4.4 Article

Comparison of Serum Hemagglutinin and Neuraminidase Inhibition Antibodies After 2010-2011 Trivalent Inactivated Influenza Vaccination in Healthcare Personnel

Journal

OPEN FORUM INFECTIOUS DISEASES
Volume 2, Issue 1, Pages -

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/ofid/ofu115

Keywords

antibody; hemagglutinin-inhibition; influenza; neuraminidase-inhibition; vaccine

Funding

  1. Abt Associates
  2. National Institutes of Health (NIH) [T32 AI007285]
  3. National Institute of Allergy and Infectious Diseases Centers of Excellence for Influenza Research and Surveillance [HHSN266200700008C]
  4. University of Rochester

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Background. Most inactivated influenza vaccines contain purified and standardized hemagglutinin (HA) and residual neuraminidase (NA) antigens. Vaccine-associated HA antibody responses (hemagglutination inhibition [HAI]) are well described, but less is known about the immune response to the NA. Methods. Serum of 1349 healthcare personnel (HCP) electing or declining the 2010-2011 trivalent-inactivated influenza vaccine ([IIV3], containing A/California/7/2009 p(H1N1), A/Perth/16/2009 [H3N2], B/Brisbane/60/2008 strains) were tested for NA-inhibiting (NAI) antibody by a modified lectin-based assay using pseudotyped N1 and N2 influenza A viruses with an irrelevant (H5) HA. Neuraminidase-inhibiting and HAI antibody titers were evaluated approximately 30 days after vaccination and end-of-season for those with polymerase chain reaction (PCR)-confirmed influenza infection. Results. In 916 HCP (68%) receiving IIV3, a 2-fold increase in N1 and N2 NAI antibody occurred in 63.7% and 47.3%, respectively. Smaller responses occurred in HCP age >50 years and those without prior 2009-2010 IIV3 nor monovalent A(H1N1) pdm09 influenza vaccinations. Forty-four PCR-confirmed influenza infections were observed, primarily affecting those with lower pre-exposure HAI and NAI antibodies. Higher pre-NAI titers correlated with shorter duration of illness for A(H1N1) pdm09 virus infections. Conclusions. Trivalent-inactivated influenza vaccine is modestly immunogenic for N1 and N2 antigens in HCP. Vaccines eliciting robust NA immune responses may improve efficacy and reduce influenza-associated morbidity.

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