Immune history shapes human antibody responses to H5N1 influenza viruses.

Avian H5N1 influenza viruses are circulating widely in cattle and other mammals and pose a risk for a human pandemic. Previous studies suggest that older humans are more resistant to H5N1 infections due to childhood imprinting with other group 1 viruses (H1N1 and H2N2); however, the immunological basis for this is incompletely understood. Here we show that antibody titers to historical and recent H5N1 strains are highest in older individuals and correlate more strongly with year of birth than with age, consistent with immune imprinting. After vaccination with an A/Vietnam/1203/2004 H5N1 vaccine, both younger and older humans produced H5-reactive antibodies to the vaccine strain and to a clade 2.3.4.4b isolate currently circulating in cattle, with higher seroconversion rates in young children who had lower levels of antibodies before vaccination. These studies suggest that younger individuals might benefit more from vaccination than older individuals in the event of an H5N1 pandemic.