Immunogenicity and Reactogenicity of High- or Standard-Dose Influenza Vaccine in a Second Consecutive Influenza Season - Report - MDSpire

Immunogenicity and Reactogenicity of High- or Standard-Dose Influenza Vaccine in a Second Consecutive Influenza Season

  • By

  • Hannah Bahakel

  • Andrew J Spieker

  • Haya Hayek

  • Jennifer E Schuster

  • Lubna Hamdan

  • Daniel E Dulek

  • Carrie L Kitko

  • Tess Stopczynski

  • Einas Batarseh

  • Zaid Haddadin

  • Laura S Stewart

  • Anna Stahl

  • Molly Potter

  • Herdi Rahman

  • Justin Amarin

  • Spyros A Kalams

  • Claire E Bocchini

  • Elizabeth A Moulton

  • Susan E Coffin

  • Monica I Ardura

  • Rachel L Wattier

  • Gabriela Maron

  • Michael Grimley

  • Grant Paulsen

  • Christopher J Harrison

  • Jason Freedman

  • Paul A Carpenter

  • Janet A Englund

  • Flor M Munoz

  • Lara Danziger-Isakov

  • Natasha Halasa

  • for the Pediatric HCT Flu Study

  • Rakesh Goyal

  • Rendie McHenry

  • Margaret Bender

  • Shari Barto

  • Michael Russo

  • Lauren Shoemaker

  • Kenny Truong

  • Christopher Dvorak

  • Kim J Allison

  • Swati Naik

  • Christopher Williams

  • Samantha Blum

  • Kirsten Lacombe

  • Hannah Smith

  • September 16, 2024

  • 0 min

Share

Immunogenicity and Safety of High- Versus Standard-Dose Influenza Vaccine in Pediatric HCT

Overview

In pediatric hematopoietic cell transplant (HCT) recipients, a single dose of either high-dose trivalent influenza vaccine (HD-TIV) or standard-dose quadrivalent influenza vaccine (SD-QIV) in the second post-transplant influenza season elicited stronger immune responses than two doses of the same vaccines in the first season. Both vaccine regimens demonstrated comparable safety profiles with similar frequencies of injection site and systemic reactions.

Background

Pediatric HCT recipients are highly susceptible to severe influenza infections, which can lead to significant morbidity and mortality despite antiviral treatments. Annual influenza vaccination is recommended starting at least 3 months post-HCT, but optimal dosing strategies in this population remain unclear. Previous phase 2 trials showed that two doses of HD-TIV were more immunogenic than two doses of SD-QIV in the first influenza season post-HCT. This study evaluates immunogenicity and safety of these vaccines in a consecutive influenza season using the same dosing regimens.

Data Highlights

GroupParticipants (n)Vaccine Doses Year 1Vaccine Doses Year 2Immunogenicity (Geometric Mean Fold Rise)Safety (Injection Site & Systemic Reactions)
SD-QIV332 doses1 doseHigher fold rise in year 2 vs year 1Comparable to HD-TIV
HD-TIV322 doses1 doseHigher fold rise in year 2 vs year 1Comparable to SD-QIV

Key Findings

  • In year 2 post-HCT, a single dose of either HD-TIV or SD-QIV induced greater hemagglutinin inhibition antibody responses compared to two doses in year 1.
  • Both vaccine groups showed similar frequencies of injection site and systemic adverse reactions, indicating comparable safety profiles.
  • HD-TIV contains a higher antigen dose per strain (60 µg) compared to SD-QIV (15 µg), but both vaccines were effective in boosting immunity in the second season.
  • Participants with stable graft-versus-host disease were eligible, reflecting real-world applicability in pediatric HCT recipients.
  • Study supports the potential sufficiency of a single influenza vaccine dose in subsequent seasons after a two-dose primary series post-HCT.

Clinical Implications

These findings suggest that pediatric HCT recipients may achieve adequate immunogenicity with a single influenza vaccine dose in subsequent seasons following an initial two-dose regimen, potentially simplifying vaccination schedules. Both HD-TIV and SD-QIV are safe and effective options, allowing clinicians flexibility in vaccine choice based on availability and patient factors.

Conclusion

A single dose of either high-dose trivalent or standard-dose quadrivalent influenza vaccine in the second post-HCT influenza season elicits superior immune responses compared to two doses in the first season, with comparable safety. This supports consideration of a simplified single-dose influenza vaccination strategy in pediatric HCT recipients after initial immunization.

References

  1. NCT02860039 -- Pediatric HCT Flu Study

Original Source(s)

Immunogenicity and Reactogenicity of High- or Standard-Dose Influenza Vaccine in a Second Consecutive Influenza Season

  • by Hannah Bahakel, Andrew J Spieker, Haya Hayek, Jennifer E Schuster, Lubna Hamdan, Daniel E Dulek, Carrie L Kitko, Tess Stopczynski, Einas Batarseh, Zaid Haddadin, Laura S Stewart, Anna Stahl, Molly Potter, Herdi Rahman, Justin Amarin, Spyros A Kalams, Claire E Bocchini, Elizabeth A Moulton, Susan E Coffin, Monica I Ardura, Rachel L Wattier, Gabriela Maron, Michael Grimley, Grant Paulsen, Christopher J Harrison, Jason Freedman, Paul A Carpenter, Janet A Englund, Flor M Munoz, Lara Danziger-Isakov, Natasha Halasa, for the Pediatric HCT Flu Study, Rakesh Goyal, Rendie McHenry, Margaret Bender, Shari Barto, Michael Russo, Lauren Shoemaker, Kenny Truong, Christopher Dvorak, Kim J Allison, Swati Naik, Christopher Williams, Samantha Blum, Kirsten Lacombe, Hannah Smith

  • September 16, 2024

Related Content

Shorter TB Regimens Advance Care

Review highlights shorter tuberculosis regimens while warning that rising bedaquiline resistance may threaten future progress.

Bivalent virus-like particles expressing SPECT1 and CSP trigger pre-erythrocytic malaria immunity and protect against transgenic Plasmodium falciparum sporozoite challenge in mice

Ensitrelvir Reduced COVID After Household Exposure

In SCORPIO-PEP, symptomatic COVID-19 occurred in 3% vs 9% of household contacts by day 10.