CB3 0ES, UK; (M.F.); (D.A.W.); (R.K.); (J.L.H.); (G.W.C.)
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Simon D. Scott
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham ME4 4BF, UK; (J.M.M.D.R.); (K.A.S.d.C.); (F.F.); (G.S.M.); (S.D.S.)
| | - Ralf Wagner
- Institute of Medical Microbiology and Hygiene, University of Regensburg, 93053 Regensburg, Germany; (B.A.); (R.W.)
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Jonathan L. Heeney
- DIOSynVax, Cambridge CB3 0ES, UK; (M.F.); (D.A.W.); (R.K.); (J.L.H.); (G.W.C.)
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - George W. Carnell
- DIOSynVax, Cambridge CB3 0ES, UK; (M.F.); (D.A.W.); (R.K.); (J.L.H.); (G.W.C.)
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
| | - Nigel J. Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham ME4 4BF, UK; (J.M.M.D.R.); (K.A.S.d.C.); (F.F.); (G.S.M.); (S.D.S.)
- DIOSynVax, Cambridge CB3 0ES, UK; (M.F.); (D.A.W.); (R.K.); (J.L.H.); (G.W.C.)
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16
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Liang Y, Jing-Xia G, Ma L, Ni L, Chaolie R, Zhou J, Guo-Yang L. Immunogenicity and safety levels of inactivated quadrivalent influenza vaccine in healthy adults via meta-analysis. Hum Vaccin Immunother 2021; 17:3652-3661. [PMID: 34156322 DOI: 10.1080/21645515.2021.1932218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective: The aim of the current study was to evaluate immunogenicity and safety levels of human inactivated quadrivalent influenza vaccine (QIV) which includes two A strains (A/H1N1, A/H3N2) and two B lineages (B/Victoria, B/Yamagata) in healthy adults via meta-analysis. Methods: Searches were conducted in PubMed, Cochrane Library, ClinicalTrials.gov, and EMBASE databases published in 2011-2020 according to inclusion and exclusion criteria. The purpose was to collect and perform meta-analysis of related randomized clinical trial (RCT) data concerning safety and immunogenicity levels of human QIV compared with inactivated trivalent influenza vaccine (TIV). Results: A total of 9 literatures were included. There was no significant difference in the seroconversion(SCR) and seroprotection(SPR) between QIV and TIV for influenza A strains (A/H1N1, A/H3N2) and the B lineage included in the TIV. QIV showed superior efficacy for the B lineage not included in the TIV: SCR RR of 2.20 (95%CI: 1.44-3.37, p = .0003) and SPR RR of 1.34 (95%CI: 1.10-1.63, p = .004) for B/Victoria, and SCR RR of 1.88 (95%CI: 1.53-2.31, p < .00001) and SPR RR of 1.11 (95%CI: 1.03-1.19, p = .006) for B/Yamagata, respectively. There were no significant differences between QIV and TIV for local and systemic adverse events(AE) post-vaccination. Conclusion: In adults 18-64 years old, QIV not only produced similar immunogenicity and safety levels to TIV, but also had better immunogenicity against influenza B vaccine strains not included in TIV.
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Affiliation(s)
- Yu Liang
- The Fifth Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, China
| | - Gao Jing-Xia
- The Fifth Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, China
| | - Lei Ma
- The Fifth Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, China
| | - Li Ni
- The Fifth Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, China
| | - Ruan Chaolie
- The Fifth Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, China
| | - Jian Zhou
- Vaccine Technology and Process Research Center, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, China
| | - Liao Guo-Yang
- The Fifth Department of Biological Products, Institute of Medical Biology, Chinese Academy of Medical Science and Peking Union Medical College, Kunming, China
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17
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Ferrara F, Del Rosario JMM, da Costa KAS, Kinsley R, Scott S, Fereidouni S, Thompson C, Kellam P, Gilbert S, Carnell G, Temperton N. Development of Lentiviral Vectors Pseudotyped With Influenza B Hemagglutinins: Application in Vaccine Immunogenicity, mAb Potency, and Sero-Surveillance Studies. Front Immunol 2021; 12:661379. [PMID: 34108964 PMCID: PMC8182064 DOI: 10.3389/fimmu.2021.661379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/05/2021] [Indexed: 12/16/2022] Open
Abstract
Influenza B viruses (IBV) cause respiratory disease epidemics in humans and are therefore components of seasonal influenza vaccines. Serological methods are employed to evaluate vaccine immunogenicity prior to licensure. However, classical methods to assess influenza vaccine immunogenicity such as the hemagglutination inhibition assay (HI) and the serial radial hemolysis assay (SRH), have been proven to have many limitations. As such, there is a need to develop innovative methods that can improve on these traditional assays and provide advantages such as ease of production and access, safety, reproducibility, and specificity. It has been previously demonstrated that the use of replication-defective viruses, such as lentiviral vectors pseudotyped with influenza A hemagglutinins in microneutralization assays (pMN) is a safe and sensitive alternative to study antibody responses elicited by natural influenza infection or vaccination. Consequently, we have produced Influenza B hemagglutinin-pseudotypes (IBV PV) using plasmid-directed transfection. To activate influenza B hemagglutinin, we have explored the use of proteases in increasing PV titers via their co-transfection during pseudotype virus production. When tested for their ability to transduce target cells, the influenza B pseudotypes produced exhibit tropism for different cell lines. The pseudotypes were evaluated as alternatives to live virus in microneutralization assays using reference sera standards, mouse and human sera collected during vaccine immunogenicity studies, surveillance sera from seals, and monoclonal antibodies (mAbs) against IBV. The influenza B pseudotype pMN was found to effectively detect neutralizing and cross-reactive responses in all assays and shows promise as an effective and versatile tool in influenza research.
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Affiliation(s)
- Francesca Ferrara
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent & University of Greenwich, Chatham, United Kingdom
| | - Joanne Marie M Del Rosario
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent & University of Greenwich, Chatham, United Kingdom.,Department of Physical Sciences & Mathematics, College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines
| | - Kelly A S da Costa
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent & University of Greenwich, Chatham, United Kingdom
| | - Rebecca Kinsley
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent & University of Greenwich, Chatham, United Kingdom.,Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Simon Scott
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent & University of Greenwich, Chatham, United Kingdom
| | - Sasan Fereidouni
- Research Institute of Wildlife Ecology, Veterinary Medicine University, Vienna, Austria
| | - Craig Thompson
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Paul Kellam
- Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Sarah Gilbert
- The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - George Carnell
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent & University of Greenwich, Chatham, United Kingdom.,Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Nigel Temperton
- Viral Pseudotype Unit, Medway School of Pharmacy, University of Kent & University of Greenwich, Chatham, United Kingdom
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18
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Jagielska AM, Brydak LB, Nitsch-Osuch AS. Immunogenicity of Split Inactivated Quadrivalent Influenza Vaccine in Adults with Obesity in the 2017/2018 Season. Med Sci Monit 2021; 27:e929572. [PMID: 33994536 PMCID: PMC8139133 DOI: 10.12659/msm.929572] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Obesity is associated with susceptibility to severe influenza infection and several disturbances of the immune response to the influenza vaccine. However, the effect of obesity on the immunogenicity of the influenza vaccine is not fully understood. Our objective here was to assess the immunogenicity of the split, inactivated quadrivalent influenza vaccine (QIV) in Polish adults with obesity. MATERIAL AND METHODS Fifty-three subjects with obesity aged 21-69 years were vaccinated with the QIV in 2017/2018 season. Antibody titers against the 4 vaccine strains were measured using the hemagglutination inhibition (HI) assay. The mean fold antibody increase (MFI), seroprotection rate (protection rate, PR), and seroconversion rate (response rate, RR) were calculated to assess vaccine immunogenicity. RESULTS The vaccine elicited a significant increase in the anti-HI titers against the QIV antigens. The MFI, PR, and RR for the QIV antigens also reached the required age-specific values, indicating the QIV meets current immunogenicity criteria. Individuals with class I and class II/III obesity had similar anti-HI titers, MFI, PR, and RR to each of the vaccine strains. Adults aged <60 years had similar anti-HI titers, MFI, PR, and RR to the QIV strains to those aged ≥60 years. CONCLUSIONS Our results indicate that the split virion, inactivated QIV is immunogenic in adults with obesity regardless of their degree of obesity and age (ie, <60 and ≥60 years).
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Affiliation(s)
- Anna M Jagielska
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Lidia B Brydak
- Department of Influenza Research, National Influenza Center, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Aneta S Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
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19
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Basu I, Agarwal M, Shah V, Shukla V, Naik S, Supe PD, Srivastava MK, Giriraja KV, Pinjar P, Mishra PK, Joshi S, Vijayakumar R, van de Witte S. Immunogenicity and safety of two quadrivalent influenza vaccines in healthy adult and elderly participants in India - A phase III, active-controlled, randomized clinical study. Hum Vaccin Immunother 2021; 18:1-10. [PMID: 33957854 PMCID: PMC8920161 DOI: 10.1080/21645515.2021.1885278] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background: This study was conducted to compare the immunogenicity and safety profile of two quadrivalent influenza vaccines (QIVs) in healthy adults (18-60 years) and elderly (>61 years) participants.Method: This phase III study was conducted from March 2018 to April 2018 across 12 sites in India. In this randomized, observer-blind, active-controlled study, 480 participants were randomized to receive a single dose of test vaccine (subunit, inactivated influenza vaccine; Influvac® Tetra, Abbott) (n = 240) or reference vaccine (split virion, inactivated influenza vaccine; VaxiFlu-4, Zydus Cadilla Healthcare) (n = 240). The primary objective was to describe and compare the immunogenicity of each vaccination group based on hemagglutination inhibition (HI) assay seroprotection and seroconversion rates, and geometric mean fold increase (GMFI) against four vaccine strains in two age groups. Safety and reactogenicity were also compared for the vaccines in both the age groups.Results: The pre- and post-vaccination HI titers for both the vaccines were comparable. The GMFI varied from 4.3 - 22.7 in the test and 3.7-21.6 in the reference vaccine group. The seroprotection rates were >90% for the A-strains and ranged between >43% and <60% for B-strains for both the vaccines. Seroconversion rates varied between 41.4% and 78.8%. Overall, the reported adverse events (AEs) for both the vaccines were <1% and comparable. Reported local and systemic reactions were comparable.Conclusion: Influvac® Tetra elicited an adequate immune response with a favorable safety profile which was comparable with the reference vaccine. (Clinical trial registry number: CTRI/2018/02/012222).
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Affiliation(s)
- Indraneel Basu
- Department of Medicine, Popular Hospital, Varanasi, Uttar Pradesh, India
| | - Manish Agarwal
- Department of Medicine, Medilink Hospital Research Centre, Ahmedabad, Gujrat, India
| | - Viral Shah
- Department of Medicine, Panchshil Hospital, Ahmedabad, Gujarat, India
| | - Vijay Shukla
- Department of Ear, Nose and Throat, Ajanta Research Centre, Lucknow, Uttar Pradesh, India
| | - Sunil Naik
- Department of Medicine, Rajiv Gandhi Institute of Medical Sciences, Adilabad, Andhra Pradesh, India
| | - Pravin Dinkar Supe
- Department of Medicine, Supe Heart and Diabetes Hospital and Research Center, Nasik, Maharashtra, India
| | | | | | - Peersab Pinjar
- Department of General Medicine, S.S Institute of Medical Sciences and Research Center, Davangere, Karnataka, India
| | - Pradeep Kumar Mishra
- Department of General Medicine, Yashoda Hospital, Secunderabad, Andhra Pradesh, India
| | - Shishir Joshi
- Department of Medicine, Sahyadri Hospital, Pune, Maharashtra, India
| | - Ranjit Vijayakumar
- Department of General Medicine, Krishna Rajendra Hospital, Mysuru, Karnataka, India
| | - Serge van de Witte
- Established Pharmaceuticals Division, Abbott Healthcare Products B.V, Weesp, The Netherlands
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20
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Kostinov MP, Latysheva EA, Kostinova AM, Akhmatova NK, Latysheva TV, Vlasenko AE, Dagil YA, Khromova EA, Polichshuk VB. Immunogenicity and Safety of the Quadrivalent Adjuvant Subunit Influenza Vaccine in Seropositive and Seronegative Healthy People and Patients with Common Variable Immunodeficiency. Vaccines (Basel) 2020; 8:E640. [PMID: 33147763 PMCID: PMC7712402 DOI: 10.3390/vaccines8040640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/12/2020] [Accepted: 09/30/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Influenza prophylaxis with the use of quadrivalent vaccines (QIV) is increasingly being introduced into healthcare practice. METHODS In total, 32 healthy adults and 6 patients with common variable immunodeficiency (CVID) received adjuvant QIV during 2018-2019 influenza season. Depending on initial antibody titers, healthy volunteers were divided into seronegative (≤1:20) and seropositive (≥1:40). To evaluate immunogenicity hemagglutination inhibition assay was used. RESULTS All participants completed the study without developing serious post-vaccination reactions. Analysis of antibody titer 3 weeks after immunization in healthy participants showed that seroprotection, seroconversion levels, GMR and GMT for strains A/H1N1, A/H3N2 and B/Colorado, B/Phuket among initially seronegative and seropositive participants meet the criterion of CHMP effectiveness. CVID patients showed increase in post-vaccination antibody titer without reaching conditionally protective antibody levels. CONCLUSION Adjuvant QIV promotes formation of specific immunity to vaccine strains, regardless of antibodies' presence or absence before. In CVID patients search of new regimens should be continued.
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Affiliation(s)
- Mikhail P. Kostinov
- Federal State Budgetary Scientific Institution, I.I. Mechnikov Research Institute of Vaccines and Sera, Malyi Kazenniy pereulok, 5a, 105064 Moscow, Russia; (M.P.K.); (N.K.A.); (E.A.K.); (V.B.P.)
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Trubetskaya Str., 8/2, 119991 Moscow, Russia
| | - Elena A. Latysheva
- National Research Center—Institute of Immunology Federal Medical-Biological Agency of Russia, Kashirskoe Shosse, 24, 115478 Moscow, Russia; (E.A.L.); (T.V.L.); (Y.A.D.)
| | - Aristitsa M. Kostinova
- National Research Center—Institute of Immunology Federal Medical-Biological Agency of Russia, Kashirskoe Shosse, 24, 115478 Moscow, Russia; (E.A.L.); (T.V.L.); (Y.A.D.)
| | - Nelly K. Akhmatova
- Federal State Budgetary Scientific Institution, I.I. Mechnikov Research Institute of Vaccines and Sera, Malyi Kazenniy pereulok, 5a, 105064 Moscow, Russia; (M.P.K.); (N.K.A.); (E.A.K.); (V.B.P.)
| | - Tatyana V. Latysheva
- National Research Center—Institute of Immunology Federal Medical-Biological Agency of Russia, Kashirskoe Shosse, 24, 115478 Moscow, Russia; (E.A.L.); (T.V.L.); (Y.A.D.)
| | - Anna E. Vlasenko
- Novokuznetsk State Institute for Advanced Training of Physicians—Branch Campus of the Russian Medical Academy of Continuous Professional Education, Prospect Stroiteley, 5, 654005 Novokuznetsk, Russia;
| | - Yulia A. Dagil
- National Research Center—Institute of Immunology Federal Medical-Biological Agency of Russia, Kashirskoe Shosse, 24, 115478 Moscow, Russia; (E.A.L.); (T.V.L.); (Y.A.D.)
| | - Ekaterina A. Khromova
- Federal State Budgetary Scientific Institution, I.I. Mechnikov Research Institute of Vaccines and Sera, Malyi Kazenniy pereulok, 5a, 105064 Moscow, Russia; (M.P.K.); (N.K.A.); (E.A.K.); (V.B.P.)
| | - Valentina B. Polichshuk
- Federal State Budgetary Scientific Institution, I.I. Mechnikov Research Institute of Vaccines and Sera, Malyi Kazenniy pereulok, 5a, 105064 Moscow, Russia; (M.P.K.); (N.K.A.); (E.A.K.); (V.B.P.)
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21
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Kostinova AM, Akhmatova NK, Latysheva EA, Dagil YA, Klimova SV, Vlasenko AE, Khromova EA, Latysheva TV, Kostinov MP. Assessment of Immunogenicity of Adjuvanted Quadrivalent Inactivated Influenza Vaccine in Healthy People and Patients With Common Variable Immune Deficiency. Front Immunol 2020; 11:1876. [PMID: 32973775 PMCID: PMC7466564 DOI: 10.3389/fimmu.2020.01876] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Recent addition to vaccines of adjuvants has been actively used to enhance the immunogenicity. However, the use of adjuvants for the development of quadrivalent inactivated influenza vaccines (QIV) is currently limited. The aim of this study was to examine immunogenicity of adjuvanted QIV in healthy people and patients with primary immune deficiency—common variable immune deficiency (CVID). Methods: In total before the flu season 2018–2019 in the study were involved 32 healthy volunteers aged 18–52 years and 6 patients with a confirmed diagnosis of CVID aged 18–45 years. To evaluate antibody titers 21 days after vaccination against the influenza A and B strains a hemagglutination inhibition assay (HI) was used. Results: In healthy volunteers adjuvanted QIV has proved its immunogenicity to strains A/H1N1, A/H3N2, B/Phuket and B/Colorado in seroprotection (90, 97, 86, and 66%, respectively), seroconversion (50, 60, 52, and 45%, respectively), GMR (6.2, 5.7, 4.2, and 3.4, respectively). Statistically significant differences in the level of all criteria were revealed between groups of healthy and CVID patients regardless of the virus strain. Most patients with CVID showed an increase in post-vaccination antibody titer without reaching conditionally protective antibody levels. Conclusion: Immunization with single dose of adjuvanted QIV with decreased amount of hemagglutinin protein to all virus strains due to the use of azoximer bromide forms protective immunity in healthy people, but in patients with CVID the search for new vaccination schemes is the subject of further investigations, as well as the effectiveness of boosterization with adjuvant vaccines.
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Affiliation(s)
| | - Nelli Kimovna Akhmatova
- Federal State Budgetary Scientific Institution I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russia
| | | | - Yulia Alexeevna Dagil
- National Research Center Institute of Immunology Federal Medical-Biological Agency of Russia, Moscow, Russia
| | | | - Anna Egorovna Vlasenko
- Novokuznetsk State Institute for Advanced Training of Physicians, Branch Campus of the Russian Medical Academy of Continuous Professional Education, Novokuznetsk, Russia
| | | | | | - Mikhail Petrovich Kostinov
- Federal State Budgetary Scientific Institution I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russia
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22
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Immunogenicity and safety of an inactivated quadrivalent influenza vaccine: A randomized, double-blind, controlled phase III study in healthy population aged ≥3 years. Vaccine 2020; 38:5940-5946. [DOI: 10.1016/j.vaccine.2020.06.071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 11/18/2022]
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Ojeda J, Arredondo JL, Salcedo P, Paredes-Paredes M, Dupuy M, Petit C, Chabanon AL, Rivas E, Gurunathan S, De Bruijn I, Pepin S. Immunogenicity and safety of a multi-dose quadrivalent inactivated influenza vaccine in individuals aged 6 months to 17 years: a randomized phase III trial. Hum Vaccin Immunother 2020; 16:1380-1384. [PMID: 31810418 PMCID: PMC7482911 DOI: 10.1080/21645515.2019.1697595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Annual vaccination is the most effective way to prevent seasonal influenza. Influenza vaccines in multi-dose vial (MDV) formats can facilitate timely vaccination of large populations by reducing per-dose costs and cold storage requirements compared to single-dose pre-filled syringe (PFS) formats. MDV vaccines require thiomersal or another preservative to prevent microbial contamination. We conducted a randomized, open-label trial in 302 healthy subjects aged 6 months to 17 years to evaluate the immunogenicity and safety of a quadrivalent influenza vaccine (QIV) in a thiomersal-containing MDV format compared to the licensed thiomersal-free PFS format. Subjects were randomly assigned in a 1:1 ratio to receive the MDV (n = 153) or PFS (n = 149) format. Post-vaccination hemagglutination inhibition titers for all four vaccine strains were ≥4.9-fold higher than baseline titers with no difference in magnitude between the MDV and PFS groups. Seroconversion rates per strain were also comparable between the two groups. There were no differences in reactogenicity or safety between the two vaccine formats. These results showed that the MDV format of QIV was as safe and immunogenic as the PFS format in infants, children, and adolescents. These findings support the use of MDV QIV as a resource-saving alternative for seasonal influenza vaccination.
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Affiliation(s)
- Joyce Ojeda
- Global Clinical Science, Sanofi Pasteur , Mexico City, Mexico
| | - José Luis Arredondo
- Instituto Nacional de Pediatría, Unidad de Investigación Clínica , Mexico City, Mexico
| | - Perla Salcedo
- Hospital General de Ecatepec "Las Américas", Fraccionamiento las Américas , Ecatepec de Morelos, Mexico
| | | | - Martin Dupuy
- Global Biostatistical Sciences, Sanofi Pasteur , Marcy l'Étoile, France
| | - Celine Petit
- Global Clinical Immunology, Sanofi Pasteur , Marcy l'Étoile, France
| | | | - Enrique Rivas
- Global Clinical Sciences, Sanofi Pasteur , Mexico City, Mexico
| | | | - Iris De Bruijn
- Global Clinical Sciences, Sanofi Pasteur , Marcy l'Étoile, France
| | - Stephanie Pepin
- Global Clinical Sciences, Sanofi Pasteur , Marcy l'Étoile, France
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Meng Z, Zhang J, Shi J, Zhao W, Huang X, Cheng L, Yang X. Immunogenicity of influenza vaccine in elderly people: a systematic review and meta-analysis of randomized controlled trials, and its association with real-world effectiveness. Hum Vaccin Immunother 2020; 16:2680-2689. [PMID: 32347787 PMCID: PMC7746244 DOI: 10.1080/21645515.2020.1747375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background: Older people (≥60 years old) are particularly vulnerable to influenza virus infection, and vaccine is effective in reducing the disease burden in this population. However, it remains obscure whether their antibody response is lower than those of younger adults (18–60 years old). Thus, this meta-analysis was performed to compare the immunogenicity of influenza vaccines and understand their association with real-world vaccine effectiveness (VE) between these two age groups. Methods: A systematic literature search was conducted to identify relevant studies from Jan 01, 2008 to Nov 10, 2018. These are randomized controlled trials that included older adult samples, which assessed the immunogenicity of inactivated quadrivalent influenza vaccines produced in embryonated eggs. We excluded the studies focused only in children or adults. The outcomes were seroprotecton rate (SPR) and seroconversion rate (SCR). Results: Six studies were eventually included in the present meta-analysis (7,976 participants). For the SPR, the pooled risk ratio (RR) was 0.92 (95% CI: 0.90–0.94, I2 = 66%, P < .0001) for A/H1N1 and 0.94 (95% CI: 0.90–0.98, I2 = 91%, P = .002) for B/Victoria, and the antibody responses of A/H3N2 and B/Yamagata were similar in the two age groups. For the SCR, the pooled RR was 0.85 (95% CI: 0.76–0.94, I2 = 93%, P = .003), 0.77 (95% CI: 0.66–0.91, I2 = 94%, P = .002), and 0.83 (95% CI: 0.71–0.96, I2 = 94%, P = .02) for A/H1N1, B/Victoria and B/Yamagata, respectively, and the antibody responses of A/H3N2 were similar in the two groups. Some variations were found in the antibody responses across virus types and subtypes after influenza vaccination. Conclusion: The SPR and SCR of older adults were lower than those in younger adults for A/H1N1 and B/Victoria, while the two age groups had similar antibody responses for A/H3N2. The antibody responses to vaccines were not significantly associated with real-world VE, indicating that antibody response might not fully reflect the vaccine effectiveness of A/H3N2.
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Affiliation(s)
- Ziyan Meng
- National Institute of Engineering Technology Research in Combination Vaccines , Wuhan, China.,Wuhan Institute of Biological Products 430207 , Wuhan, China
| | - Jiayou Zhang
- National Institute of Engineering Technology Research in Combination Vaccines , Wuhan, China.,Wuhan Institute of Biological Products 430207 , Wuhan, China
| | - Jinrong Shi
- National Institute of Engineering Technology Research in Combination Vaccines , Wuhan, China.,Wuhan Institute of Biological Products 430207 , Wuhan, China
| | - Wei Zhao
- National Institute of Engineering Technology Research in Combination Vaccines , Wuhan, China.,Wuhan Institute of Biological Products 430207 , Wuhan, China
| | - Xiaoyuan Huang
- National Institute of Engineering Technology Research in Combination Vaccines , Wuhan, China.,Wuhan Institute of Biological Products 430207 , Wuhan, China
| | - Li Cheng
- Center for Evaluation and Inspection of Hubei Food and Drug Administration , Wuhan, China
| | - Xiaoming Yang
- National Institute of Engineering Technology Research in Combination Vaccines , Wuhan, China.,China National Biotech Group Company Limited , Beijing, China
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25
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Investigating the association of receipt of seasonal influenza vaccine with occurrence of anesthesia/paresthesia and severe headaches, Canada 2012/13-2016/17, the Canadian Vaccine Safety Network. Vaccine 2020; 38:3582-3590. [PMID: 32229052 DOI: 10.1016/j.vaccine.2020.03.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Concern about adverse events following immunization is frequently cited by both those who receive or decline vaccines. Neurological adverse events are especially concerning. OBJECTIVES Our aim was to detect associations between seasonal influenza vaccination and the occurrence of severe anesthesia/paresthesia or severe headaches. METHODS Data were analyzed from the Canadian National Vaccine Safety network. Events occuring on days 0-7 were self-reported and prevented daily activity, led to school or work absenteeism, or required medical attention. Controls were the previous year's vaccinees; events in controls were collected prior to the start of the influenza vaccination program of each year (2012/13 through 2016/17). Multivariable logistic regression was used to determine the association between seasonal influenza vaccination and the occurrence of anesthesia/paresthesia or severe headaches. RESULTS The total sample was 107,565 for investigating anesthesia/paresthesia and 97,420 for investigating severe headaches. Anesthesia/paresthesia was reported by 104/107,565 (0.10%) participants; 63/69,129 (0.09%) vaccinees and 41/38,436 (0.11%) controls (adjusted odds ratio (aOR) = 0.89; 95% CI = 0.60, 1.32). Severe headaches were reported by 1361/97,420 (1.40%) participants; 907/61,463 (1.48%) vaccinees and 454/35,957 (1.26%) controls (aOR = 1.21; 95% CI = 1.08, 1.36). No specific vaccine product was associated with severe headaches. CONCLUSIONS Our study found no association between severe anesthesia/paresthesia and seasonal influenza vaccination. While there was an association with severe headaches as an adverse event following influenza vaccination, the rates of these events are similar to rates reported from clinical trials and are not a cause for additional concern.
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Vesikari T, Nauta J, Lapini G, Montomoli E, van de Witte S. Immunogenicity and safety of quadrivalent versus trivalent inactivated subunit influenza vaccine in children and adolescents: A phase III randomized study. Int J Infect Dis 2020; 92:29-37. [DOI: 10.1016/j.ijid.2019.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 11/26/2022] Open
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Quadrivalent Influenza Vaccine-Induced Antibody Response and Influencing Determinants in Patients ≥ 55 Years of Age in the 2018/2019 Season. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224489. [PMID: 31739554 PMCID: PMC6887788 DOI: 10.3390/ijerph16224489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/04/2019] [Accepted: 11/12/2019] [Indexed: 02/06/2023]
Abstract
The effects of immunization with subunit inactivated quadrivalent influenza vaccine (QIV) are not generally well assessed in the elderly Polish population. Therefore, this study evaluated vaccine-induced antibody response and its determinants. Methods: Consecutive patients ≥ 55 years old, attending a Primary Care Clinic in Gryfino, Poland, received QIV (A/Michigan/ 45/2015(H1N1)pdm09, A/Singapore/INFIMH-16-0019/2016 (H3N2), B/Colorado/06/2017, B/Phuket/ 3073/2013) between October-December 2018. Hemagglutination inhibition assays measured antibody response to vaccine strains from pre/postvaccination serum samples. Geometric mean titer ratio (GMTR), protection rate (PR) and seroconversion rate (SR) were also calculated. Results: For 108 patients (54.6% males, mean age: 66.7 years) the highest GMTR (61.5-fold) was observed for A/H3N2/, then B/Colorado/06/2017 (10.3-fold), A/H1N1/pdm09 (8.4-fold) and B/Phuket/ 3073/2013 (3.0-fold). Most patients had post-vaccination protection for A/H3N2/ and B/Phuket/3073/ 2013 (64.8% and 70.4%, respectively); lower PRs were observed for A/H1N1/pdm09 (41.8%) and B/Colorado/06/ 2017 (57.4%). The SRs for A/H3N2/, A/H1N1/pdm09, B Victoria and B Yamagata were 64.8%, 38.0%, 46.8%, and 48.2%, respectively. Patients who received QIV vaccination in the previous season presented lower (p < 0.001 and p = 0.03, respectively) response to B Victoria and B Yamagata. Conclusions: QIV was immunogenic against the additional B lineage strain (B Victoria) without significantly compromising the immunogenicity of the other three vaccine strains, therefore, adding a second B lineage strain in QIV could broaden protection against influenza B infection in this age group. As the QIV immunogenicity differed regarding the four antigens, formulation adjustments to increase the antigen concentration of the serotypes that have lower immunogenicity could increase effectiveness. Prior season vaccination was associated with lower antibody response to a new vaccine, although not consistent through the vaccine strains.
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Vesikari T, Virta M, Heinonen S, Eymin C, Lavis N, Chabanon AL, Gresset-Bourgeois V. Immunogenicity and safety of a quadrivalent inactivated influenza vaccine in pregnant women: a randomized, observer-blind trial. Hum Vaccin Immunother 2019; 16:623-629. [PMID: 31526225 PMCID: PMC7227680 DOI: 10.1080/21645515.2019.1667202] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Vaccination against influenza during pregnancy provides direct protection to pregnant women and indirect protection to their infants. Trivalent inactivated influenza vaccines (IIV3s) are safe and effective during pregnancy, but quadrivalent inactivated influenza vaccines (IIV4s) have not been evaluated in pregnant women and their infants. Here, we report the results of a randomized phase IV study to evaluate the immunogenicity and safety of IIV4 vs. IIV3 in pregnant women. Participants aged ≥18 years at weeks 20 to 32 of gestation were randomly assigned in a 2:1 ratio to receive a single dose of IIV4 (n = 230) or IIV3 (n = 116). Between baseline and 21 days after vaccination, hemagglutination inhibition (HAI) antibody titers increased in both groups by similar magnitudes for the two influenza A strains and single B strain common to IIV4 and IIV3. For the additional B strain in IIV4, HAI titers were higher in IIV4 recipients than IIV3 recipients (post-/pre-vaccination geometric mean titer ratio, 6.3 [95% CI: 5.1 − 7.7] vs. 3.4 [95% CI: 2.7 − 4.3]). At delivery, in both groups, HAI antibody titers for all strains were 1.5 − 1.9-fold higher in umbilical cord blood than in maternal blood, confirming active transplacental antibody transfer. Rates of solicited and unsolicited vaccine-related adverse events in mothers were similar between the two groups. Live births were reported for all participants and there were no vaccine-related adverse events in newborns. These results suggest IIV4 is as safe and immunogenic as IIV3 in pregnant women, and that maternal immunization with IIV4 should protect newborns against influenza via passively acquired antibodies.
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Affiliation(s)
- Timo Vesikari
- Vaccine Research Center, Tampere University, Tampere, Finland
| | - Miia Virta
- Tampere Vaccine Research Clinic, Vaccine Research Center, Tampere University, Tampere, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland.,University of Helsinki, Helsinki, Finland
| | - Cécile Eymin
- Medical Operations, Sanofi Pasteur, Campus Sanofi Lyon, Lyon, France
| | - Nathalie Lavis
- Medical Operations, Sanofi Pasteur, Campus Sanofi Lyon, Lyon, France
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Hu Y, Chu K, Lavis N, Li X, Liang B, Liu S, Shao M, Shu JD, Tabar C, Samson S. Immunogenicity and safety of a trivalent inactivated influenza vaccine produced in Shenzhen, China versus a comparator influenza vaccine: a phase IV randomized study. Hum Vaccin Immunother 2019; 15:1066-1069. [PMID: 30779689 PMCID: PMC6605815 DOI: 10.1080/21645515.2019.1581541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/18/2019] [Accepted: 02/01/2019] [Indexed: 11/03/2022] Open
Abstract
Seasonal influenza causes substantial morbidity and mortality in China, which largely results from limited vaccine accessibility and poor vaccination coverage. Since 2013, Sanofi Pasteur's facilities in Shenzhen, China have produced a trivalent inactivated influenza vaccine (Shz-IIV3) for each influenza season according to Chinese pharmacopeia requirements. However, the immunogenicity of Shz-IIV3 has not been compared to existing Chinese trivalent inactivated influenza vaccines (IIV3s). Here, we describe the results of a phase IV, observer-blind, randomized study to evaluate whether the immunogenicity of Shz-IIV3 was non-inferior to a comparator IIV3 (Hualan Biological Engineering Inc) also manufactured and licensed in China. Healthy adults aged 18-59 years were randomly assigned in a 1:1 ratio to receive a single 0.5-mL intramuscular injection of the 2017-2018 Northern Hemisphere formulation of Shz-IIV3 (n = 800) or the comparator IIV3 (n = 799). Between baseline and day 28 after vaccination, hemagglutination inhibition titers for the three vaccine strains increased by at least 4-fold and were of similar magnitude in Shz-IIV3 and comparator IIV3 recipients. The rate of seroconversion or significant increase in titers was 62% to 92% in Shz-IIV3 recipients, and 63% to 91% in comparator IIV3 recipients. Post-vaccination hemagglutination inhibition titers and seroconversion rates for Shz-IIV3 were statistically non-inferior to the comparator IIV3 for all three influenza vaccine strains. Rates of solicited and unsolicited vaccine-related adverse events were similar between the two vaccine groups. These results demonstrated that Shz-IIV3 was as immunogenic and safe in adults as a comparator Chinese IIV3, and support the continued use of Shz-IIV3 in China.
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Affiliation(s)
- Yuemei Hu
- Vaccine Clinical Evaluation Department, Jiangsu Center for Disease Prevention and Control, Nanjing, China
| | - Kai Chu
- Vaccine Clinical Evaluation Department, Jiangsu Center for Disease Prevention and Control, Nanjing, China
| | | | - Xiaoling Li
- Medical Operations, Sanofi Pasteur, Beijing, China
| | - Bill Liang
- Medical Department, Sanofi Pasteur, Beijing, China
| | - Shuzhen Liu
- Division of Respiratory Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Ming Shao
- Division of Respiratory Virus Vaccines, National Institutes for Food and Drug Control, Beijing, China
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Agarkhedkar S, Chhatwal J, Kompithra RZ, Lalwani SK, Narayan A, Muninarayanaswam V, Gogtay N, Dotter K, Gresset-Bourgeois V. Immunogenicity and safety of an intramuscular split-virion quadrivalent inactivated influenza vaccine in individuals aged ≥ 6 months in India. Hum Vaccin Immunother 2019; 15:973-977. [PMID: 30762467 PMCID: PMC6605869 DOI: 10.1080/21645515.2019.1565259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
A quadrivalent split-virion inactivated influenza vaccine (IIV4; Fluzone® Quadrivalent, Sanofi Pasteur) has been available in the US since 2013 for individuals aged ≥ 6 months. Here, we describe the results of an open-label, multicenter trial (WHO Universal Trial Number U1111-1143-8370) evaluating the immunogenicity and safety of IIV4 in Indian children aged 6-35 months and 3-8 years, adolescents aged 9-17 years, and adults aged ≥ 18 years (n = 100 per group). Post-vaccination hemagglutination inhibition titers for all strains in all age groups were ≥ 8 fold higher than at baseline (range, 8-51). At least 70% of participants in all age groups seroconverted or had a significant increase in titer for each strain. The most common solicited reactions were injection-site pain and tenderness, plus fever in participants 6-23 months and myalgia in older children and adolescents. All injection-site reactions and most systemic reactions were grade 1 or 2 and resolved within 3 days. Only three vaccine-related unsolicited adverse events were reported, all of which were grade 1 or 2 and transient. No immediate adverse events, adverse events leading to study discontinuation, adverse events of special interest, or serious adverse events were reported. This study showed that IIV4 was well tolerated and highly immunogenic in all age groups. This adds important data on the safety, tolerability, and immunogenicity of influenza vaccines in India.
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Affiliation(s)
- Sharad Agarkhedkar
- a Dr. D. Y. Patil Medical College, Hospital & Research Centre , Pune , Maharashtra , India
| | - Jugesh Chhatwal
- b Department of Pediatrics , Christian Medical College & Hospital , Ludhiana , Punjab , India
| | - Rajeev Zachariah Kompithra
- c Well Baby Immunization Clinic, Department of Pediatrics , Christian Medical College & Hospital , Vellore , Tamil Nadu , India
| | - Sanjay K Lalwani
- d Department of Pediatrics , Medical College Road , Pune , Maharashtra , India
| | - Arun Narayan
- e Department of Medicine , M.S. Ramaiah Medical College and Hospitals , Bangalore , India
| | - Vinay Muninarayanaswam
- f Department of Community Medicine , Mandya Institute of Medical Sciences , Mandya , Karnataka , India
| | - Nithya Gogtay
- g Department of Clinical Pharmacology , Seth GS Medical College & KEM Hospital , Mumbai , Maharashtra , India
| | - Kristin Dotter
- h Medical Operations , Sanofi Pasteur , Swiftwater , PA , USA
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Yamazaki S, Fujiwara M, Inoue C, Watanabe M, Takayanagi S, Taniguchi T, Watanabe A, Ishiwada N, Igari H. [Adverse Events after the Introduction of Quadrivalent Influenza Vaccine in Comparison with AH1pdm Vaccine (2009) in Japan]. YAKUGAKU ZASSHI 2019; 139:469-474. [PMID: 30828025 DOI: 10.1248/yakushi.18-00160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Inactivated quadrivalent influenza vaccine (IIV4) has been used as seasonal influenza vaccine since 2016 in Japan. This study examined the safety of IIV4 in comparison with the AH1pdm monovalent vaccine used for novel influenza in 2009. Questionnaire surveillance associated with adverse events (AEs) was conducted at Chiba University Hospital, Japan. After being vaccinated, all health care workers (HCWs) were given a daily AEs check sheet on which they recorded solicited events, the same surveillance program used after AH1pdm vaccination in 2009. The frequency of injection site AEs with IIV4 was significantly higher than with the monovalent vaccine, but there was no significant difference with systemic AEs. Injection site and systemic AEs were reported as 83.7% and 25.5%, respectively, with IIV4. The grades of AE, mild, moderate and severe, were 67.2%, 16.4% and 0.1% with IIV4, respectively, indicating that almost all of the AEs reported with IIV4 were mild or moderate. Systemic AEs with IIV4 and monovalent vaccine were reported to be 25.5% and 23.1%, respectively, with the difference not being significant. The grade of AEs with IIV4, mild, moderate and severe, was 19.1%, 5.6% and 0.9%, respectively. The ratio of HCWs reporting AEs peaked at around 80% on day 1, then decreasing to less than 5% by day 7. AEs with IIV4 were reported more frequently compared with the AH1pdm monovalent vaccine. However, in consideration of the grade and duration of AEs, IIV4 was a well-tolerated, safe vaccine.
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Affiliation(s)
| | | | - Chikako Inoue
- Division of Infection Control, Chiba University Hospital
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32
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Pepin S, Dupuy M, Borja-Tabora CFC, Montellano M, Bravo L, Santos J, de Castro JA, Rivera-Medina DM, Cutland C, Ariza M, Diez-Domingo J, Gonzalez CD, Martinón-Torres F, Papadopoulou-Alataki E, Theodoriadou M, Kazek-Duret MP, Gurunathan S, De Bruijn I. Efficacy, immunogenicity, and safety of a quadrivalent inactivated influenza vaccine in children aged 6–35 months: A multi-season randomised placebo-controlled trial in the Northern and Southern Hemispheres. Vaccine 2019; 37:1876-1884. [DOI: 10.1016/j.vaccine.2018.11.074] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/09/2018] [Accepted: 11/26/2018] [Indexed: 11/27/2022]
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Song JY, Lee J, Woo HJ, Wie SH, Lee JS, Kim SW, Kim TH, Jung SI, Noh JY, Choi WS, Cheong HJ, Kim WJ. Immunogenicity and safety of an egg-based inactivated quadrivalent influenza vaccine (GC3110A) versus two inactivated trivalent influenza vaccines with alternate B strains: A phase Ⅲ randomized clinical trial in adults. Hum Vaccin Immunother 2018; 15:710-716. [PMID: 30396317 DOI: 10.1080/21645515.2018.1536589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Two antigenically distinct influenza B lineage viruses (Yamagata/Victoria) have been co-circulating globally since the mid-1980s. The quadrivalent influenza vaccine (QIV) may provide better protection against unpredictable B strains. We conducted a randomized, double-blind, phase III trial to evaluate the immunogenicity and safety of an egg-based inactivated, split-virion QIV (GC3110A). Subjects aged ≥ 19 years were randomized 2:1:1 to be vaccinated with QIV- GC3110A, trivalent influenza vaccine (TIV) containing the Yamagata lineage strain (TIV-Yamagata), or TIV containing the Victoria lineage strain (TIV-Victoria). Hemagglutination inhibition assays were performed 21 days post-vaccination. Solicited/unsolicited adverse events (AEs) were assessed within 21 days after vaccination, while serious AEs were reported up to six months after vaccination. A total of 1,299 were randomized to receive QIV-GC3110A (648 subjects), TIV-Yamagata (325 subjects), or TIV-Victoria (326 subjects). Compared to the TIVs, the QIV-GC3110A met the non-inferiority criteria for all four subtype/lineage strains with respect to the geometric mean titer (GMT) ratio and the difference of seroconversion rate. The safety profiles of QIV-GC3110A were consistent with those of TIV. In conclusion, QIV-GC3110A is safe, immunogenic, and comparable to strain-matched TIV.
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Affiliation(s)
- Joon Young Song
- a Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine1 , Seoul , Korea
| | - Jacob Lee
- b Division of Infectious Diseases, Department of Internal Medicine, Kangnam Sacred Heart Hospital , Hallym University College of Medicine , Seoul , Korea
| | - Heung Jeong Woo
- c Division of Infectious Diseases, Department of Internal Medicine, Dongtan Sacred Heart Hospital , Hallym University College of Medicine , Hwasung , Korea
| | - Seong-Heon Wie
- d Division of Infectious Diseases, Department of Internal Medicine , Catholic University Medical College, St. Vincent's Hospital , Suwon , Korea
| | - Jin Soo Lee
- e Division of Infectious Diseases, Department of Internal Medicine , Inha University College of Medicine , Incheon , Korea
| | - Shin Woo Kim
- f Division of Infectious Diseases, Department of Internal Medicine , Kyungpook National University School of Medicine , Daegu , Korea
| | - Tae Hyong Kim
- g Division of Infectious Diseases, Department of Internal Medicine , Soon Chun Hyang University Hospital, Soon Chun Hyang University College of Medicine , Seoul , Korea
| | - Sook-In Jung
- h Division of Infectious Diseases, Department of Internal Medicine, Chonnam National University Medical School , Chonnam National University Hospital , Gwangju , Korea
| | - Ji Yun Noh
- a Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine1 , Seoul , Korea
| | - Won Suk Choi
- a Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine1 , Seoul , Korea
| | - Hee Jin Cheong
- a Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine1 , Seoul , Korea
| | - Woo Joo Kim
- a Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine1 , Seoul , Korea
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Pillsbury AJ, Glover C, Jacoby P, Quinn HE, Fathima P, Cashman P, Leeb A, Blyth CC, Gold MS, Snelling T, Macartney KK. Active surveillance of 2017 seasonal influenza vaccine safety: an observational cohort study of individuals aged 6 months and older in Australia. BMJ Open 2018; 8:e023263. [PMID: 30341132 PMCID: PMC6196842 DOI: 10.1136/bmjopen-2018-023263] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To actively solicit adverse events experienced in the days following immunisation with quadrivalent inactivated influenza vaccine using Australia's near real-time, participant-based vaccine safety surveillance system, AusVaxSafety. DESIGN AND SETTING Observational cohort study conducted in 194 sentinel surveillance immunisation sites (primary care, hospital and community-based clinics) across Australia. PARTICIPANTS Individuals aged ≥6 months who received a routine seasonal influenza vaccine at a participating site (n=102 911) and responded to a survey (via short message service or email) sent 3 days after vaccination about adverse events experienced (n=73 892; 71.8%). MAIN OUTCOME MEASURE Near real-time and cumulative participant-reported rates of any adverse event, fever or medical attendance experienced within 3 days after vaccination overall, by brand, age, pregnancy status and concomitant vaccine receipt. RESULTS Participant median age was 57 years (range: 6 months to 102 years); 58.1% (n=42 869) were female and 2.7% (n=2018) were pregnant. Near real-time fast initial response cumulative summation and Bayesian analyses of weekly event rates did not demonstrate a safety signal. Children aged 6 months to 4 years had higher event rates (522/6180; 8.4%) compared with older ages; participants aged ≥65 years reported fewer events (1695/28 154; 6.0%). There were no clinically significant differences in safety between brands, by age group or overall. Cumulative data analysis demonstrated that concomitant vaccination was associated with increased rates of fever (2.1% vs 0.8%) and medical attendance (0.8% vs 0.4%), although all rates were low and did not exceed expected levels. CONCLUSIONS Novel, postmarketing AusVaxSafety surveillance demonstrated comparable and expected safety outcomes for the 2017 quadrivalent inactivated influenza vaccine brands used in Australia. These near real-time, participant-reported data are expected to encourage confidence in vaccine safety and promote uptake.
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Affiliation(s)
- Alexis J Pillsbury
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Catherine Glover
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Peter Jacoby
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Helen E Quinn
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Parveen Fathima
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Patrick Cashman
- Hunter New England Population Health, Newcastle, New South Wales, Australia
| | - Alan Leeb
- SmartVax, c/o Illawarra Medical Centre, Ballajura, Western Australia, Australia
- Illawarra Medical Centre, Ballajura, Western Australia, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- PathWest Laboratory Medicine WA, Department of Microbiology, QEII Medical Centre, Perth, Western Australia, Australia
| | - Michael S Gold
- Discipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Thomas Snelling
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Princess Margaret Hospital for Children, Perth, Western Australia, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kristine K Macartney
- National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Microbiology and Infectious Disease, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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Whitaker JA, von Itzstein MS, Poland GA. Strategies to maximize influenza vaccine impact in older adults. Vaccine 2018; 36:5940-5948. [PMID: 30153995 DOI: 10.1016/j.vaccine.2018.08.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 07/30/2018] [Accepted: 08/15/2018] [Indexed: 01/13/2023]
Abstract
Older adults are disproportionately affected by influenza morbidity and mortality. In most high income countries, influenza vaccine policies target persons age ≥65 years for influenza vaccination. Many low-resource settings do not utilize seasonal influenza vaccination. Barriers to influenza prevention among older adults around the globe are multiple and some vary between high- and low-resource settings. To maximize influenza prevention in the older adult population, gaps in influenza vaccination coverage and improvements in vaccine efficacy are needed. The focus of this article is on the data for currently available vaccine strategies to maximize influenza vaccine impact, with a focus on high-resource settings. We also discuss novel influenza vaccine strategies needed for older adults worldwide.
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Affiliation(s)
| | | | - Gregory A Poland
- Mayo Vaccine Research Group, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
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36
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López Trigo JA, López Mongil R, Mariano Lázaro A, Mato Chaín G, Moreno Villajos N, Ramos Cordero P. [Seasonal flu vaccination for older people: Evaluation of the quadrivalent vaccine. Positioning report]. Rev Esp Geriatr Gerontol 2018; 53 Suppl 2:185-202. [PMID: 30107941 DOI: 10.1016/j.regg.2018.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 06/22/2018] [Indexed: 01/08/2023]
Abstract
Influenza is a significant health problem, particularly in those persons susceptible to having associated complications, older people, children less than 2 years, patients with chronic diseases, immunocompromised patients, and pregnant women. But influenza also has a large impact on the health system, with an increase in the healthcare demand and a spectacular increase in outpatient visits, overloading the emergency and hospital services. During epidemic outbreaks, the hospital admission rates of people over 65 years are at a maximum, and the mortality notified for the 2017/2018 influenza season was 960 deaths. The seasonal anti-influenza vaccine is the method with a better cost-effective ratio of primary prevention of influenza, reducing associated respiratory diseases, the number of hospital admissions, and deaths in high risk individuals, as well as work absenteeism in adults. In the last few years, influenza B has received little attention in the scientific literature, although in the periods between epidemics influenza B can be one of the main causes of seasonal epidemics, causing considerable morbidity and mortality and an increase in costs. The quadrivalent vaccine has a second-line immunological protection against influenza B, and according to a critical review of the scientific literature, it provides wider protection without affecting immunogenicity of the other three vaccine strains common to the trivalent and tetravalent vaccine. The quadrivalent vaccine is cost-effective in reducing the number of influenza cases, and is always a worthwhile intervention, with a significant cost saving for the health system and for society, by reducing the hospital admission rates and mortality associated with the complications of influenza. Supplement information: This article is part of a supplement entitled 'Seasonal flu vaccination for older people: Evaluation of the quadrivalent vaccine' which is sponsored by Sanofi-Aventis, S.A.
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Affiliation(s)
- José Antonio López Trigo
- Geriatría, Ayuntamiento de Málaga. Presidencia de la Sociedad Española de Geriatría y Gerontología (SEGG), Málaga, España.
| | | | - Alberto Mariano Lázaro
- Medicina Preventiva y Salud Pública, Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España
| | - Gloria Mato Chaín
- Medicina Preventiva y Salud Pública, Unidad de Vacunación del Adulto, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España
| | | | - Primitivo Ramos Cordero
- Coordinación médico-asistencial, Servicio Regional de Bienestar Social, Comunidad de Madrid, Madrid, España
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Greenberg DP, Robertson CA, Talbot HK, Decker MD. Safety and immunogenicity of a quadrivalent influenza vaccine in adults 65 y of age and older. Hum Vaccin Immunother 2018; 13:2058-2064. [PMID: 28700265 PMCID: PMC5612218 DOI: 10.1080/21645515.2017.1344375] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Frequent mismatches between the predominant circulating B strain lineage and the B strain lineage in trivalent influenza vaccines have resulted in missed opportunities to prevent influenza illness. Quadrivalent influenza vaccines containing B strains from each of the 2 lineages have been developed for improved prevention of influenza B infections. Here, we describe the results of a phase III, randomized, double-blind, active-controlled, multicenter trial examining the safety and immunogenicity of a split-virion inactivated quadrivalent influenza vaccine (IIV4) in 675 adults ≥ 65 y of age (NCT01218646). Participants were randomly assigned 1:1:1 to receive a single intramuscular injection with the investigational IIV4, or one of 2 split-virion trivalent inactivated influenza vaccines (IIV3s): a licensed IIV3 containing a B Victoria-lineage strain or an investigational IIV3 containing a B Yamagata-lineage strain. Post-vaccination (day 21) hemagglutinin inhibition titers to all strains induced by IIV4 were statistically non-inferior to those induced by the 2 IIV3s. In addition, for each B strain, rates of seroconversion in the IIV4 group were superior to those induced by the comparator IIV3 not containing that B strain. For all vaccines, the most common solicited reaction was injection-site pain, and most reactions were mild to moderate in intensity and transient. Overall safety profiles were similar between IIV4 and the IIV3s, and no vaccine-related serious adverse events were reported. These results confirm that in adults ≥ 65 y of age, IIV4 was well tolerated and immunogenic against the additional B lineage strain without compromising the immunogenicity of the other 3 vaccine strains.
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Affiliation(s)
- David P Greenberg
- a Sanofi Pasteur , Swiftwater , PA , USA.,b Department of Pediatrics , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | | | - H Keipp Talbot
- c Department of Medicine , Vanderbilt University Medical Center , A2200 MCN, Nashville , TN , USA
| | - Michael D Decker
- a Sanofi Pasteur , Swiftwater , PA , USA.,d Department of Health Policy , Vanderbilt University School of Medicine , Nashville , TN , USA
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van de Witte S, Nauta J, Montomoli E, Weckx J. A Phase III randomised trial of the immunogenicity and safety of quadrivalent versus trivalent inactivated subunit influenza vaccine in adult and elderly subjects, assessing both anti-haemagglutinin and virus neutralisation antibody responses. Vaccine 2018; 36:6030-6038. [PMID: 29709447 DOI: 10.1016/j.vaccine.2018.04.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Trivalent influenza vaccines (TIVs) offer substantial protection against matching B-strains, however, protection against alternate-lineage B-strains may be enhanced by adding a second B-strain in quadrivalent influenza vaccines (QIVs). In this Phase III, double-blind, multicentre, randomised study, the immunogenicity and safety of subunit inactivated QIV versus TIV was assessed in adult (aged ≥18 to ≤60 years) and elderly (aged ≥61 years) subjects by analysing a combination of haemagglutinin inhibition (HI) and virus neutralisation (VN). METHODS Subjects (n = 1980) were recruited off season (2015/2016) from 20 centres in five European countries and randomised to receive either QIV (n = 1538), TIV with B-strain of the Victoria lineage (n = 221) or TIV with B-strain of the Yamagata lineage (n = 221). The primary aim was to demonstrate non-inferiority of QIV to TIV for immunogenicity against matched influenza strains based on post-vaccination HI titres. Secondary aims were to show superiority of QIV to TIV for immunogenicity against alternate-lineage B-strains and to characterise the immune response by reverse cumulative distribution (RCD) curves of antibody titres and derived serological parameters for HI and VN. Reactogenicity and occurrence of adverse events were assessed post-vaccination. RESULTS QIV elicited a non-inferior immune response for matched strains (upper limit of 95% CI for HI geometric mean ratios [GMRs] <1.5) and a superior response for alternate-lineage B-strains (HI GMRs < 1; p < 0.0001) versus TIV. RCD curves demonstrated that post-vaccination HI and VN titres were higher for QIV versus TIV for both alternate-lineage B-strains. Seroconversion rates and geometric mean fold increases of the VN assay were consistent with the HI assay for all strains in QIV. Reporting rates of local and systemic reactions were similar in both vaccine groups. CONCLUSIONS QIV was non-inferior in immunogenicity to TIV for matched strains and superior to the alternate-lineage B-strains in TIV. Safety and tolerability profiles of QIV and TIV were comparable.
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Affiliation(s)
- Serge van de Witte
- Abbott Healthcare Products B.V., C.J. van Houtenlaan 36, 1381 CP Weesp, Netherlands.
| | - Jos Nauta
- Abbott Healthcare Products B.V., C.J. van Houtenlaan 36, 1381 CP Weesp, Netherlands
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Banchi di Sotto, 53100 Siena, Italy; VisMederi srl, Str. Del Petriccio e Belriguardo, 35, 53100 Siena, Italy
| | - Jos Weckx
- Medisch Centrum Tessenderlo, Groenstraat 27, 3980 Tessenderlo, Belgium
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Claeys C, Drame M, García-Sicilia J, Zaman K, Carmona A, Tran PM, Miranda M, Martinón-Torres F, Thollot F, Horn M, Schwarz TF, Behre U, Merino JM, Sadowska-Krawczenko I, Szymański H, Schu P, Neumeier E, Li P, Jain VK, Innis BL. Assessment of an optimized manufacturing process for inactivated quadrivalent influenza vaccine: a phase III, randomized, double-blind, safety and immunogenicity study in children and adults. BMC Infect Dis 2018; 18:186. [PMID: 29669531 PMCID: PMC5907359 DOI: 10.1186/s12879-018-3079-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 04/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND GSK has modified the licensed monovalent bulk manufacturing process for its split-virion inactivated quadrivalent influenza vaccine (IIV4) to harmonize the process among different strains, resulting in an increased number of finished vaccine doses, while compensating for the change from inactivated trivalent influenza vaccine (IIV3) to IIV4. To confirm the manufacturing changes do not alter the profile of the vaccine, a clinical trial was conducted to compare IIV4 made by the currently licensed process with a vaccine made by the new (investigational) process (IIV4-I). The main objectives were to compare the reactogenicity and safety of IIV4-I versus IIV4 in all age groups, and to demonstrate the non-inferiority of the hemagglutination-inhibition (HI) antibody responses based on the geometric mean titer ratio of IIV4-I versus IIV4 in children. METHODS The Phase III, randomized, double-blind, multinational study included three cohorts: adults (18-49 years; N = 120), children (3-17 years; N = 821), and infants (6-35 months; N = 940). Eligible subjects in each cohort were randomized 1:1 to receive IIV4-I or IIV4. Both vaccines contained 15 μg of hemagglutinin antigen for each of the four seasonal virus strains. Adults and vaccine-primed children received one dose of vaccine, and vaccine-unprimed children received two doses of vaccine 28 days apart. All children aged ≥9 years were considered to be vaccine-primed and received one dose of vaccine. RESULTS The primary immunogenicity objective of the study was met in demonstrating immunogenic non-inferiority of IIV4-I versus IIV4 in children. The IIV4-I was immunogenic against all four vaccine strains in each age cohort. The reactogenicity and safety profile of IIV4-I was similar to IIV4 in each age cohort, and there was no increase in the relative risk of fever (≥38 °C) with IIV4-I versus IIV4 within the 7-day post-vaccination period in infants (1.06; 95% Confidence Interval: 0.75, 1.50; p = 0.786). CONCLUSIONS The study demonstrated that in adults, children, and infants, the IIV4-I made using an investigational manufacturing process was immunogenic with a reactogenicity and safety profile that was similar to licensed IIV4. These results support that the investigational process used to manufacture IIV4-I is suitable to replace the current licensed process. TRIAL REGISTRATION ClinicalTrials.gov: NCT02207413 ; trial registration date: August 4, 2014.
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Affiliation(s)
- Carine Claeys
- GSK, Clinical Research and Development, Wavre, Belgium
| | - Mamadou Drame
- GSK, Clinical Evidence Generation (CEG), King of Prussia, PA USA
| | - José García-Sicilia
- Hospital Universitario HM Sanchinarro, Clinical Investigation in Vaccines Unit, Madrid, Spain
| | | | - Alfonso Carmona
- Instituto Hispalense de Pediatría, Pediatría, Sevilla, Spain
| | - Phu My Tran
- Cabinet Médical Tran, Pédiatrie, Nice, France
| | | | - Federico Martinón-Torres
- Department of Pediatrics, Santiago de Compostela, Hospital Clínico Universitario de Santiago, Translational Pediatrics and Infectious Diseases, Galicia, Spain
- Instituto de Investigación Sanitaria de Santiago and Universidade de Santiago de Compostela (USC), Grupo de Investigación en Genética, Vacunas, Infecciones y Pediatría (GENVIP), Galicia, Spain
| | - Franck Thollot
- Association Française de Pédiatrie Ambulatoire (AFPA), Pédiatrie, Essey-les-Nancy, France
| | - Michael Horn
- Dr. med. Michael R. Horn Office, Pediatrics, Schoenau am Koenigssee, Germany
| | - Tino F. Schwarz
- Klinikum Würzburg Mitte, Standort Juliusspital, Central Laboratory and Vaccination Centre, Würzburg, Germany
| | | | - José M. Merino
- Pediatric Department, Hospital Universitario de Burgos, Burgos, Spain
| | - Iwona Sadowska-Krawczenko
- Department of Obstetrics and Gynecology, Faculty of Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Torun, Poland
- Department of Neonatology, University Hospital No 2, Bydgoszcz, Poland
| | | | - Peter Schu
- GSK, Global Industrial Operations, Dresden, Germany
| | | | - Ping Li
- GSK, Clinical Evidence Generation (CEG), King of Prussia, PA USA
- Present Address: Pfizer VRD, Collegeville, PA USA
| | - Varsha K. Jain
- GSK, Clinical Research and Development, King of Prussia, PA USA
- Present Address: Bill and Melinda Gates Foundation, Seattle, WA USA
| | - Bruce L. Innis
- GSK, Clinical Research and Development, King of Prussia, PA USA
- Present Address: PATH, Washington, DC USA
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Montomoli E, Torelli A, Manini I, Gianchecchi E. Immunogenicity and Safety of the New Inactivated Quadrivalent Influenza Vaccine Vaxigrip Tetra: Preliminary Results in Children ≥6 Months and Older Adults. Vaccines (Basel) 2018; 6:E14. [PMID: 29518013 PMCID: PMC5874655 DOI: 10.3390/vaccines6010014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 02/26/2018] [Accepted: 03/05/2018] [Indexed: 12/31/2022] Open
Abstract
Since the mid-1980s, two lineages of influenza B viruses have been distinguished. These can co-circulate, limiting the protection provided by inactivated trivalent influenza vaccines (TIVs). This has prompted efforts to formulate quadrivalent influenza vaccines (QIVs), to enhance protection against circulating influenza B viruses. This review describes the results obtained from seven phase III clinical trials evaluating the immunogenicity, safety, and lot-to-lot consistency of a new quadrivalent split-virion influenza vaccine (Vaxigrip Tetra®) formulated by adding a second B strain to the already licensed TIV. Since Vaxigrip Tetra was developed by means of a manufacturing process strictly related to that used for TIV, the data on the safety profile of TIV are considered supportive of that of Vaxigrip Tetra. The safety and immunogenicity of Vaxigrip Tetra were similar to those of the corresponding licensed TIV. Moreover, the new vaccine elicits a superior immune response towards the additional strain, without affecting immunogenicity towards the other three strains. Vaxigrip Tetra is well tolerated, has aroused no safety concerns, and is recommended for the active immunization of individuals aged ≥6 months. In addition, preliminary data confirm its immunogenicity and safety even in children aged 6-35 months and its immunogenicity in older subjects (aged 66-80 years).
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Affiliation(s)
- Emanuele Montomoli
- VisMederi srl, Strada del Petriccio e Belriguardo, 35, 53100 Siena, Italy.
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy.
| | - Alessandro Torelli
- VisMederi srl, Strada del Petriccio e Belriguardo, 35, 53100 Siena, Italy.
- Department of Life Sciences, University of Siena, 53100 Siena, Italy.
| | - Ilaria Manini
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy.
| | - Elena Gianchecchi
- VisMederi srl, Strada del Petriccio e Belriguardo, 35, 53100 Siena, Italy.
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Trombetta CM, Gianchecchi E, Montomoli E. Influenza vaccines: Evaluation of the safety profile. Hum Vaccin Immunother 2018; 14:657-670. [PMID: 29297746 PMCID: PMC5861790 DOI: 10.1080/21645515.2017.1423153] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/30/2017] [Accepted: 12/23/2017] [Indexed: 12/15/2022] Open
Abstract
The safety of vaccines is a critical factor in maintaining public trust in national vaccination programs. Vaccines are recommended for children, adults and elderly subjects and have to meet higher safety standards, since they are administered to healthy subjects, mainly healthy children. Although vaccines are strictly monitored before authorization, the possibility of adverse events and/or rare adverse events cannot be totally eliminated. Two main types of influenza vaccines are currently available: parenteral inactivated influenza vaccines and intranasal live attenuated vaccines. Both display a good safety profile in adults and children. However, they can cause adverse events and/or rare adverse events, some of which are more prevalent in children, while others with a higher prevalence in adults. The aim of this review is to provide an overview of influenza vaccine safety according to target groups, vaccine types and production methods.
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Affiliation(s)
| | | | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- VisMederi srl, Siena, Italy
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Sesay S, Brzostek J, Meyer I, Donazzolo Y, Leroux-Roels G, Rouzier R, Astruc B, Szymanski H, Toursarkissian N, Vandermeulen C, Kowalska E, Van Damme P, Salamand C, Pepin S. Safety, immunogenicity, and lot-to-lot consistency of a split-virion quadrivalent influenza vaccine in younger and older adults: A phase III randomized, double-blind clinical trial. Hum Vaccin Immunother 2017; 14:596-608. [PMID: 28968138 PMCID: PMC5861783 DOI: 10.1080/21645515.2017.1384106] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Here, we report a randomized multicenter phase III trial assessing the lot-to-lot consistency of the 2014–2015 Northern Hemisphere quadrivalent split-virion inactivated influenza vaccine (IIV4; Sanofi Pasteur) and comparing its immunogenicity and safety with that of trivalent inactivated influenza vaccine (IIV3) in younger and older adults (EudraCT no. 2014-000785-21). Younger (18–60 y, n = 1114) and older (>60 y, n = 1111) adults were randomized 2:2:2:1:1 to receive a single dose of one of three lots of IIV4, the licensed IIV3 containing the B Yamagata lineage strain, or an investigational IIV3 containing the B Victoria lineage strain. Post-vaccination (day 21) hemagglutination inhibition antibody titers were equivalent for the three IIV4 lots. For the pooled IIV4s vs. IIV3, hemagglutination inhibition antibody titers were also non-inferior for the A strains, non-inferior for the B strain when present in the comparator IIV3, and superior for the B strain lineage when absent from the comparator IIV3. For all vaccine strains, seroprotection rates were ≥98% in younger adults and ≥90% in older adults. IIV4 also increased seroneutralizing antibody titers against all three vaccine strains of influenza. All vaccines were well tolerated, with no safety concerns identified. Solicited injection-site reactions were similar for IIV4 and IIV3 and mostly grade 1 and transient. This study showed that in younger and older adults, IIV4 had a similar safety profile as the licensed IIV3 and that including a second B strain lineage in IIV4 provided superior immunogenicity for the added B strain without affecting the immunogenicity of the three IIV3 strains.
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Affiliation(s)
| | - Jerzy Brzostek
- b Clinic of Infectious Diseases Health Care Team , Dębica , Poland
| | - Ingo Meyer
- c CRS Clinical Research Services Kiel GmbH , Lübeck , Germany
| | | | - Geert Leroux-Roels
- e Center for Vaccinology, Ghent University and University Hospital , Gent , Belgium
| | - Régine Rouzier
- f Centre CAP, Centre Médical Odysseum , Montpellier , France
| | | | - Henryk Szymanski
- h St Hedwig of Silesia Hospital , Department of Paediatrics , Prusicka , Trzebnica , Poland
| | | | | | | | - Pierre Van Damme
- l Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute , Antwerpen (Wilrijk) , Belgium
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Gresset-Bourgeois V, Leventhal PS, Pepin S, Hollingsworth R, Kazek-Duret MP, De Bruijn I, Samson SI. Quadrivalent inactivated influenza vaccine (VaxigripTetra™). Expert Rev Vaccines 2017; 17:1-11. [PMID: 29157068 DOI: 10.1080/14760584.2018.1407650] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION VaxigripTetra™ (IIV4; Sanofi Pasteur) is a quadrivalent split-virion influenza vaccine approved in Europe in 2016 for individuals ≥ 3 years of age. IIV4 builds on the well-established record of the trivalent split-virion influenza vaccine (Vaxigrip®). Areas covered: This literature review summarizes the rationale for developing quadrivalent influenza vaccines and discusses the phase III clinical trial results supporting the immunogenicity, safety, and tolerability of IIV4. Expert commentary: IIV4 is immunogenic and well tolerated. Adding a second B strain to the trivalent split-virion influenza vaccine provides a superior immune response for the additional strain but does not reduce the immune response for the three other strains or negatively affect the safety profile. By offering broader protection against co-circulating influenza B lineages, IIV4 has the potential to further reduce influenza-related morbidity and mortality beyond that achieved with trivalent vaccines.
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Affiliation(s)
| | | | - Stéphanie Pepin
- c Clinical Development , Sanofi Pasteur , Marcy l'Étoile , France
| | | | | | - Iris De Bruijn
- c Clinical Development , Sanofi Pasteur , Marcy l'Étoile , France
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Choi WS, Noh JY, Lee J, Choi JY, Lee JS, Kim MS, Kim HS, Bang J, Lavis N, Kim WJ. Immunogenicity and safety of a split-virion quadrivalent influenza vaccine in adults 18-60 years of age in the Republic of Korea. Hum Vaccin Immunother 2017; 14:587-592. [PMID: 28933625 PMCID: PMC5861787 DOI: 10.1080/21645515.2017.1381808] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
VaxigripTetra® (Sanofi Pasteur, Lyon, France) is a quadrivalent split-virion inactivated influenza vaccine (IIV4) containing two B-lineage strains approved in the European Union and Taiwan in 2016 for individuals ≥ 3 years of age. Here, we describe an observer-blind, randomized, controlled, multicenter trial study evaluating the immunogenicity and safety of the Northern Hemisphere 2015-2016 formulations of IIV4 and the licensed split-virion trivalent inactivated influenza vaccine (IIV3) in the Republic of Korea (ClinicalTrials.gov no. NCT02550197). The study included 300 Korean adults 18-60 years of age randomized 2:1 to receive a single injection of IIV4 or IIV3. For each of the four vaccine strains in IIV4, 21 days after vaccination, geometric mean post-/pre-vaccination ratios of hemagglutination inhibition titers were ≥ 3.97. Seroconversion/significant increases rates were ≥ 40% for all but the A/H1N1 strain, for which the rate was 39.7%. Results were similar for the three strains in IIV3. For the additional B-lineage strain not in IIV3 (Victoria), hemagglutination inhibition antibody titers were higher for IIV4 than for IIV3. Solicited reactions and adverse events were similar between IIV4 and IIV3, and no serious adverse events or new safety signals were detected. These results confirm the robust immunogenicity and acceptable safety of IIV4 in adults 18-60 years of age and show that including a second B-lineage strain should provide broader protection against B-strain influenza without affecting vaccine safety or the immunogenicity of other three vaccine strains.
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Affiliation(s)
- Won Suk Choi
- a Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Ji Yun Noh
- a Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
| | - Jacob Lee
- b Division of Infectious Diseases, Department of Internal Medicine , Hallym University College of Medicine , Seoul , Republic of Korea
| | - Jun Yong Choi
- c Division of Infectious Diseases, Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Republic of Korea
| | - Jin-Soo Lee
- d Division of Infectious Diseases, Department of Internal Medicine , Inha University School of Medicine , Incheon , Republic of Korea
| | - Moo Soo Kim
- e Sanofi Pasteur, Regulatory Affairs , Seoul , Republic of Korea
| | - Hee Soo Kim
- f Sanofi Pasteur, Global Medical Affairs , Seoul , Republic of Korea
| | - Joon Bang
- f Sanofi Pasteur, Global Medical Affairs , Seoul , Republic of Korea
| | | | - Woo Joo Kim
- a Division of Infectious Diseases, Department of Internal Medicine , Korea University College of Medicine , Seoul , Republic of Korea
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Latreille-Barbier M, Rouzier R, Astruc B, Lavis N, Donazzolo Y. Immunogenicity and safety of the Southern Hemisphere 2015 formulation of Vaxigrip®. Hum Vaccin Immunother 2017; 13:2674-2677. [PMID: 28937844 PMCID: PMC5703369 DOI: 10.1080/21645515.2017.1363944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/12/2017] [Accepted: 08/01/2017] [Indexed: 10/27/2022] Open
Abstract
An inactivated split-virion trivalent influenza vaccine (IIV3; Vaxigrip®, Sanofi Pasteur) has been available globally since 1968. Here, we describe the results of an open-label, post-licensure trial (EudraCT no. 2014-005078-12) to confirm the immunogenicity and safety of the Southern Hemisphere 2015 formulation of IIV3. Adults 18-60 years of age and > 60 years of age (60 per age group) received a single 0.5-ml intramuscular injection of IIV3. Between baseline and day 21 after vaccination, hemagglutination inhibition (HAI) titers for each strain in IIV3 increased, on average, by at least 11-fold for younger adults and at least 5-fold for older adults. After vaccination, 89%-100% of the younger adult participants and 90%-98% of the older adult participants attained seroprotection (HAI titer ≥ 40) for each strain. Also, 66%-81% of younger adults and 45%-63% of older adults seroconverted or had a significant increase in HAI titer for each strain. For both age groups, these post-vaccination immune responses exceeded the criteria of the Committee for Human Medicinal Products former Note for Guidance for influenza vaccines. No serious adverse events were reported, and no new safety signals were detected. In conclusion, this study confirmed that the Southern Hemisphere 2015 formulation of IIV3 was well tolerated, highly immunogenic, and met the criteria for influenza vaccine efficacy and safety.
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Affiliation(s)
| | - Regine Rouzier
- Centre CAP, Centre Médical Odysseum, Montpellier, France
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Montalban C, Montellano MB, Santos J, Lavis N. Immunogenicity and safety of the 2015 Southern Hemisphere formulation of a split-virion inactivated quadrivalent vaccine. Hum Vaccin Immunother 2017; 14:593-595. [PMID: 28933626 PMCID: PMC5861779 DOI: 10.1080/21645515.2017.1377378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
An inactivated split-virion quadrivalent influenza vaccine (IIV4; Fluzone® Quadrivalent; Sanofi Pasteur) has been available in the US since 2013 and in the Southern Hemisphere since 2015. Here, we describe the results of an open-label, post-licensure trial (WHO Universal Trial Number, U1111-1143-9256) to confirm the immunogenicity and safety of the Southern Hemisphere 2015 formulation of IIV4. Adults 18–60 years of age and > 60 years of age (n = 60 per age group) received a single 0.5-mL intramuscular injection of IIV4. After vaccination, hemagglutination inhibition titers for each strain in IIV4 increased by a geometric mean of at least 10-fold for younger adults and at least 9-fold for older adults. All of the younger adult participants and 98%–100% of the older adult participants had seroprotective titers for each strain. Also, at least 80% of younger adults and 78% of older adults seroconverted or had a significant increase in titer for all four vaccine strains. These post-vaccination immune responses exceeded the criteria of the Committee for Human Medicinal Products former Note for Guidance for influenza vaccines. Finally, no serious adverse events were reported, and no new safety signals were detected. These results confirmed that the Southern Hemisphere 2015 formulation of IIV4 was well tolerated, highly immunogenic, and met the criteria for influenza vaccine immunogenicity and safety.
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Affiliation(s)
- Cecilia Montalban
- a Manila Doctors Hospital, Infectious Disease Section , Department of Medicine , Ermita , Manila , Philippines
| | - May Book Montellano
- b Mary Chiles General Hospital , Department of Pediatrics, Sampaloc, Manila , Philippines
| | - Jaime Santos
- c Philippine Children's Medical Center, Infectious Diseases Section , Quezon , Quezon City , Philippines
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Harper JA, South C, Trivedi MH, Toups MS. Pilot investigation into the sickness response to influenza vaccination in adults: Effect of depression and anxiety. Gen Hosp Psychiatry 2017; 48:56-61. [PMID: 28779589 PMCID: PMC5606200 DOI: 10.1016/j.genhosppsych.2017.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine whether depressed or anxious patients experience greater affective change than mentally healthy individuals following influenza vaccination. METHODS Participants (n=112) completed the Positive and Negative Affect Schedule (PANAS) before influenza vaccination and 1-2days post-vaccination (M=32.3h). Pre- and post-vaccination PANAS scores were compared using two-tailed, paired-samples t-tests. Change in positive affect between participants with depression or anxiety and those without was compared using two-way ANOVA. Follow up positive affect was further examined using multiple linear regression. RESULTS Positive affect decreased following vaccination (M=2.18, 95% CI [1.07, 3.29], t(111)=3.89, p<0.001) for all participants and was more pronounced for those with anxiety or depression (F(1, 110)=7.51, p=0.009). Similarly, predicted follow up affect score was higher for those without a mental health conditions (β=3.67, 95% CI [1.18, 6.16], t(103)=2.92, p=0.004). CONCLUSIONS These data suggest that influenza vaccine has a greater effect on affect in patients with depression and anxiety than in mentally healthy individuals. This effect was focused on positive affect, suggesting that influenza vaccine induced inflammation may be best suited to examine alterations in positive affect and positive valence systems.
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Affiliation(s)
- Jessica A. Harper
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, 75390
| | - Charles South
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, 75390
| | - Madhukar H. Trivedi
- Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, 75390
| | - Marisa S. Toups
- Psychiatry, Dell Medical School, The University of Texas at Austin, Austin, TX, 78712
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Haugh M, Gresset-Bourgeois V, Macabeo B, Woods A, Samson SI. A trivalent, inactivated influenza vaccine (Vaxigrip®): summary of almost 50 years of experience and more than 1.8 billion doses distributed in over 120 countries. Expert Rev Vaccines 2017; 16:545-564. [PMID: 28460594 DOI: 10.1080/14760584.2017.1324302] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Vaxigrip, a trivalent split-virion, inactivated vaccine available since 1968 has been in use longer than any other influenza vaccine. It is the most widely-used influenza vaccine, with more than 1.8 billion doses distributed in more than 120 countries. Areas covered: The significant body of evidence that confirms the efficacy, effectiveness, immunogenicity, and safety of Vaxigrip in healthy individuals of all ages and at-risk populations is summarized. The results from at least 15 randomized efficacy trials and 15 other studies have demonstrated that vaccination with Vaxigrip is efficacious against various clinical endpoints. It was estimated that more than 37 million laboratory-confirmed influenza episodes, 476,000 influenza-related hospitalizations, and 67,000 influenza-related deaths have been avoided by the more than 1.8 billion doses of Vaxigrip that have been distributed, emphasizing its important public health impact. Expert commentary: This strong evidence base in favor of Vaxigrip provides a robust foundation to support the implementation of the quadrivalent formulation. This quadrivalent formulation of Vaxigrip contains two A and two B influenza strains (VaxigripTetra), and has a similar immunogenicity and safety profile to the trivalent formulation while offering broader protection due to the addition of the second influenza B strain.
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Affiliation(s)
| | - Viviane Gresset-Bourgeois
- b Department of Medical Affairs, Value and Access and Pharmacovigilance , Sanofi Pasteur , Lyon cedex 07 , France
| | - Bérengère Macabeo
- b Department of Medical Affairs, Value and Access and Pharmacovigilance , Sanofi Pasteur , Lyon cedex 07 , France
| | - Anne Woods
- b Department of Medical Affairs, Value and Access and Pharmacovigilance , Sanofi Pasteur , Lyon cedex 07 , France
| | - Sandrine I Samson
- b Department of Medical Affairs, Value and Access and Pharmacovigilance , Sanofi Pasteur , Lyon cedex 07 , France
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Treanor JT, Albano FR, Sawlwin DC, Graves Jones A, Airey J, Formica N, Matassa V, Leong J. Immunogenicity and safety of a quadrivalent inactivated influenza vaccine compared with two trivalent inactivated influenza vaccines containing alternate B strains in adults: A phase 3, randomized noninferiority study. Vaccine 2017; 35:1856-1864. [PMID: 28302411 DOI: 10.1016/j.vaccine.2017.02.066] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Vaccination is the most effective means of influenza prevention. Efficacy of trivalent vaccines may be enhanced by including both B strain lineages. This phase 3, double-blind study assessed the immunogenicity and safety/tolerability of a quadrivalent inactivated influenza vaccine (IIV4) versus the United States (US)-licensed 2014-2015 trivalent inactivated influenza vaccine (IIV3-Yamagata [IIV3-YAM]; Afluria) and IIV3 containing the alternate Victoria B strain (IIV3-VIC) in adults ≥18years. METHODS Participants (n=3484) were randomized 2:1:1 and stratified by age to receive IIV4 (n=1741), IIV3-YAM (n=871), or IIV3-VIC (n=872). The primary objective was to demonstrate noninferiority of the immunological response to IIV4 versus IIV3-YAM and IIV3-VIC. Noninferiority was assessed by hemagglutination inhibition geometric mean titer (GMT) ratio (IIV3/IIV4; upper bound of two-sided 95% confidence interval [CI]≤1.5) and seroconversion rate (SCR) difference (IIV3 - IIV4; upper bound of two-sided 95% CI≤10%) for vaccine strains. Solicited local and systemic adverse events (AEs) were assessed for 7days postvaccination, AEs recorded for 28days postvaccination, and serious AEs for 6months postvaccination. RESULTS IIV4 elicited a noninferior immune response for matched strains, and superior response for unmatched B strains not contained in IIV3 comparators. Adjusted GMT ratios (95% CI) for A/H1N1, A/H3N2, B/YAM, and B/VIC strains were 0.93 (0.88, 0.99), 0.93 (0.88, 0.98), 0.87 (IIV3-YAM; 0.82, 0.93), and 0.95 (IIV3-VIC; 0.88, 1.03), respectively. Corresponding values for SCR differences (95% CI) were -1.1 (-4.5, 2.3), -1.7 (-5.0, 1.7), -3.2 (IIV3-YAM; -7.4, 0.9), and -1.6 (IIV3-VIC; -5.8, 2.5). AEs were generally mild and experienced by 52.9% of participants. Serious AEs were reported with a slightly higher frequency with IIV4 (2.3%) versus IIV3-YAM (1.6%) and IIV3-VIC (1.5%). CONCLUSIONS IIV4 demonstrated immunological noninferiority to the US-licensed IIV3, and superiority for unmatched B strains not contained in IIV3 comparators. Safety/tolerability profiles were similar across vaccine groups. FUNDING Seqirus; Clinicaltrials.gov: NCT02214225.
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Affiliation(s)
- John T Treanor
- University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY, United States
| | - Frank R Albano
- Clinical Development, Seqirus Pty Ltd, Parkville, Victoria, Australia.
| | - Daphne C Sawlwin
- Pharmacovigilance and Risk Management, Seqirus Pty Ltd, Parkville, Victoria, Australia
| | - Alison Graves Jones
- Pharmacovigilance and Risk Management, Seqirus Pty Ltd, Parkville, Victoria, Australia
| | - Jolanta Airey
- Clinical Development, Seqirus Pty Ltd, Parkville, Victoria, Australia
| | - Neil Formica
- Clinical Development, Seqirus Pty Ltd, Parkville, Victoria, Australia
| | - Vince Matassa
- Clinical Development, Seqirus Pty Ltd, Parkville, Victoria, Australia
| | - Jane Leong
- Medical Affairs, Seqirus Pty Ltd, Parkville, Victoria, Australia
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Haut Conseil de la santé publique. Avis relatif à l’utilisation des vaccins quadrivalents inactivés contre la grippe saisonnière (septembre 2016). Rev Mal Respir 2017; 34:165-170. [DOI: 10.1016/j.rmr.2016.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 10/23/2016] [Indexed: 11/17/2022]
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