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. 2014 Jun 1;209(11):1705-14.
doi: 10.1093/infdis/jit825. Epub 2013 Dec 19.

Antibody response to influenza A(H1N1)pdm09 among healthcare personnel receiving trivalent inactivated vaccine: effect of prior monovalent inactivated vaccine

Manjusha Gaglani  1 , Sarah Spencer, Sarah Ball, Juhee Song, Allison Naleway, Emily Henkle, Sam Bozeman, Sue Reynolds, Wendy Sessions, Kathy Hancock, Mark Thompson
Affiliations

Antibody response to influenza A(H1N1)pdm09 among healthcare personnel receiving trivalent inactivated vaccine: effect of prior monovalent inactivated vaccine

Manjusha Gaglani et al. J Infect Dis. .

Abstract

Background: Few data are available on the immunogenicity of repeated annual doses of influenza A(H1N1)pdm09-containing vaccines.

Methods: We enrolled healthcare personnel (HCP) in direct patient care during the autumn of 2010 at 2 centers with voluntary immunization. We verified the receipt of A(H1N1)pdm09-containing monovalent inactivated influenza vaccine (MIIV) and 2010-2011 trivalent inactivated vaccine (TIV). We performed hemagglutination inhibition antibody (HI) assays on preseason, post-TIV, and end-of-season serum samples. We compared the proportion of HCPs with HI titer ≥ 40 against A(H1N1)pdm09 per receipt of prior-season MIIV, current-season TIV, both, or neither.

Results: At preseason (n = 1417), HI ≥ 40 was significantly higher among those who received MIIV (34%) vs those who did not (14%) (adjusted relative risk [ARR], 3.26; 95% confidence interval [CI], 2.72-3.81). At post-TIV (n = 865), HI ≥ 40 was lower among HCP who received MIIV and TIV (66%) than among those receiving only TIV (85%) (ARR, 0.93 [95% CI, .84-.997]). At end-of-season (n = 1254), HI ≥ 40 was 40% among those who received both MIIV and TIV and 67% among those receiving only TIV (ARR, 0.76 [95% CI, .65-.88]), 52% among those who received MIIV only, and 12% among those receiving neither.

Conclusions: HCP immunization programs should consider effects of host immune response and vaccine antigenic distance on immunogenicity of repeated annual doses of influenza vaccines.

Keywords: 2009 influenza pandemic H1N1; healthcare workers; hemagglutination inhibition antibody; influenza vaccine; influenza vaccine immunogenicity or response.

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Figures

Figure 1.
Figure 1.
Influenza A(H1N1)pdm09 hemagglutination inhibition antibody (HI) geometric mean titer (GMT) at 2010–2011 preseason (S1), about 30 days post–trivalent inactivated vaccine (TIV) (S2), and end-of-season (S3) among 834 TIV recipients, by those who received 2009 A(H1N1)pdm09 monovalent inactivated influenza vaccine (MIIV) vs those not vaccinated during the prior season and stratified by 2010–2011 preseason HI titers.
See this image and copyright information in PMC

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