A Randomized Controlled Trial Comparing Intradermal vs. Intramuscular Influenza Vaccine in Lung Transplant Recipients
Details
Serval ID
serval:BIB_8A5E2030A4A8
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
A Randomized Controlled Trial Comparing Intradermal vs. Intramuscular Influenza Vaccine in Lung Transplant Recipients
Title of the conference
10th American Transplant Congress
Address
San Diego, California, United-States, May 1-5, 2010
ISBN
1600-6135
Publication state
Published
Issued date
2010
Peer-reviewed
Oui
Volume
10
Series
American Journal of Transplantation
Pages
208
Language
english
Notes
Publication type : Meeting Abstract
Abstract
Background: Immunogenicity of standard infl uenza vaccine is suboptimal in
lung transplant recipients. Intradermal vaccine may elicit stronger responses due
to recruitment of local dendritic cells. We compared the immunogenicity of the
infl uenza vaccine administered intradermally (ID) to the standard intramuscular
(IM) vaccination.
Methods: In this investigator-blinded, two-center, prospective trial, lung transplant
patients were randomized to receive intradermal (6ug) or intramuscular (15ug)
2008/9 trivalent inactivated infl uenza vaccine. Immunogenicity was evaluated
using a standard hemagglutination inhibition assay (HIA). Response to the vaccine
was defi ned as a fourfold increase of the HIA levels for any of the 3 viral strains
in the vaccine. Geometric mean titers (GMT) and seroprotection rate (HIA ≥32)
were also analyzed. Patients were followed during 6 months for the development
of infl uenza or acute rejection.
Results: We randomized 84 patients to receive the ID (n=41) vs. IM (n=43) vaccine,
respectively. Baseline characteristics were similar between groups. Median time
from transplantation was 3.4 yrs (ID) vs. 3.3 yrs (IM) (p=0.84). Vaccine response
to at least one antigen was seen in 6/41 (14.6%) patients in the ID vs. 8/43 (18.6%)
in the IM group (p=0.77). In the ID group, GMTs (95% CI) after vaccination were
15.7 (11.1-22.3) for H1N1, 84.0 (52.0-135.7) for H3N2, and 14.5 (9.6-21.8) for B
strains vs. in the IM group 17.5 (11.8-25.9) for H1N1, 108.9 (77.5-153.2) for H3N2,
and 20.2 (12.8-31.9) for B (p=NS, all 3 strains). Seroprotection was 39% (H1N1),
82.9% (H3N2) and 29.3% (B strain) in the ID group vs. 27.9% (H1N1), 97.7%
(H3N2) and 58.1% (B strain) in the IM group. No factors associated with vaccine
response were identifi ed. Mild adverse events were seen in 44% of patients (ID)
vs. 34% (IM) (p=0.38). Two patients (4.8%) in the ID group developed infl uenza
infection compared to none in the IM group. Two patients in each group developed
biopsy-proven acute rejection during follow-up.
Conclusions: Immunogenicity of the 2008/09 infl uenza vaccine was poor in lung
transplant recipients. ID administration of the vaccine elicited similar immune
responses to standard IM vaccination. Novel strategies of vaccination are needed
to protect lung transplant recipients from infl uenza.
lung transplant recipients. Intradermal vaccine may elicit stronger responses due
to recruitment of local dendritic cells. We compared the immunogenicity of the
infl uenza vaccine administered intradermally (ID) to the standard intramuscular
(IM) vaccination.
Methods: In this investigator-blinded, two-center, prospective trial, lung transplant
patients were randomized to receive intradermal (6ug) or intramuscular (15ug)
2008/9 trivalent inactivated infl uenza vaccine. Immunogenicity was evaluated
using a standard hemagglutination inhibition assay (HIA). Response to the vaccine
was defi ned as a fourfold increase of the HIA levels for any of the 3 viral strains
in the vaccine. Geometric mean titers (GMT) and seroprotection rate (HIA ≥32)
were also analyzed. Patients were followed during 6 months for the development
of infl uenza or acute rejection.
Results: We randomized 84 patients to receive the ID (n=41) vs. IM (n=43) vaccine,
respectively. Baseline characteristics were similar between groups. Median time
from transplantation was 3.4 yrs (ID) vs. 3.3 yrs (IM) (p=0.84). Vaccine response
to at least one antigen was seen in 6/41 (14.6%) patients in the ID vs. 8/43 (18.6%)
in the IM group (p=0.77). In the ID group, GMTs (95% CI) after vaccination were
15.7 (11.1-22.3) for H1N1, 84.0 (52.0-135.7) for H3N2, and 14.5 (9.6-21.8) for B
strains vs. in the IM group 17.5 (11.8-25.9) for H1N1, 108.9 (77.5-153.2) for H3N2,
and 20.2 (12.8-31.9) for B (p=NS, all 3 strains). Seroprotection was 39% (H1N1),
82.9% (H3N2) and 29.3% (B strain) in the ID group vs. 27.9% (H1N1), 97.7%
(H3N2) and 58.1% (B strain) in the IM group. No factors associated with vaccine
response were identifi ed. Mild adverse events were seen in 44% of patients (ID)
vs. 34% (IM) (p=0.38). Two patients (4.8%) in the ID group developed infl uenza
infection compared to none in the IM group. Two patients in each group developed
biopsy-proven acute rejection during follow-up.
Conclusions: Immunogenicity of the 2008/09 infl uenza vaccine was poor in lung
transplant recipients. ID administration of the vaccine elicited similar immune
responses to standard IM vaccination. Novel strategies of vaccination are needed
to protect lung transplant recipients from infl uenza.
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Create date
06/03/2011 15:51
Last modification date
20/08/2019 15:49
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