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Zhang Y, Wang Y, Jia C, Li G, Zhang W, Li Q, Chen X, Leng W, Huang L, Xie Z, Zhang H, You W, An R, Jiang H, Zhao X, Cheng S, Tan J, Cui W, Gao F, Lu W, Wang Y, Yang Y, Xia S, Wang S. Immunogenicity and safety of an egg culture-based quadrivalent inactivated non-adjuvanted subunit influenza vaccine in subjects ≥3 years: A randomized, multicenter, double-blind, active-controlled phase III, non-inferiority trial. Vaccine 2022; 40:4933-4941. [PMID: 35810063 DOI: 10.1016/j.vaccine.2022.06.078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022]
Abstract
Subunit influenza vaccine only formulated with surface antigen proteins has better safety profiles relative to split-virion influenza vaccine. Compared to the traditional quadrivalent split-virion influenza vaccine, a novel quadrivalent subunit influenza vaccine is urgently needed in China. We completed a phase 3, randomized, double-blind, active-controlled, non-inferiority clinical study at two sites in Henan Province, China. Eligible volunteers were split into four age cohorts (3-8 years, 9-17 years, 18-64 years, and ≥ 65 years, based on their dates of birth) and randomly assigned (1:1) to the subunit and the split-virion ecNAIIV4 groups. All volunteers were intramuscularly administered a single vaccine dose at baseline, and children aged 3-8 years received a boosting dose at day 28. And the immune response was evaluated by measuring hemagglutinin-inhibition antibody titers against the four vaccine strains in blood samples. Safety profiles had nonsignificant differences between the study groups in ≥ 3 years cohort. Most adverse reactions post-vaccination, both local and systemic, were mild to moderate and resolved within 3 days. And no serious adverse events occurred. The immunogenicity of the trial vaccine was non-inferior to the comparator. Further, a two-dose vaccine series can provide better seroprotection than that of a one-dose series in children aged 3-8 years, with clinically acceptable safety profiles. Clinical Trials Registration. ChiCTR2100049934.
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Affiliation(s)
| | - Yanxia Wang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | | | | | - Wei Zhang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Qin Li
- Ab&b Biotec Co., Ltd, Taizhou, China.
| | | | | | - Lili Huang
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Zhiqiang Xie
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | | | - Wangyang You
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Rui An
- Ab&b Biotec Co., Ltd, Taizhou, China.
| | | | - Xue Zhao
- Ab&b Biotec Co., Ltd, Taizhou, China.
| | | | - Jiebing Tan
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Weiyang Cui
- Puyang Centre for Disease Control and Prevention, Henan, China.
| | - Feilong Gao
- Kaifeng Municipal Centre for Disease Control and Prevention, Henan, China.
| | - Weifeng Lu
- Kaifeng Municipal Centre for Disease Control and Prevention, Henan, China.
| | - Yuping Wang
- Puyang Centre for Disease Control and Prevention, Henan, China.
| | - Yongli Yang
- Department of Epidemiology and Public Health, College of Public Health, Zhengzhou University, Zhenzhou, China.
| | - Shengli Xia
- Henan Provincial Centre for Disease Control and Prevention, Zhenzhou, China.
| | - Shuai Wang
- Ab&b Biotec Co., Ltd, Taizhou, China; Yither Biotech Co., Ltd, Shanghai, China.
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Antibody Persistence in Adults Two Years after Vaccination with an H1N1 2009 Pandemic Influenza Virus-Like Particle Vaccine. PLoS One 2016; 11:e0150146. [PMID: 26919288 PMCID: PMC4769292 DOI: 10.1371/journal.pone.0150146] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/09/2016] [Indexed: 02/02/2023] Open
Abstract
The influenza virus is a human pathogen that causes epidemics every year, as well as potential pandemic outbreaks, as occurred in 2009. Vaccination has proven to be sufficient in the prevention and containment of viral spreading. In addition to the current egg-based vaccines, new and promising vaccine platforms, such as cell culture-derived vaccines that include virus-like particles (VLPs), have been developed. VLPs have been shown to be both safe and immunogenic against influenza infections. Although antibody persistence has been studied in traditional egg-based influenza vaccines, studies on antibody response durations induced by VLP influenza vaccines in humans are scarce. Here, we show that subjects vaccinated with an insect cell-derived VLP vaccine, in the midst of the 2009 H1N1 influenza pandemic outbreak in Mexico City, showed antibody persistence up to 24 months post-vaccination. Additionally, we found that subjects that reported being revaccinated with a subsequent inactivated influenza virus vaccine showed higher antibody titres to the pandemic influenza virus than those who were not revaccinated. These findings provide insights into the duration of the antibody responses elicited by an insect cell-derived pandemic influenza VLP vaccine and the possible effects of subsequent influenza vaccination on antibody persistence induced by this VLP vaccine in humans.
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Long-Term Immunogenicity and Safety of a Conventional Influenza Vaccine in Patients with Type 2 Diabetes. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 22:1160-5. [PMID: 26376926 DOI: 10.1128/cvi.00288-15] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/03/2015] [Indexed: 12/28/2022]
Abstract
No previous studies have assessed the persistence of immune responses in individuals with diabetes. We conducted this study to evaluate the long-term immunogenicity and safety of an influenza vaccine in type 2 diabetic subjects compared with nondiabetic controls. A randomized and controlled study was conducted at two university hospitals during the 2012-2013 influenza season. The study vaccine was a standard-dose trivalent subunit inactivated intramuscular vaccine. Serum hemagglutination-inhibiting (HI) antibodies were measured at the time of vaccination and 1 month and 6 months after vaccination. Local and systemic reactions were recorded for 7 days. A total of 105 diabetic patients and 108 controls were included in the analysis. One month after vaccination, both the diabetic and nondiabetic groups satisfied all of the criteria of the Committee for Medical Products for Human Use (CHMP), and the immunogenicity profiles were statistically similar between the two groups. Although the vaccine was well tolerated, and all adverse reactions were mild to moderate, there was a tendency toward a reduced incidence of local reactions in the diabetic group. All values in the long-term immunogenicity profiles were statistically similar between the two groups, except for the seroprotection rate for the A/H1N1 influenza virus strain, which was significantly lower in the elderly diabetic group than that in the elderly nondiabetic group. However, in multivariate analysis, long-term immunogenicity was associated with age and prevaccination titer, regardless of diabetes status. (This study has been registered at CRIS [https://cris.nih.go.kr/cris/en/] under registration no. KCT0001423.).
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Radin JM, Hawksworth AW, Ortiguerra RG, Brice GT. Seroprotective antibodies to 2011 variant influenza A(H3N2v) and seasonal influenza A(H3N2) among three age groups of US Department of Defense service members. PLoS One 2015; 10:e0121037. [PMID: 25816244 PMCID: PMC4376909 DOI: 10.1371/journal.pone.0121037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 01/28/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In 2011, a new variant of influenza A(H3N2) emerged that contained a recombination of genes from swine H3N2 viruses and the matrix (M) gene of influenza A(H1N1)pdm09 virus. New combinations and variants of pre-existing influenza viruses are worrisome if there is low or nonexistent immunity in a population, which increases chances for an outbreak or pandemic. METHODS Sera collected in 2011 were obtained from US Department of Defense service members in three age groups: 19-21 years, 32-33 years, and 47-48 years. Pre- and post-vaccination samples were available for the youngest age group, and postvaccination samples for the two older groups. Specimens were tested using microneutralization assays for antibody titers against H3N2v (A/Indiana/10/2011) and seasonal H3N2 virus (A/Perth/16/2009). RESULTS The youngest age group had significantly (p<0.05) higher geometric mean titers for H3N2v with 165 (95% confidence interval [CI]: 105-225) compared with the two older groups, aged 32-33 and 47-48 years, who had geometric mean titers of 68 (95% CI: 55-82) and 46 (95% CI: 24-65), respectively. Similarly, the youngest age group also had the highest geometric mean titers for seasonal H3N2. In the youngest age group, the proportion of patients who seroconverted after vaccination was 12% for H3N2v and 27% for seasonal H3N2. DISCUSSION Our results were similar to previous studies that found highest seroprotection among young adults and decreasing titers among older adults. The proportion of 19- to 21-year-olds who seroconverted after seasonal vaccination was low and similar to previous findings. Improving our understanding of H3N2v immunity among different age groups in the United States can help inform vaccination plans if H3N2v becomes more transmissible in the future.
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Affiliation(s)
- Jennifer M. Radin
- Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California, United States of America
- * E-mail:
| | - Anthony W. Hawksworth
- Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California, United States of America
| | - Ryan G. Ortiguerra
- Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California, United States of America
| | - Gary T. Brice
- Operational Infectious Diseases Department, Naval Health Research Center, San Diego, California, United States of America
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Abstract
Influenza directly or indirectly contributes to the four leading causes of global mortality, at rates that are highest in older adults. As the proportion of older adults in the Korean population is greater than in most other countries, influenza prevention is a greater public health priority in Korea than elsewhere. Conventional inactivated influenza vaccine (IIV) is less immunogenic and efficacious (-50%) in older than in young adults, but adjuvanting the vaccine with oil-in-water emulsion MF59® increases immunogenicity, resulting in comparatively higher levels of hemagglutination inhibition antibodies and greater protection against all influenza, as well as cases requiring hospitalization. A recent observational study demonstrated that the adjuvanted vaccine protected older adults against influenza in a year when nonadjuvanted IIV was ineffective. In another multiyear study, the adjuvanted vaccine was estimated to be 25% more effective in preventing pneumonia and influenza hospitalizations compared to nonadjuvanted vaccine. Although MF59-adjuvanted vaccine is transiently more reactogenic than nonadjuvanted vaccine, there is no evidence that it increases risks for serious adverse events, including those with an autoimmune etiology. Experience thus far indicates a favorable balance of benefit to risk for MF59. This may reflect the adjuvant's mechanism of action in which the squalene oil emulsion increases antibody responses to co-administered antigen without acting more generally as an immunopotentiator.
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Affiliation(s)
- Theodore F Tsai
- Novartis Vaccines and Diagnostics Inc., 350 Massachusetts Ave, Cambridge, USA
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