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Martin JM, Moehling Geffel K, Ortiz MA, Rajasundaram D, Nowalk MP, Zimmerman RK, Alcorn JF. Differential Induction of Interferon-Stimulated Genes by Cell-Based Versus Egg-Based Quadrivalent Influenza Vaccines in Children During the 2018-2019 Season. J Infect Dis 2024; 229:1393-1401. [PMID: 37665976 DOI: 10.1093/infdis/jiad380] [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: 03/30/2023] [Revised: 08/23/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Cell-based quadrivalent-inactivated influenza vaccine has been shown to have higher vaccine effectiveness than traditional egg-based quadrivalent-inactivated influenza vaccine. This is observed despite similar levels of serum hemagglutinin antibodies induced by each vaccine. METHODS In this study, we examine peripheral immune activation after egg-based or cell-based influenza vaccination in a clinical trial in children. Peripheral blood mononuclear cells were isolated, and ribonucleic acid was sequenced from 81 study participants (41 Fluzone, egg based and 40 Flucelvax, cell based) pre- and 7 days postvaccination. Seroconversion was assessed by hemagglutinin inhibition assay. Differential gene expression was determined and pathway analysis was conducted. RESULTS Cell-based influenza vaccine induced greater interferon-stimulated and innate immune gene activation compared with egg-based influenza vaccine. Participants who seroconverted had increased interferon-signaling activation versus those who did not seroconvert. CONCLUSIONS These data suggest that cell-based influenza vaccine stimulates immune activation differently from egg-based influenza vaccine, shedding light on reported differences in vaccine effectiveness.
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Affiliation(s)
- Judith M Martin
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Marianna A Ortiz
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dhivyaa Rajasundaram
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary Patricia Nowalk
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Richard K Zimmerman
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John F Alcorn
- Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Hamamoto I. Developments and current challenges in the process of cell culture-based seasonal influenza vaccine manufacture in Japan. Glob Health Med 2024; 6:93-100. [PMID: 38690131 PMCID: PMC11043132 DOI: 10.35772/ghm.2023.01070] [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: 06/28/2023] [Revised: 11/25/2023] [Accepted: 12/22/2023] [Indexed: 05/02/2024]
Abstract
Seasonal influenza is an acute respiratory infection primarily caused by influenza A and B viruses, which circulate annually and cause substantial morbidity and mortality worldwide. Annual influenza vaccination is currently the most effective measure for preventing influenza and greatly reduces the risk of disease severity and the incidence of complications and death. Annual seasonal influenza vaccines are traditionally produced in Japan and many other countries using viruses propagated in embryonated chicken eggs. However, at present, the effectiveness of the seasonal influenza vaccines has some significant limitations, partly because of egg-adaptive mutations in the antigenic sites of the influenza virus haemagglutinin, which are caused by the continued evolution of seasonal influenza viruses. To overcome the limitations of egg-based influenza vaccine production, a mammalian cell culture-based influenza vaccine production system has been developed in Japan in the past decade as an alternative to the current production method. In this review, I have summarised the progress in the development of cell-based seasonal influenza vaccines and discussed the technological challenges encountered in the development of influenza vaccines.
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Affiliation(s)
- Itsuki Hamamoto
- Laboratory of Cell-based Vaccine Development, Research Center for Influenza and Respiratory Viruses, National Institute of Infectious Diseases, Tokyo, Japan
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Williams KV, Li ZN, Zhai B, Alcorn JF, Nowalk MP, Levine MZ, Kim SS, Flannery B, Moehling Geffel K, Merranko AJ, Collins M, Susick M, Clarke KS, Zimmerman RK, Martin JM. A Randomized Controlled Trial to Compare Immunogenicity to Cell-Based Versus Live-Attenuated Influenza Vaccines in Children. J Pediatric Infect Dis Soc 2023; 12:342-352. [PMID: 37232430 PMCID: PMC10312301 DOI: 10.1093/jpids/piad033] [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] [Received: 12/15/2022] [Accepted: 05/22/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Few studies have focused on the immune response to more recent influenza vaccine formulations such as cell-cultured inactivated influenza vaccine (ccIIV4) or live-attenuated influenza vaccine (LAIV4) in older children and young adults, or differences in immunoglobulin response using newer antibody landscape technology. METHODS Participants ages 4-21 were randomized to receive ccIIV4 (n = 112) or LAIV4 (n = 118). A novel high-throughput multiplex influenza antibody detection assay was used to provide detailed IgG, IgA, and IgM antibody isotypes, along with hemagglutination inhibition levels (HAI), measured pre- and 28 days post-vaccination. RESULTS The HAI and immunoglobulin isotype response to ccIIV4 was greater than LAIV4, with significant increases in IgG but not IgA or IgM. The youngest participants had the highest LAIV4 response. Prior LAIV4 vaccination was associated with a higher response to current season ccIIV4. Cross-reactive A/Delaware/55/2019(H1N1)pdm09 antibodies were present pre-vaccination and increased in response to ccIIV4, but not LAIV4. Immunoglobulin assays strongly correlated with and confirmed the findings of HAI titers to measure immune response. CONCLUSIONS Age and prior season vaccination may play a role in the immune response in children and young adults to ccIIV4 and LAIV4. While immunoglobulin isotypes provide high-level antigen-specific information, HAI titers alone can provide a meaningful representation of day 28 post-vaccination response. CLINICAL TRIALS NO NCT03982069.
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Affiliation(s)
- Katherine V Williams
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Zhu-Nan Li
- National Center Immunizations and Respiratory Disease, Center for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bo Zhai
- Department of Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John F Alcorn
- Department of Immunology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mary Patricia Nowalk
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Min Z Levine
- National Center Immunizations and Respiratory Disease, Center for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sara S Kim
- National Center Immunizations and Respiratory Disease, Center for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Brendan Flannery
- National Center Immunizations and Respiratory Disease, Center for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Amanda Jaber Merranko
- Falk Pharmacy, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, USA
| | - Mark Collins
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Michael Susick
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Karen S Clarke
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Richard K Zimmerman
- Department of Family Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Judith M Martin
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Furlong E, Kotecha RS. Lessons learnt from influenza vaccination in immunocompromised children undergoing treatment for cancer. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:199-213. [PMID: 36706776 DOI: 10.1016/s2352-4642(22)00315-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 01/26/2023]
Abstract
Influenza infection contributes substantially to global morbidity and mortality, with children undergoing treatment for cancer among the most vulnerable due to immunosuppression associated with disease and treatment. However, influenza remains one of the most common vaccine-preventable diseases. Despite international guidelines recommending inactivated influenza vaccination on the basis of data supporting efficacy and an excellent safety profile in this population, uptake has often been suboptimal due to persisting hesitancy among both patients and oncologists regarding the ability of the vaccine to mount a sufficient immune response, the optimal vaccine schedule and timing, and the best method to assess response in immunocompromised populations. In this Review, we discuss the evidence regarding influenza vaccination in children with cancer, factors that influence response, and highlight strategies to optimise vaccination. Host immune factors play a substantial role, thus principles learnt from influenza vaccination can be broadly applied for the use of inactivated vaccines in children with cancer.
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Affiliation(s)
- Eliska Furlong
- Department of Clinical Haematology, Oncology, Blood and Marrow Transplantation, Perth Children's Hospital, Perth, WA, Australia; Leukaemia Translational Research Laboratory, Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Rishi S Kotecha
- Department of Clinical Haematology, Oncology, Blood and Marrow Transplantation, Perth Children's Hospital, Perth, WA, Australia; Leukaemia Translational Research Laboratory, Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia; Curtin Medical School, Curtin University, Perth, WA, Australia.
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