Immunogenicity and safety of cell-derived MF59®-adjuvanted A/H1N1 influenza vaccine for children

Abstract

Mass immunization of children has the potential to decrease infection rates and prevent the transmission of influenza. We evaluated the immunogenicity, safety, and tolerability of different formulations of cell-derived MF59-adjuvanted and nonadjuvanted A/H1N1 influenza vaccine in children and adolescents. This was a randomized, single-blind, multicenter study with a total of 666 healthy subjects aged 6 months-17 y in one of 3 vaccination groups, each receiving formulations containing different amounts of influenza A/H1N1 antigen with or without MF59. A booster trivalent seasonal MF59 vaccine was administered one year after primary vaccinations. Antibody titers were assessed by hemagglutination inhibition (HI) and microneutralization assays obtained on days 1, 22, 43, 366, and 387 (3 weeks post booster). Safety was monitored throughout the study. One vaccination with 3.75 μg of A/H1N1 antigen formulated with 50% MF59 (3.75_halfMF59) or 7.5 μg of A/H1N1 antigen formulated with 100% MF59 (7.5_fullMF59) induced an HI titer ≥1:40 in >70% of children in the 1-<3, 3-8, and 9-17 y cohorts; however, 2 vaccinations with nonadjuvanted 15 μg A/H1N1 antigen were needed to achieve this response in the 1-<3 and 3-8 y cohorts. Among children aged 6-11 months, 1 dose of 7.5_fullMF59 resulted in an HI titer ≥1:40 in >70% while 2 doses of 3.75_halfMF59 were required to achieve this result. All vaccines were well tolerated. Our findings support the immunogenicity and safety of the 3.75_halfMF59 (2 doses for children <12 months) and 7.5_fullMF59 vaccine formulations for use in children and adolescents aged 6 months to 17 y The use of the 3.75_halfMF59 could have the benefit of antigen and adjuvant sparing, increasing the available vaccine doses allowing vaccination of more people.

Keywords: AE, adverse event; CHMP, European Committee for Medicinal Products for Human Use; CI, confidence interval; GMR, geometric mean ratio; GMT, geometric mean titer; H1N1; HI, hemagglutination inhibition; MF59; MN, microneutralization; PPS, per-protocol set; SAE, serious adverse event; WHO, World Health Organization; adjuvant; cell-culture; pandemic; pediatric.

Figure 1.

Subject disposition in each age cohort and vaccine group. *N values include blood draws outside the specified time window; ^†Fourth vaccination to be done only on the subset of naïve subjects <9 years of age. HI – hemagglutination inhibition.

Figure 2.

Reverse cumulative distribution of hemagglutination inhibition (HI) titers in cohort 1 (A), cohort 2 (B), cohort 3 (C) and cohort 4 (D) on days 1, 22 and 43.