Background
In this study we compared the immunogenicity of influenza vaccine administered intradermally
to the standard intramuscular vaccination in lung transplant recipients.
Methods
Patients were randomized to receive the trivalent inactivated seasonal 2008–9 influenza
vaccine containing either 6 μg (intradermal) or 15 μg (intramuscular) of hemagglutinin
per viral strain. Immunogenicity was assessed by measurement of geometric mean titer
of antibodies using the hemagglutination-inhibition (HI) assay. Vaccine response was
defined as a 4-fold or higher increase of antibody titers to at least one vaccine
antigen.
Results
Eighty-five patients received either the intradermal (n = 41) or intramuscular (n = 44) vaccine. Vaccine response was seen in 6 of 41 patients (14.6%) in the intradermal
vs 8 of 43 (18.6%) in the intramuscular group (p = 0.77). Seroprotection (HI ≥1:32) was 39% for H1N1, 83% for H3N2 and 29% for B strain
in the intradermal group vs 28% for H1N1, 98% for H3N2 and 58% for B strain in the
intramuscular group (p = 0.36 for H1N1, p = 0.02 for H3N2, p < 0.01 for B). Mild adverse events were seen in 44% of patients in the intradermal
group and 34% in the intramuscular group (p = 0.38).
Conclusions
Immunogenicity of the 2008–9 influenza vaccine given intradermally or intramuscularly
was overall poor in lung transplant recipients. Novel strategies for influenza vaccination
in this population are needed.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Heart and Lung TransplantationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Influenza virus infection in adult solid organ transplant recipients.Am J Transplant. 2002; 2: 287-291
- Clinical impact of community-acquired respiratory viruses on bronchiolitis obliterans after lung transplant.Am J Transplant. 2005; 5: 2031-2036
- AST Infectious Diseases Community of Practice.Am J Transplant. 2009; 9: S258-S262
- Vaccinations for adult solid-organ transplant recipients: current recommendations and protocols.Clin Microbiol Rev. 2003; 16: 357-364
- The humoral immune response to influenza vaccination in lung transplant patients.Eur Respir J. 2001; 18: 971-976
- Influenza vaccine antibody responses in lung transplant recipients.Prog Transplant. 2004; 14: 346-351
- Immunogenicity and safety of an intradermal boosting strategy for vaccination against influenza in lung transplant recipients.Am J Transplant. 2007; 7: 2567-2572
- Effect of annual influenza immunization on antibody response in lung transplant patients.Prog Transplant. 2009; 19: 153-159
- Antigen delivery by dendritic cells.Int J Med Microbiol. 2004; 294: 337-344
- Exploiting dendritic cells to improve vaccine efficacy.J Clin Invest. 2002; 109: 1519-1526
- Intradermal influenza vaccination in immunocompromised patients is immunogenic and feasible.Vaccine. 2009; 27: 2469-2474
- Serum antibody responses after intradermal vaccination against influenza.N Engl J Med. 2004; 351: 2286-2294
- Molecular investigation of an outbreak of influenza in the United Kingdom.Eur J Epidemiol. 1997; 13: 369-372
Committee for Proprietary Medicinal Products (CPMP), 1997. Note for guidance on harmonisation of requirements for influenza vaccines (CPMP/BWP/214/96), 12 March 1997, pp 15-9.
- Revision of the 1996 working formulation for the standardization of nomenclature in the diagnosis of lung rejection.J Heart Lung Transplant. 2007; 26: 1229-1242
- Dose sparing with intradermal injection of influenza vaccine.N Engl J Med. 2004; 351: 2295-2301
- Immunosuppressive drugs for kidney transplantation.N Engl J Med. 2004; 351: 2715-2729
- Influenza vaccination is efficacious and safe in renal transplant recipients.Am J Transplant. 2008; 8: 332-337
- Influenza virus vaccination in kidney transplant recipients: serum antibody response to different immunosuppressive drugs.Clin Transplant. 2010; 24: E17-E23
- Effectiveness and safety of inactivated influenza vaccination in pediatric liver transplant recipients over three influenza seasons.Pediatr Transplant. 2011; 15: 112-116
- Seasonal influenza vaccine delivered by intradermal microinjection: a randomised controlled safety and immunogenicity trial in adults.Vaccine. 2008; 26: 6614-6619
- Intradermal influenza vaccine administered using a new microinjection system produces superior immunogenicity in elderly adults: a randomized controlled trial.J Infect Dis. 2008; 198: 650-658
- Evaluation of non-inferiority of intradermal versus adjuvanted seasonal influenza vaccine using two serological techniques: a randomised comparative study.BMC Infect Dis. 2010; 10: 134
- Immunogenicity and safety of intradermal influenza vaccination in renal transplant patients who were non-responders to conventional influenza vaccination.Vaccine. 2010; 28: 6885-6890
Article info
Publication history
Published online: March 07, 2011
Identification
Copyright
© 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
