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Observational Study
. 2014 Jan 23;32(5):585-91.
doi: 10.1016/j.vaccine.2013.11.073. Epub 2013 Dec 12.

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

Nathalie Dhédin  1 , Anne Krivine  2 , Nicole Le Corre  3 , Alain Mallet  4 , Bruno Lioure  5 , Jacques-Olivier Bay  6 , Marie-Thérèse Rubio  7 , Philippe Agape  8 , Anne Thiébaut  9 , Jérôme Le Goff  10 , Brigitte Autran  3 , Patricia Ribaud  11
Affiliations
Observational Study

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

Nathalie Dhédin et al. Vaccine. .

Abstract

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

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

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

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

Keywords: Hematopoietic stem cell transplantation; Humoral immune response; Influenza A/H1N1pdm09 infection; Influenza vaccination.

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Figures

Fig. 1
Fig. 1
Humoral response induced by the adjuvanted influenza A/H1N1pdm2009 vaccine in 21 HSCT recipients. Hemagglutination-inhibition (HAI) antibody titers in 21 patients vaccinated with two doses of adjuvanted influenza A/H1N1pdm2009 vaccine, before vaccination, at day 21, day 42 and at 6 months. A. Reverse cumulative distribution curves of antibody titers; B. Antibody titers (log10 transformed) represented in plots, the median titer (horizontal bar), minimal and maximal titers (error bars).
See this image and copyright information in PMC

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