Pre-vaccination immunity and immune responses to a cell culture-derived whole-virus H1N1 vaccine are similar to a seasonal influenza vaccine

Global R&D, Baxter BioScience, Vienna, Austria. hartmut
Vaccine (Impact Factor: 3.62). 04/2012; 30(30):4543-51. DOI: 10.1016/j.vaccine.2012.03.061
Source: PubMed


Immune responses to novel pandemic influenza vaccines may be influenced by previous exposure to antigenically similar seasonal strains.
An open-label, randomized, phase I/II study was conducted to assess the immunogenicity and safety of a non-adjuvanted, inactivated whole-virus H1N1 A/California/07/2009 vaccine. 408 subjects were stratified by age (18-59 and >60 years) and randomized 1:1 to receive two vaccinations with either 3.75 or 7.5 μg hemagglutinin antigen 21 days apart. Safety, immunogenicity and the influence of seasonal influenza vaccination and antibody cross-reactivity with a seasonal H1N1 strain was assessed.
A single vaccination with either dose induced substantial increases in H1N1 A/California/07/2009 hemagglutination inhibition (HI) and neutralizing (MN) antibody titers in both adult and elderly subjects. A single 7.5 μg dose induced seroprotection rates of 86.9% in adults and 75.2% in elderly subjects. Two 7.5 μg vaccinations induced seroprotection rates in adult and elderly subjects of 90.9% and 89.1%, respectively. The robust immune response to vaccination was confirmed by analyses of neutralizing antibody titers. Both HI and MN antibodies persisted for ≥ 6 months post-vaccination. Between 34% and 49% of subjects had seroprotective levels of H1N1 A/California/07/2009 antibodies at baseline. Higher baseline HI titers were associated with receipt of the 2008-09 or 2009-10 seasonal influenza vaccine. High baseline A/California/07/2009 neutralizing antibody titers were also associated with high baseline titers against A/New Caledonia/20/99, a seasonal H1N1 strain which circulated and was included in the seasonal vaccine from 2000-01 to 2006-07. Pre-adsorption with A/H1N1/New Caledonia/20/99 antigen reduced A/H1N1/California/07/2009 baseline titers in 55% of tested sera. The vaccine was well tolerated with low rates of fever.
A whole-virus H1N1 A/California/07/2009 vaccine was safe and well tolerated and a single dose induced substantial immune responses similar to seasonal influenza vaccines, probably due to immunological priming by previous seasonal influenza vaccines or infections.

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    • "This could be due to the limitations of the assay that ( 1 ) does not detect conformational epitopes and ( 2 ) does not allow for the identification of antibodies that depend on glycosylation for binding . Several previous studies have compared the pre - GMT ( baseline titers ) with influenza in elderly versus young individuals with no general consensus ( Clark et al , 2009 ; Vajo et al , 2010 ; Chen et al , 2011 ; Ehrlich et al , 2012 ) . These discrepancies have been examined in detail by Sasaki et al ( 2011 ) who used plasmablast - derived poly - clonal antibodies and found greater influenza - specific broad reactivity of antibodies from older versus young vaccine recipients . "
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