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. 2016 Feb 10;34(7):981-8.
doi: 10.1016/j.vaccine.2015.10.119.

Effects of Repeated Annual Inactivated Influenza Vaccination among Healthcare Personnel on Serum Hemagglutinin Inhibition Antibody Response to A/Perth/16/2009 (H3N2)-like virus during 2010-11

Mark G Thompson  1 , Allison Naleway  2 , Alicia M Fry  3 , Sarah Ball  4 , Sarah M Spencer  3 , Sue Reynolds  3 , Sam Bozeman  2 , Min Levine  3 , Jacqueline M Katz  3 , Manjusha Gaglani  5
Affiliations

Effects of Repeated Annual Inactivated Influenza Vaccination among Healthcare Personnel on Serum Hemagglutinin Inhibition Antibody Response to A/Perth/16/2009 (H3N2)-like virus during 2010-11

Mark G Thompson et al. Vaccine. .

Abstract

Background: Recently, lower estimates of influenza vaccine effectiveness (VE) against A(H3N2) virus illness among those vaccinated during the previous season or multiple seasons have been reported; however, it is unclear whether these effects are due to differences in immunogenicity.

Methods: We performed hemagglutination inhibition antibody (HI) assays on serum collected at preseason, ∼ 30 days post-vaccination, and postseason from a prospective cohort of healthcare personnel (HCP). Eligible participants had medical and vaccination records for at least four years (since July, 2006), including 578 HCP who received 2010-11 trivalent inactivated influenza vaccine [IIV3, containing A/Perth/16/2009-like A(H3N2)] and 209 HCP who declined vaccination. Estimates of the percentage with high titers (≥ 40 and>100) and geometric mean fold change ratios (GMRs) to A/Perth/16/2009-like virus by number of prior vaccinations were adjusted for age, sex, race, education, household size, hospital care responsibilities, and study site.

Results: Post-vaccination GMRs were inversely associated with the number of prior vaccinations, increasing from 2.3 among those with 4 prior vaccinations to 6.2 among HCP with zero prior vaccinations (F[4,567]=9.97, p<.0005). Thirty-two percent of HCP with 1 prior vaccination achieved titers >100 compared to only 11% of HCP with 4 prior vaccinations (adjusted odds ratio=6.8, 95% CI=3.1 - 15.3).

Conclusion: Our findings point to an exposure-response association between repeated IIV3 vaccination and HI for A(H3N2) and are consistent with recent VE observations. Ultimately, better vaccines and vaccine strategies may be needed in order to optimize immunogenicity and VE for HCP and other repeated vaccinees.

Keywords: healthcare personnel; hemagglutination inhibition antibody; immunogenicity; influenza vaccination.

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Conflict of interest statement

4. Conflicts of Interest M. G. has received research funding from MedImmune and Novartis, and A. N. has received research funding from GlaxoSmithKline. All other authors report no potential conflicts. Supported by the Centers for Disease Control and Prevention (contract 200-2010-F-33132 to Abt Associates Inc.).

Figures

Figure 1
Figure 1
Estimated Geometric Mean Titer (GMT) for A/Perth/16/2009 (H3N2) and 95% Confidence Intervals at Preseason, Post 2010–11 Vaccination, and End-of-Season by the Number of Inactivated Influenza Vaccinations (IIV3s) during the Prior Four Seasons Received by Healthcare Personnel.
Figure 2
Figure 2
Percentage of Healthcare Personnel with Geometric Mean Titer (GMT) ≥40 and >100 for A/Perth/16/2009 (H3N2) (and 95% Confidence Intervals) at Preseason, Post 2010–11 Vaccination, and Post-Season by the Number of Inactivated Influenza Vaccinations (IIV3s) during the Prior Four Years.
See this image and copyright information in PMC

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