Faustini Siân E, Backhouse Claire, Duggal Niharika A, Toellner Kai-Michael, Harvey Ruth, Drayson Mark T, Lord Janet M, Richter Alex G
Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, UK; Clinical Immunology Service, Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, UK.
Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, UK; Clinical Immunology Service, Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, UK.
Vaccine. 2025 Mar 7;49:126770. doi: 10.1016/j.vaccine.2025.126770. Epub 2025 Feb 8.
Vaccines are less immunogenic in older adults, partly due to immunosenescence. Having previously shown that morning influenza vaccination may be more immunogenic in older adults (mean age 71), we assessed if this could be replicated in a younger cohort (mean age 57) and with a T-cell independent vaccine. This study examined whether diurnal timing of a single dose of Pneumovax® (PPV-23) and seasonal influenza vaccine influenced antibody responses in 140 healthy adults over the age of 50. Pneumococcal serotype-specific (PnPS) antibodies and Haemagglutination Inhibition Assays (HAI) were used to characterize antibody responses at Baseline, 1, 4, and 52 weeks post-vaccination. Protective thresholds were set at 0.35 μg/mL for two-thirds of PnPS tested (WHO) and a titre of ≥40 HAI for H1N1, H3N2, and B/Victoria strains. Both AM and PM cohorts showed increased Pn-specific antibodies to one PPV-23 dose at weeks 1, 4, and 52; however, time of day did not significantly influence antibody responses. Baseline immunity for pneumococcus was high (57.1 % AM, 50.0 % PM had WHO), and immunity was maintained with at least 7/12 serotypes elevated at 52 weeks. Time of day did not alter short- or long-term influenza antibody responses. H1N1 had the highest baseline immunity (67.6 % AM, 48.6 % PM had ≥40 HAI) and the most increased responses at week 4 post-vaccination (92.8 % AM, 94.1 % PM) that were maintained at 52 weeks post-vaccination (91.7 % AM, 89.3 % PM). The poorest serotype immunity was for the B/Victoria strain at all time points. Although time of day did not influence vaccine immunogenicity in AM and PM cohorts, sustained cohort-wide antibody responses were demonstrated in an older population. Identifying 18 % of the total cohort exhibited suboptimal responses to pneumococcal or influenza vaccines underscores the imperative for enhancing vaccine efficacy within this age group to reduce morbidity and mortality.
疫苗在老年人中的免疫原性较低，部分原因是免疫衰老。此前我们已经表明，上午接种流感疫苗在老年人（平均年龄71岁）中可能具有更高的免疫原性，我们评估了这一现象是否能在更年轻的队列（平均年龄57岁）以及使用非T细胞依赖型疫苗的情况下得到重现。本研究调查了单剂量肺炎球菌多糖疫苗（PPV-23）和季节性流感疫苗的接种时间是否会影响140名50岁以上健康成年人的抗体反应。采用肺炎球菌血清型特异性（PnPS）抗体和血凝抑制试验（HAI）来表征接种疫苗后第0、1、4和52周时的抗体反应。对于三分之二检测的PnPS（世界卫生组织标准），保护性阈值设定为0.35μg/mL，对于H1N1、H3N2和B/维多利亚毒株，HAI滴度≥40。上午接种组和下午接种组在第1、4和52周时，针对一剂PPV-23的Pn特异性抗体均有所增加；然而，接种时间并未显著影响抗体反应。肺炎球菌的基线免疫力较高（上午接种组为57.1%，下午接种组为50.0%达到世界卫生组织标准），且在52周时至少有7/12种血清型的免疫力保持升高。接种时间并未改变短期或长期的流感抗体反应。H1N1的基线免疫力最高（上午接种组为67.6%，下午接种组为48.6%达到HAI≥40），且在接种后第4周反应增加最多（上午接种组为92.8%，下午接种组为94.1%），并在接种后52周保持（上午接种组为91.7%，下午接种组为89.3%）。在所有时间点，B/维多利亚毒株的血清型免疫力最差。尽管接种时间并未影响上午接种组和下午接种组的疫苗免疫原性，但在老年人群体中证实了整个队列的抗体反应持续存在。在整个队列中，有18%的人对肺炎球菌或流感疫苗的反应不理想，这突出表明迫切需要提高该年龄组的疫苗效力，以降低发病率和死亡率。
