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Safety and Immunogenicity of a Subvirion Monovalent Unadjuvanted Inactivated Influenza A(H3N2) Variant Vaccine in Healthy Persons ?18 Years Old.

ABSTRACT: BACKGROUND:Variant influenza A(H3N2) viruses (H3N2v) have transmitted recently from pigs to humans in the United States. Vaccines strategies are needed. METHODS:Healthy adults received 2 doses of subvirion H3N2v vaccine (15 µg of hemagglutinin/dose) 21 days apart in this open-label trial. Serum hemagglutination inhibition (HAI) and neutralizing (Neut) antibody (Ab) titers were measured before and 8 and 21 days after each dose. Memory B-cell (MBC) responses were assessed. RESULTS:Vaccine was well tolerated. A total of 40% of subjects had an HAI Ab titer of ?40 before vaccination. Eight-seven percent (95% confidence interval [CI], 79%-93%) and 73% (95% CI, 63%-81%) of subjects 18-64 years old (98 subjects) and ?65 years old (90 subjects), respectively, had an HAI titer of ?40 21 days after dose 1 (P = .01); 51% (95% CI, 41%-61%) and 52% (95% CI, 41%-62%) of younger and older subjects, respectively, developed ?4-fold rises in titer (P = not significant). Neut Ab response patterns were similar. Geometric mean titers were higher in younger subjects. Dose 2 provided no significant enhancement in responses. Cross-reactive MBCs were detected before vaccination and expanded after vaccination. Preexisting H3N2v-specific MBCs positively correlated with early increases in vaccine-induced Ab. CONCLUSIONS:In most healthy adults, one 15-µg dose of vaccine elicited levels of HAI Abs associated with protection. Studies in children and elderly individuals are indicated to define the immunization needs of these groups. CLINICAL TRIALS REGISTRATION:NCT01746082.

SUBMITTER: Keitel WA

PROVIDER: S-EPMC4539893 | biostudies-literature | 2015 Aug

REPOSITORIES: biostudies-literature

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Safety and Immunogenicity of a Subvirion Monovalent Unadjuvanted Inactivated Influenza A(H3N2) Variant Vaccine in Healthy Persons ≥18 Years Old.

Keitel Wendy A WA Jackson Lisa A LA Edupuganti Srilatha S Winokur Patricia L PL Mulligan Mark J MJ Thornburg Natalie J NJ Patel Shital M SM Rouphael Nadine G NG Lai Lilin L Bangaru Sandhya S McNeal Monica M MM Bellamy Abbie R AR Hill Heather R HR

The Journal of infectious diseases 20150203 4

<h4>Background</h4>Variant influenza A(H3N2) viruses (H3N2v) have transmitted recently from pigs to humans in the United States. Vaccines strategies are needed.<h4>Methods</h4>Healthy adults received 2 doses of subvirion H3N2v vaccine (15 µg of hemagglutinin/dose) 21 days apart in this open-label trial. Serum hemagglutination inhibition (HAI) and neutralizing (Neut) antibody (Ab) titers were measured before and 8 and 21 days after each dose. Memory B-cell (MBC) responses were assessed.<h4>Result ...[more]

PMID: 25649171

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Project description:BackgroundTwo antigenically distinct influenza B lineages have co-circulated since the 1980s, yet inactivated trivalent influenza vaccines (TIVs) include strains of influenza A/H1N1, A/H3N2, and only one influenza B from either the Victoria or Yamagata lineage. This means that exposure to B-lineage viruses mismatched to the TIV is frequent, reducing vaccine protection. Formulations including both influenza B lineages could improve protection against circulating influenza B viruses. We assessed a candidate inactivated quadrivalent influenza vaccine (QIV) containing both B lineages versus TIV in adults in stable health.MethodsA total of 4659 adults were randomized 5:5:5:5:3 to receive one dose of QIV (one of three lots) or a TIV containing either a B/Victoria or B/Yamagata strain. Hemagglutination-inhibition assays were performed pre-vaccination and 21-days after vaccination. Lot-to-lot consistency of QIV was assessed based on geometric mean titers (GMT). For QIV versus TIV, non-inferiority against the three shared strains was demonstrated if the 95% confidence interval (CI) upper limit for the GMT ratio was ≤1.5 and for the seroconversion difference was ≤10.0%; superiority of QIV versus TIV for the alternate B lineage was demonstrated if the 95% CI lower limit for the GMT ratio was > 1.0 and for the seroconversion difference was > 0%. Reactogenicity and safety profile of each vaccine were assessed. Clinicaltrials.gov: NCT01204671.ResultsConsistent immunogenicity was demonstrated for the three QIV lots. QIV was non-inferior to TIV for the shared vaccine strains, and was superior for the added alternate-lineage B strains. QIV elicited robust immune responses against all four vaccine strains; the seroconversion rates were 77.5% (A/H1N1), 71.5% (A/H3N2), 58.1% (B/Victoria), and 61.7% (B/Yamagata). The reactogenicity and safety profile of QIV was consistent with TIV.ConclusionsQIV provided superior immunogenicity for the additional B strain compared with TIV, without interfering with antibody responses to the three shared antigens. The additional antigen did not appear to alter the safety profile of QIV compared with TIV. This suggests that the candidate QIV is a viable alternative to TIV for use in adults, and could potentially improve protection against influenza B.Trial registrationClinical Trials.gov: NCT01204671/114269.

Project description:IntroductionEffective, programmatically suitable influenza vaccines are needed for low-resource countries.Materials and methodsThis phase II, placebo-controlled, randomized safety and immunogenicity trial (NCT01819155) was conducted in Senegal using the 2012-2013 Northern Hemisphere trivalent influenza vaccine (TIV) formulation. Participants were allocated in a 2:2:1 ratio to receive TIV (full-dose for all age groups), adjuvanted TIV (aTIV), or placebo. Participants were stratified into age groups: 6-11, 12-35, and 36-71 months. All participants were vaccine-naïve and received two doses of study vaccine 4 weeks apart. The two independent primary objectives were to estimate the immunogenicity of TIV and of aTIV as the proportion of children with a hemagglutination inhibition (HI) antibody titer of ≥1:40 to each vaccine strain at 28 days post-dose two. Safety was evaluated by solicited local and systemic reactions, unsolicited adverse events, and serious adverse events.Results296 children received TIV, aTIV, or placebo, and 235 were included in the final analysis. After two doses, children aged 6-11, 12-35, and 36-71 months receiving TIV had HI titers ≥1:40 against A/H1N1 (73.1%, 94.1%, and 97.0%), A/H3N2 (96.2%, 100.0%, and 100.0%), and B (80.8%, 97.1%, and 97.0%), respectively. After two doses, 100% children aged 6-11, 12-35, and 36-71 months receiving aTIV had ≥1:40 titers against A/H1N1, A/H3N2, and B. After a single dose, the aTIV response was comparable to or greater than the TIV response for all vaccine strains. TIV and aTIV reactogenicity were similar, except for mild elevation in temperature (37.5-38.4 °C) which occurred more frequently in aTIV than TIV after each vaccine dose. TIV and aTIV had similarly increased pain/tenderness at the injection site compared to placebo.ConclusionsBoth aTIV and full-dose TIV were well-tolerated and immunogenic in children aged 6-71 months. These vaccines may play a role in programmatically suitable strategies to prevent influenza in low-resource settings.

Project description:BACKGROUND:There is a lack of evidence on caries prevalence among 18?years old Israeli young adults with only a scarce evidence regarding this index age group. In the last few years dental care policy in Israel underwent substantial changes and a major reform in dental services was led by the Israeli Ministry of Health, including coverage of dental care for children by the state. In addition, a cessation of community water fluoridation was in a debate. The objective of the current study was to describe prevalence of caries among 18?years old Israeli young adults and to evaluate possible associations with personal and demographic variables. METHODS:The study was a cross sectional clustered survey. Participants were recruited to the study at their first day of military service. Participants completed a questionnaire for personal and demographic data, including: age, country of birth, education, and current smoking status. Then participants underwent clinical evaluation included DMFT and caries free rates. No radiographic evaluation was included in the current study. Univariate and multivariate statistical analysis were performed. RESULTS:A total of 702 participants were included in the study, 58.4% were males. Their mean age was 19.03?±?0.65?years, 91.3% of the participants were born in Israel. Mean DMFT was 1.95?±?2.67, and 46.7% (n?=?328) were caries free. Higher DMFT score was significantly associated with participant's parents' education, country of birth, and smoking status. Lower caries free rates were significantly associated with participant's parents' education, and smoking status. After linear regression for total DMFT, all variables were significant predictors to higher DMFT, except father's education, while logistic regression for caries free, only mother's education was found to be a significant predictor. CONCLUSIONS:The current study presents encouraging low DMFT levels. Participants in this study were not included in the dental care services reform, and did enjoy the benefits of water fluoridation, enabling the results to play an important baseline data for future reference. Additionally, results should be considered when planning intervention programs for at risk groups. TRIAL REGISTRATION:This study was registered in ClinicalTrials.gov (Identifier No. NCT02958891 , November 8th, 2016) and was approved by the IDF Institutional Review Board (#1524-2015).

Dataset Information

Safety and Immunogenicity of a Subvirion Monovalent Unadjuvanted Inactivated Influenza A(H3N2) Variant Vaccine in Healthy Persons ?18 Years Old.

Publications

Safety and Immunogenicity of a Subvirion Monovalent Unadjuvanted Inactivated Influenza A(H3N2) Variant Vaccine in Healthy Persons ≥18 Years Old.

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