Safety and immunogenicity of 2010-2011 H1N12009-containing trivalent inactivated influenza vaccine in children 12-59 months of age previously given AS03-adjuvanted H1N12009 pandemic vaccine: a PHAC/CIHR Influenza Research Network (PCIRN) study.
ABSTRACT Concern arose in 2010 that reactogenicity, particularly febrile seizures, to influenza A/H1N1-containing 2010-2011 trivalent seasonal inactivated influenza vaccine (TIV) could occur in young children who had been previously immunized and/or infected with the pandemic strain. We conducted a pre-season study of 2010-2011 TIV safety and immunogenicity in children 12-59 months of age to inform public health decision making.
Children immunized with 1 or 2 doses of the pandemic vaccine, with or without the 2009-10 TIV, received 1 or 2 doses of 2010-11 TIV in an observational, multicentre Canadian study. Standard safety monitoring was enhanced by a telephone call at ~24 h post-TIV when adverse events were expected to peak. Summary safety reports were rapidly reported to public health before the launch of public programs. TIV immunogenicity was assessed day 0, and 21 days after final vaccination. Clinical Trials Registration NCT01180621.
Among 207 children, a general adverse event was reported by 60.9% of children post-dose one and by 58.3% post-dose two. Only severe fever (>38.5°C) was more common in two-dose compared to one dose recipients (16.7%, n=4 v. 1.0%, n=2). At baseline 99.0% of participants had A/H1N1 hemagglutinin inhibition (HAI) titers ≥10, and 85.5% had a protective titer of ≥40 (95% CI 80.0, 90.0). Baseline geometric mean titers (GMT) were higher in recipients of a 2-dose schedule of pandemic vaccine compared to one-dose recipients: 153.1 (95% CI 126.2, 185.7) v. 78.8 ((58.1, 106.8, p<0.001). At 21 days, all regulatory criteria for influenza vaccine immunogenicity were exceeded for A/H1N1 and H3N2, but responses to the B antigen were poor. No correlations between reactogenicity and either baseline high influenza titers or serologic response to revaccination were evident.
Infants and toddlers who received AS03-adjuvanted A/H1N1 2009 vaccine up to 11 months earlier retained high titers in the subsequent season but re-exposure to A/H1N1 2009 antigen in TIV resulted in no unusual adverse effects and 100% were sero-protected for A/H1N1 after receipt of the 2010-11 TIV.
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ABSTRACT: Adverse effects following immunization to vaccines (AEFI) are considered extremely rare events, the occurrence of which could gain a major role in optimizing allergy diagnosis by cellular tests. The urgent need to eradicate infectious diseases from population, is the main goal of vaccination campaign, therefore its successful outcome should be almost undisputable. Basophil Activation Test (BAT) is commonly used to ascertain a type I hypersensitivity reaction, often replacing reasability tests. Therefore, flow cytometry assay of basophil, as performed in BATs, is employed to test if a particular antigen elicits some activatory response from cells. The allergic subject may undergo an AEFI to vaccine not necessarily by an atopic reaction with an allergen within vaccines but because of the existence of an asymptomatic or not diagnosed inflammatory chronic allergy or other immune-disregulating allergy disorder in the subject. BAT, also in its basilar fashion, might be used from a simple heparinized whole blood specimen, but its application in diagnosing allergy before mandatory of facultative vaccination, must be associated to improve other diagnostic tools, at least in its pivotal application. If the application of BAT can be suggested to improve allergy diagnosis by introducing a cellular test in routinely used tools, such as sIgE and SPT, its use, due to possible expertise-consuming and relatively expensive issues, can be included in a specialized allergy consultancy panel as an exploratory approach of allergy inflammation, for which a subject undergoing immunization by vaccines is suggested to undergo and advised to sign an informed consent for BAT performing. This may extend BAT use in many other forms of chronic allergy and immunity disorders related to AEFI with vaccines.Iranian journal of allergy, asthma, and immunology 09/2013; 12(3):196-202. · 0.65 Impact Factor
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ABSTRACT: Vaccination against influenza represents our most effective form of prevention. Historical approaches toward vaccine creation and production have yielded highly effective vaccines that are safe and immunogenic. Despite their effectiveness, these historical approaches do not allow for the incorporation of changes into the vaccine in a timely manner. In 2013, a recombinant protein-based vaccine that induces immunity toward the influenza virus hemagglutinin was approved for use in the USA. This vaccine represents the first approved vaccine formulation that does not require an influenza virus intermediate for production. This review presents a brief history of influenza vaccines, with insight into the potential future application of vaccines generated using recombinant technology.Expert Review of Vaccines 11/2013; · 4.22 Impact Factor
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ABSTRACT: Background. We report a follow up clinical and serological investigation of 274 children receiving seasonal influenza vaccine (TIV) one year after receipt of either AS03B-adjuvanted subunit or whole virus monovalent A(H1N1)pdm09 vaccine and describe the antibody responses to the H3N2 A/Perth/16/2009 and B/Brisbane/60/2008 components of TIV. Method and Findings. Vaccine responses were analysed using Haemagglutination Inhibition (HAI) assays. In individuals under 3 years of age, previous receipt of adjuvanted vaccine resulted in higher HAI antibody responses to H3N2 and B strains compared to non-adjuvanted vaccine (fold change 16.8 vs 4.3 for H3N2 and 7.0 vs 1.6 for B). In older children, responses to the H3 and B components of TIV were similar between vaccine groups. Sera taken pre- and post pandemic vaccine were also analysed by HAI with A/Perth/16/2009 virus. This analysis showed that 11.1% of children receiving the AS03B-adjuvanted vaccine but only 1.4% in the non-adjuvanted group had a 4-fold rise to A/Perth/16/2009. Conculsion. AS03B-adjuvanted A(H1N1)pdm09 influenza vaccine generates a cross-reactive antibody response to H3N2 in children and enhances responses to heterologous subtypes in <3-year-old children one year later.Clinical Infectious Diseases 10/2013; · 9.37 Impact Factor