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

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Clinical Scorecard: Immunogenic and Safety Profiles of High-Dose Versus Standard-Dose Influenza Vaccination in Pediatric Hematopoietic Cell Transplant Recipients During a Successive Influenza Season

At a Glance

CategoryDetail
ConditionInfluenza virus infection in pediatric hematopoietic cell transplant (HCT) recipients
Key MechanismsImmunogenicity of high-dose trivalent influenza vaccine (HD-TIV) versus standard-dose quadrivalent influenza vaccine (SD-QIV) measured by hemagglutinin inhibition titers
Target PopulationPediatric allogeneic HCT recipients aged 3 to 17 years, 3 to 35 months post-transplant
Care SettingMulticenter clinical trial settings including outpatient vaccination clinics

Key Highlights

  • Two doses of HD-TIV administered 4 weeks apart were more immunogenic than two doses of SD-QIV in the initial influenza season.
  • In the subsequent influenza season, a single dose of either HD-TIV or SD-QIV elicited higher immunogenicity compared to two doses in the prior year.
  • Both HD-TIV and SD-QIV had comparable safety profiles with similar frequencies of injection site and systemic reactions.

Guideline-Based Recommendations

Diagnosis

  • Identify pediatric HCT recipients at risk for influenza infection post-transplant.
  • Monitor hemagglutinin inhibition titers to assess vaccine immunogenicity.

Management

  • Administer annual influenza vaccination starting at least 3 months post-HCT.
  • Consider two doses of HD-TIV spaced 4 weeks apart for improved immunogenicity in the first post-HCT influenza season.
  • In subsequent influenza seasons, a single dose of influenza vaccine may suffice after a prior two-dose schedule.

Monitoring & Follow-up

  • Evaluate immunogenicity via hemagglutinin inhibition titers before and after vaccination.
  • Monitor for injection site and systemic reactions post-vaccination.
  • Assess stability of graft-versus-host disease and exclude active hematologic malignancy or relapse before vaccination.

Risks

  • Potential morbidity and mortality from influenza infection despite antiviral therapy.
  • Risk of adverse reactions similar between HD-TIV and SD-QIV vaccines.

Patient & Prescribing Data

Pediatric allogeneic HCT recipients 3 to 35 months post-transplant, aged 3 to 17 years.

Two doses of HD-TIV provide superior immunogenicity in the first season; a single dose of either HD-TIV or SD-QIV may be adequate in subsequent seasons with comparable safety.

Clinical Best Practices

  • Begin annual influenza vaccination at least 3 months after HCT in pediatric patients.
  • Use a two-dose regimen of HD-TIV spaced 4 weeks apart during the first post-HCT influenza season for enhanced immunogenicity.
  • In subsequent influenza seasons, a single dose of influenza vaccine may be sufficient if a two-dose schedule was completed previously.
  • Ensure stable graft-versus-host disease status and absence of relapse before vaccination.
  • Monitor patients for injection site and systemic reactions, which are generally comparable between HD-TIV and SD-QIV.

References

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

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