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Serum antibody responses after intradermal vaccination against influenza.

Abstract

BACKGROUND

If found to be safe and immunogenic, reduced doses of influenza vaccine given by the intradermal route could increase the number of available doses of vaccine.

METHODS

In an open-label study, we randomly assigned 119 subjects to receive an intradermal injection of trivalent inactivated influenza vaccine, containing 6 mug of hemagglutinin for each antigen (40 percent of the usual dose), and 119 to receive an intramuscular injection of the standard dose of 15 mug of hemagglutinin for each antigen. The two groups were subdivided according to age (18 to 60 years and older than 60 years).

RESULTS

Among subjects who were 18 to 60 years of age, serum antibody responses were vigorous and did not differ significantly between the intradermal and intramuscular groups, and all subjects had hemagglutination-inhibition (HAI) titers of at least 1:40. Although the subjects who were older than 60 years of age also had a vigorous antibody response, there was a trend toward a better response in the intramuscular route, but this finding was significant only for antigen to the H3N2 strain. Nevertheless, 100 percent of older subjects in the intramuscular group and 93 percent of such subjects in the intradermal group had an HAI antibody titer to the H3N2 strain of more than 1:40, and 100 percent in each group had a titer of this level for both the H1N1 and B strains. Local pain was significantly more common in the intramuscular group than in the intradermal group among subjects who were 18 to 60 years of age but not among subjects who were over 60 years old. Signs of local inflammation were significantly more common among subjects in the intradermal group than among those in the intramuscular group, in both age groups.

CONCLUSIONS

As compared with an intramuscular injection of full-dose influenza vaccine, an intradermal injection of a reduced dose resulted in similarly vigorous antibody responses among persons 18 to 60 years of age but not among those over the age of 60 years.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Division of Infectious Diseases and Immunology, Saint Louis University, St. Louis, MO 63110, USA. belsherb@slu.edu

    , , , , , ,

    Source

    The New England journal of medicine 351:22 2004 Nov 25 pg 2286-94

    MeSH

    Adolescent
    Adult
    Aged
    Aging
    Antibodies, Viral
    Female
    Hemagglutinin Glycoproteins, Influenza Virus
    Humans
    Influenza A virus
    Influenza B virus
    Influenza Vaccines
    Influenza, Human
    Injections, Intradermal
    Injections, Intramuscular
    Male
    Middle Aged

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15525713

    Citation

    Belshe, Robert B., et al. "Serum Antibody Responses After Intradermal Vaccination Against Influenza." The New England Journal of Medicine, vol. 351, no. 22, 2004, pp. 2286-94.
    Belshe RB, Newman FK, Cannon J, et al. Serum antibody responses after intradermal vaccination against influenza. N Engl J Med. 2004;351(22):2286-94.
    Belshe, R. B., Newman, F. K., Cannon, J., Duane, C., Treanor, J., Van Hoecke, C., ... Dubin, G. (2004). Serum antibody responses after intradermal vaccination against influenza. The New England Journal of Medicine, 351(22), pp. 2286-94.
    Belshe RB, et al. Serum Antibody Responses After Intradermal Vaccination Against Influenza. N Engl J Med. 2004 Nov 25;351(22):2286-94. PubMed PMID: 15525713.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Serum antibody responses after intradermal vaccination against influenza. AU - Belshe,Robert B, AU - Newman,Frances K, AU - Cannon,Joan, AU - Duane,Carol, AU - Treanor,John, AU - Van Hoecke,Christian, AU - Howe,Barbara J, AU - Dubin,Gary, Y1 - 2004/11/03/ PY - 2004/11/5/pubmed PY - 2004/12/16/medline PY - 2004/11/5/entrez SP - 2286 EP - 94 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 351 IS - 22 N2 - BACKGROUND: If found to be safe and immunogenic, reduced doses of influenza vaccine given by the intradermal route could increase the number of available doses of vaccine. METHODS: In an open-label study, we randomly assigned 119 subjects to receive an intradermal injection of trivalent inactivated influenza vaccine, containing 6 mug of hemagglutinin for each antigen (40 percent of the usual dose), and 119 to receive an intramuscular injection of the standard dose of 15 mug of hemagglutinin for each antigen. The two groups were subdivided according to age (18 to 60 years and older than 60 years). RESULTS: Among subjects who were 18 to 60 years of age, serum antibody responses were vigorous and did not differ significantly between the intradermal and intramuscular groups, and all subjects had hemagglutination-inhibition (HAI) titers of at least 1:40. Although the subjects who were older than 60 years of age also had a vigorous antibody response, there was a trend toward a better response in the intramuscular route, but this finding was significant only for antigen to the H3N2 strain. Nevertheless, 100 percent of older subjects in the intramuscular group and 93 percent of such subjects in the intradermal group had an HAI antibody titer to the H3N2 strain of more than 1:40, and 100 percent in each group had a titer of this level for both the H1N1 and B strains. Local pain was significantly more common in the intramuscular group than in the intradermal group among subjects who were 18 to 60 years of age but not among subjects who were over 60 years old. Signs of local inflammation were significantly more common among subjects in the intradermal group than among those in the intramuscular group, in both age groups. CONCLUSIONS: As compared with an intramuscular injection of full-dose influenza vaccine, an intradermal injection of a reduced dose resulted in similarly vigorous antibody responses among persons 18 to 60 years of age but not among those over the age of 60 years. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/15525713/Serum_antibody_responses_after_intradermal_vaccination_against_influenza_ L2 - https://www.nejm.org/doi/10.1056/NEJMoa043555?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=www.ncbi.nlm.nih.gov DB - PRIME DP - Unbound Medicine ER -