Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States.
Emmes, Rockville, MD, United States.
Vaccine. 2019 Sep 3;37(37):5535-5543. doi: 10.1016/j.vaccine.2019.04.066. Epub 2019 May 31.
Recent studies have suggested that among those receiving seasonal influenza vaccine (SIV), reduced immunogenicity is observed in recently vaccinated (RV; within the past season or 2) persons when compared with those not recently vaccinated (NRV). We performed a meta-analysis to assess the effect of recent immunization with SIV on serum H5 hemagglutination inhibition (HAI) antibody responses after influenza A/H5N1 vaccination using data from a series of randomized controlled trials. The primary outcome was seroconversion measured by HAI assays following receipt of 2 doses of H5N1 vaccine. The geometric mean titer (GMT) of serum HAI antibody after vaccination was the secondary outcome. Analyses were performed using propensity score (PS) matching. The PS for each individual in the meta-analysis cohort was calculated using logistic regression and covariates included age, gender, race, antigen dose, adjuvant, statin use and vaccine manufacturer. 2015 subjects enrolled in 7 clinical trials were eligible for inclusion in the meta-analysis cohort; among these, 915 (45%) were RV. 901 RV subjects were matched (1:1) with replacement to a subject who was NRV. Subjects who received SIV within the previous season were significantly less likely to seroconvert following H5N1 vaccination (adjusted odds ratio 0.76; 95%CI 0.60-0.96; p = 0.024), and the GMT was 18% higher among NRV subjects (GM ratio of HAI antibody 1.18; 95%CI 1.04-1.33; p = 0.008). Further work is needed to better define the effects of, and mechanisms contributing to, reduced immune responses to H5N1 vaccine among RV subjects.
最近的研究表明，在接种季节性流感疫苗（SIV）的人群中，与未近期接种（NRV）的人群相比，近期接种（RV；过去一个季节或 2 季内）的人群中观察到免疫原性降低。我们进行了一项荟萃分析，以评估使用一系列随机对照试验的数据，评估 SIV 近期免疫对甲型流感 H5N1 疫苗接种后血清 H5 血凝抑制（HAI）抗体反应的影响。主要结局是接受 2 剂 H5N1 疫苗后通过 HAI 测定的血清学转换。接种后血清 HAI 抗体的几何平均滴度（GMT）为次要结局。使用倾向评分（PS）匹配进行分析。使用逻辑回归和协变量计算荟萃分析队列中每个人的 PS，协变量包括年龄、性别、种族、抗原剂量、佐剂、他汀类药物使用和疫苗制造商。共有 2015 名受试者符合纳入 7 项临床试验的条件，可纳入荟萃分析队列；其中 915 名（45%）为 RV。901 名 RV 受试者与 NRV 受试者 1:1 配对（替换）。在过去的季节中接种过 SIV 的受试者在接种 H5N1 疫苗后发生血清学转换的可能性显著降低（调整后的优势比 0.76；95%CI 0.60-0.96；p=0.024），NRV 受试者的 GMT 高 18%（HAI 抗体 GM 比值 1.18；95%CI 1.04-1.33；p=0.008）。需要进一步研究以更好地确定 RV 受试者对 H5N1 疫苗免疫反应降低的影响和机制。
