2019 - 2020年18 - 65岁医护人员中，高剂量鸡蛋基、重组及细胞培养基流感疫苗与标准剂量鸡蛋基流感疫苗的免疫原性比较
Immunogenicity of High-Dose Egg-Based, Recombinant, and Cell Culture-Based Influenza Vaccines Compared With Standard-Dose Egg-Based Influenza Vaccine Among Health Care Personnel Aged 18-65 Years in 2019-2020.
作者信息
Naleway Allison L, Kim Sara S, Flannery Brendan, Levine Min Z, Murthy Kempapura, Sambhara Suryaprakash, Gangappa Shivaprakash, Edwards Laura J, Ball Sarah, Grant Lauren, Zunie Tnelda, Cao Weiping, Gross F Liaini, Groom Holly, Fry Alicia M, Hunt Danielle, Jeddy Zuha, Mishina Margarita, Wesley Meredith G, Spencer Sarah, Thompson Mark G, Gaglani Manjusha, Dawood Fatimah S
机构信息
Kaiser Permanente Center for Health Research, Portland, Oregon, USA.
Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
出版信息
Open Forum Infect Dis. 2023 Apr 21;10(6):ofad223. doi: 10.1093/ofid/ofad223. eCollection 2023 Jun.
BACKGROUND
Emerging data suggest that second-generation influenza vaccines with higher hemagglutinin (HA) antigen content and/or different production methods may induce stronger antibody responses to HA than standard-dose egg-based influenza vaccines in adults. We compared antibody responses to high-dose egg-based inactivated (HD-IIV3), recombinant (RIV4), and cell culture-based (ccIIV4) vs standard-dose egg-based inactivated influenza vaccine (SD-IIV4) among health care personnel (HCP) aged 18-65 years in 2 influenza seasons (2018-2019, 2019-2020).
METHODS
In the second trial season, newly and re-enrolled HCPs who received SD-IIV4 in season 1 were randomized to receive RIV4, ccIIV4, or SD-IIV4 or were enrolled in an off-label, nonrandomized arm to receive HD-IIV3. Prevaccination and 1-month-postvaccination sera were tested by hemagglutination inhibition (HI) assay against 4 cell culture propagated vaccine reference viruses. Primary outcomes, adjusted for study site and baseline HI titer, were seroconversion rate (SCR), geometric mean titers (GMTs), mean fold rise (MFR), and GMT ratios that compared vaccine groups to SD-IIV4.
RESULTS
Among 390 HCP in the per-protocol population, 79 received HD-IIV3, 103 RIV4, 106 ccIIV4, and 102 SD-IIV4. HD-IIV3 recipients had similar postvaccination antibody titers compared with SD-IIV4 recipients, whereas RIV4 recipients had significantly higher 1-month-postvaccination antibody titers against vaccine reference viruses for all outcomes.
CONCLUSIONS
HD-IIV3 did not induce higher antibody responses than SD-IIV4, but, consistent with previous studies, RIV4 was associated with higher postvaccination antibody titers. These findings suggest that recombinant vaccines rather than vaccines with higher egg-based antigen doses may provide improved antibody responses in highly vaccinated populations.
背景
新出现的数据表明，与标准剂量的基于鸡蛋的流感疫苗相比，具有更高血凝素（HA）抗原含量和/或不同生产方法的第二代流感疫苗在成人中可能会诱导更强的针对HA的抗体反应。我们比较了18至65岁的医护人员（HCP）在2个流感季节（2018 - 2019年、2019 - 2020年）中对高剂量基于鸡蛋的灭活疫苗（HD-IIV3）、重组疫苗（RIV4）和基于细胞培养的疫苗（ccIIV4）与标准剂量基于鸡蛋的灭活流感疫苗（SD-IIV4）的抗体反应。
方法
在第二个试验季节，在第一季接受SD-IIV4的新入组和重新入组的HCP被随机分配接受RIV4、ccIIV4或SD-IIV4，或被纳入一个未按标签说明、非随机的组接受HD-IIV3。通过血凝抑制（HI）试验针对4种细胞培养繁殖的疫苗参考病毒检测接种前和接种后1个月的血清。针对研究地点和基线HI滴度进行调整后的主要结局包括血清转化率（SCR）、几何平均滴度（GMT）、平均升高倍数（MFR）以及将疫苗组与SD-IIV4进行比较的GMT比率。
结果
在符合方案人群的390名HCP中，79人接受了HD-IIV3，103人接受了RIV4，106人接受了ccIIV4，102人接受了SD-IIV4。与接受SD-IIV4的人相比，接受HD-IIV3的人接种后的抗体滴度相似，而接受RIV4的人在接种后1个月针对所有结局的疫苗参考病毒的抗体滴度显著更高。
结论
HD-IIV3诱导的抗体反应并不高于SD-IIV4，但与先前研究一致，RIV4与接种后更高的抗体滴度相关。这些发现表明，在高接种率人群中，重组疫苗而非具有更高基于鸡蛋抗原剂量的疫苗可能会提供更好的抗体反应。
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