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High-dose flu vaccine demonstrated superior response in frail, elderly
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A high-dose influenza vaccine induced superior responses among frail, elderly residents of long-term care facilities, during the 2011-2012 and 2012-2013 influenza seasons, according to researchers from the University of Pittsburgh.
“High-dose inactivated influenza vaccine produced superior hemagglutination inhibition titers for all strains among frail, elderly residents … except for influenza A(H1N1) in 2012-2013 (in which case noninferiority criteria were met), perhaps because 26% of subjects participated in both seasons, during which influenza A(H1N1) strains were identical,” the researchers wrote in the Journal of Infectious Diseases.
The single blind, randomized, controlled trial included 205 frail, elderly residents of long-term care facilities during the 2011-2012 and 2012-2013 influenza seasons. The patients were randomly assigned to high-dose or standard-dose inactivated influenza vaccine. The researchers measured hemagglutination inhibition (HI) antibody titers at baseline and then at 30 days and 180 days after vaccination.
Among the 187 patients (mean age, 86.7 years; 68% women) who completed the study, the geometric mean titers (GMTs) were higher at day 30 in those who received the high-dose vaccine, for all strains except H1N1 in the 2012-2013 season. The response of the high-dose vaccine was superior for all three strains — H1N1, H3N2 and influenza B — in the 2011-2012 season. The antibody response of the high-dose vaccine was superior for H3N2 and influenza B strains in the 2012-2013 season, and noninferior for H1N1. At day 180, GMTs were greater for H3N2 in both years among those who received the high-dose vaccine.
“These results are important because this is the first study to evaluate the currently licensed high-dose inactivated influenza vaccine in the frail, long-term care facility population,” the researchers wrote. “Prior studies evaluating high-dose inactivated influenza vaccine were conducted in healthy or medically stable community-dwelling older adults and showed an enhanced immunologic response with no major safety concerns. Standard-dose inactivated influenza vaccine has decreased immunogenicity in persons aged 65 years of age or older.”
Disclosure: Some researchers report financial relationships with MedImmune, Merck, Pfizer and Sanofi Pasteur.
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