Verschoor Chris P, Andrew Melissa K, Loeb Mark, Pawelec Graham, Haynes Laura, Kuchel George A, McElhaney Janet E
Health Sciences North Research Institute, Sudbury, ON P3E 5J1, Canada.
Northern Ontario School of Medicine, Sudbury, ON P3E 2C6, Canada.
Vaccines (Basel). 2021 Jan 7;9(1):25. doi: 10.3390/vaccines9010025.
Despite efforts to design better vaccines for older adults, the risk for serious complications of influenza remains disproportionately high. Identifying correlates of vaccine effectiveness and understanding the heterogeneity of health outcomes in older adults are key to the vaccine development pipeline. We sought correlates of protection against laboratory-confirmed influenza illness (LCII) in a 4-year randomized trial of standard versus high-dose influenza vaccination of adults 65 years and older. To this end, we quantified serum hemagglutination-inhibition (HAI) titers and interferon-gamma (IFNγ) and interleukin-10 (IL-10) secretion by virus-challenged peripheral blood mononuclear cells. Of the 608 participants included, 26 developed either A/H3N2-( = 17) or B-LCII ( = 9) at 10-20 weeks post-vaccination. Antibody titres for A/H3N2 at 4-weeks post-vaccination were significantly associated with protection against LCII, where every 1-standard deviation increase reduced the odds of A/H3N2-LCII by 53%. Although B-titres did not correlate with protection against B-LCII, the fold-increase in IFNγ:IL-10 ratios from pre- to 4-weeks post-vaccination was significantly associated with protection against B-LCII, where every 1-standard deviation increase reduced the odds by 71%. Our results suggest that both antibody and cell-mediated immune measures are valuable and potentially complementary correlates of protection against LCII in vaccinated older adults, although this may depend on the viral type causing infection.
尽管人们努力为老年人设计更好的疫苗，但流感严重并发症的风险仍然过高。确定疫苗有效性的相关因素并了解老年人健康结果的异质性是疫苗研发流程的关键。在一项针对65岁及以上成年人的标准剂量与高剂量流感疫苗接种的4年随机试验中，我们寻找了预防实验室确诊流感疾病（LCII）的相关因素。为此，我们对病毒刺激的外周血单核细胞的血清血凝抑制（HAI）滴度、干扰素-γ（IFNγ）和白细胞介素-10（IL-10）分泌进行了量化。在纳入的608名参与者中，26人在接种疫苗后10 - 20周出现了A/H3N2型（n = 17）或B型LCII（n = 9）。接种疫苗后4周时A/H3N2的抗体滴度与预防LCII显著相关，每增加1个标准差可使A/H3N2-LCII的几率降低53%。虽然B型抗体滴度与预防B型LCII无关，但接种疫苗后4周IFNγ:IL-10比值较接种前的增加倍数与预防B型LCII显著相关，每增加1个标准差可使几率降低71%。我们的结果表明，抗体和细胞介导免疫指标都是预防接种疫苗的老年人发生LCII的有价值且可能互补的相关因素，尽管这可能取决于引起感染的病毒类型。
