TY - JOUR
T1 - The humoral immune response of hematopoietic stem cell transplantation recipients to AS03-adjuvanted A/California/7/2009 (H1N1)v-like virus vaccine during the 2009 pandemic
AU - Engelhard, Dan
AU - Zakay-Rones, Zichria
AU - Shapira, Michael Y.
AU - Resnick, Igor
AU - Averbuch, Diana
AU - Grisariu, Sigal
AU - Dray, Lillian
AU - Djian, Esther
AU - Strauss-Liviatan, Nurith
AU - Grotto, Itamar
AU - Wolf, Dana G.
AU - Or, Reuven
PY - 2011/2/17
Y1 - 2011/2/17
N2 - We evaluated the formation of hemagglutination-inhibition (HI) antibodies in response to vaccination of 55 allogeneic and 23 autologous hematopoietic stem cell transplantation (HSCT) recipients with 3.75 jig inactivated influenza A/California/7/2009 (H1N1)v-like virus adjuvanted with AS03, given towards the end of the 2009 influenza pandemic. The 78 HSCT recipients, aged 11-72 (median 50) years, were vaccinated 1-290 (median 27) months post-HSCT. Of the 55 allogeneic HSCT recipients, 50.9% received reduced intensity conditioning, 74.5% had a sibling donor, 67.2% had active graft-versus-host disease and 43.6% were on steroid therapy. At baseline, 14/78 (17.9%) had HI titers ≥1:40. Blood samples of 77 patients were available post-1st vaccination; of these, 34 (44.2%) patients had HI titers ≥1:40. Blood samples of 43 patients were available post-2nd vaccination; of these, 21 (48.8%) had HI titers ≥1:40. There was a significant increase in HI titers ≥1:40 from baseline to both post-1st and 2nd vaccinations (p < 0.001 each), and also from 1st to 2nd vaccination (p = 0.008). In seronegative (HI titers <1:10) patients, whose sera were available before, after one dose, and after 2 doses of vaccine, seroconversion (to ≥1:40) occurred in 4/24 (16.7%) after 1-dose and in a total of 10/24 (41.7%) after 2-dose vaccination (p = 0.031). Logistic regression analysis revealed that ≥1:40 HI titers were significantly associated with higher lymphocyte counts and higher HI baseline titers and, in allogeneic HSCT, with having a sibling donor and higher baseline titers. In conclusion, 2-dose vaccination with AS03-adjuvanted vaccine containing 3.75 μg antigen resulted in a statistically significant, yet limited, serological response. Therefore, additional precautions should be taken during influenza outbreaks.
AB - We evaluated the formation of hemagglutination-inhibition (HI) antibodies in response to vaccination of 55 allogeneic and 23 autologous hematopoietic stem cell transplantation (HSCT) recipients with 3.75 jig inactivated influenza A/California/7/2009 (H1N1)v-like virus adjuvanted with AS03, given towards the end of the 2009 influenza pandemic. The 78 HSCT recipients, aged 11-72 (median 50) years, were vaccinated 1-290 (median 27) months post-HSCT. Of the 55 allogeneic HSCT recipients, 50.9% received reduced intensity conditioning, 74.5% had a sibling donor, 67.2% had active graft-versus-host disease and 43.6% were on steroid therapy. At baseline, 14/78 (17.9%) had HI titers ≥1:40. Blood samples of 77 patients were available post-1st vaccination; of these, 34 (44.2%) patients had HI titers ≥1:40. Blood samples of 43 patients were available post-2nd vaccination; of these, 21 (48.8%) had HI titers ≥1:40. There was a significant increase in HI titers ≥1:40 from baseline to both post-1st and 2nd vaccinations (p < 0.001 each), and also from 1st to 2nd vaccination (p = 0.008). In seronegative (HI titers <1:10) patients, whose sera were available before, after one dose, and after 2 doses of vaccine, seroconversion (to ≥1:40) occurred in 4/24 (16.7%) after 1-dose and in a total of 10/24 (41.7%) after 2-dose vaccination (p = 0.031). Logistic regression analysis revealed that ≥1:40 HI titers were significantly associated with higher lymphocyte counts and higher HI baseline titers and, in allogeneic HSCT, with having a sibling donor and higher baseline titers. In conclusion, 2-dose vaccination with AS03-adjuvanted vaccine containing 3.75 μg antigen resulted in a statistically significant, yet limited, serological response. Therefore, additional precautions should be taken during influenza outbreaks.
KW - 2009 A(H1N1) influenza pandemic
KW - A/California/7/2009 vaccine
KW - Hematopoietic stem cell transplantation
KW - Humoral immune response
KW - Vaccination
UR - http://www.scopus.com/inward/record.url?scp=79952703352&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2010.12.113
DO - 10.1016/j.vaccine.2010.12.113
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AN - SCOPUS:79952703352
SN - 0264-410X
VL - 29
SP - 1777
EP - 1782
JO - Vaccine
JF - Vaccine
IS - 9
ER -