Immunogenicity of Viral Vaccines in the Italian Military

Abstract

Military personnel of all armed forces receive multiple vaccinations and have been doing so since long ago, but relatively few studies have investigated the possible negative or positive interference of simultaneous vaccinations. As a contribution to fill this gap, we analyzed the response to the live trivalent measles/mumps/rubella (MMR), the inactivated hepatitis A virus (HAV), the inactivated trivalent polio, and the trivalent subunits influenza vaccines in two cohorts of Italian military personnel. The first cohort was represented by 108 students from military schools and the second by 72 soldiers engaged in a nine-month mission abroad. MMR and HAV vaccines had never been administered before, whereas inactivated polio was administered to adults primed at infancy with a live trivalent oral polio vaccine. Accordingly, nearly all subjects had baseline antibodies to polio types 1 and 3, but unexpectedly, anti-measles/-mumps/-rubella antibodies were present in 82%, 82%, and 73.5% of subjects, respectively (43% for all of the antigens). Finally, anti-HAV antibodies were detectable in 14% and anti-influenza (H1/H3/B) in 18% of the study population. At mine months post-vaccination, 92% of subjects had protective antibody levels for all MMR antigens, 96% for HAV, 69% for the three influenza antigens, and 100% for polio types 1 and 3. An inverse relationship between baseline and post-vaccination antibody levels was noticed with all the vaccines. An excellent vaccine immunogenicity, a calculated long antibody persistence, and apparent lack of vaccine interference were observed.

Keywords: HAV; adults; influenza; measles; military; mumps; polio; rubella; vaccines; varicella.

Figure 1

Antibody levels at T0 (before vaccination, blue points/lines) and at T2 (9 months after vaccination, red points/lines) against HAV (a), measles (b), mumps (c), and rubella (d).

Figure 2

Antibody levels at T0 (before vaccination, blue points/lines) and at T2 (9 months after vaccination, orange points/lines) against polio type 1 (a) and polio type 3 (b), Influenza H1 (c), Influenza H3 (d), and Influenza B (e).