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Benefits of increasing the dose of influenza vaccine in residents of long-term care facilities: a randomized placebo-controlled trial.
J Med Virol. 2009 May; 81(5):908-14.JM

Abstract

Increased vaccine doses and mid-season boosting may increase the proportion of residents with protective immunity from influenza in long-term care facilities. In a multi-center study (1997-1998), 815 residents from 14 long-term care facilities were assigned at random to receive 15 or 30 microg of inactivated influenza vaccine, followed by a 15 microg booster vaccine or a placebo vaccine at Day 84. Seroresponses were re-analyzed by hemagglutination-inhibition (> or =4-fold titer increases, protective titer > or =40, geometric mean titers. Forty percent of the participants had pre-vaccination titers > or =40. At Day 25 after vaccination, this increased to 66.3% after a 15 microg dose versus 73.3% after a dose of 30 microg (P = 0.049). Participants receiving a 30 microg dose followed by a 15 microg booster showed more > or =4-fold titer increases at Day 109 (43.6% vs. 35.4%, P = 0.003) and protective titers > or =40 (74.2% vs. 64.6%, P = 0.041), compared to those receiving only a 15 microg dose. Differences were most apparent in participants with low pre-vaccination titers. Booster vaccination after an initial 15 microg dose of the vaccine did not increase the protective rate (61.9% vs. 63.9% after placebo). The number of participants needed to vaccinate to protect one additional resident by a dose of 15 microg was 4, by a dose of 30 microg 3, and 15 when using a 30 microg dose instead of 15 microg. Doubling the dose of influenza vaccine increased protection-related responses among residents of long-term care facilities, especially in those with low pre-vaccination titers.

Authors+Show Affiliations

Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

19319953

Citation

Cools, Herman J M., et al. "Benefits of Increasing the Dose of Influenza Vaccine in Residents of Long-term Care Facilities: a Randomized Placebo-controlled Trial." Journal of Medical Virology, vol. 81, no. 5, 2009, pp. 908-14.
Cools HJ, Gussekloo J, Remmerswaal JE, et al. Benefits of increasing the dose of influenza vaccine in residents of long-term care facilities: a randomized placebo-controlled trial. J Med Virol. 2009;81(5):908-14.
Cools, H. J., Gussekloo, J., Remmerswaal, J. E., Remarque, E. J., & Kroes, A. C. (2009). Benefits of increasing the dose of influenza vaccine in residents of long-term care facilities: a randomized placebo-controlled trial. Journal of Medical Virology, 81(5), 908-14. https://doi.org/10.1002/jmv.21456
Cools HJ, et al. Benefits of Increasing the Dose of Influenza Vaccine in Residents of Long-term Care Facilities: a Randomized Placebo-controlled Trial. J Med Virol. 2009;81(5):908-14. PubMed PMID: 19319953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Benefits of increasing the dose of influenza vaccine in residents of long-term care facilities: a randomized placebo-controlled trial. AU - Cools,Herman J M, AU - Gussekloo,Jacobijn, AU - Remmerswaal,Joyce E M, AU - Remarque,Ed J, AU - Kroes,Aloys C M, PY - 2009/3/26/entrez PY - 2009/3/26/pubmed PY - 2009/5/6/medline SP - 908 EP - 14 JF - Journal of medical virology JO - J Med Virol VL - 81 IS - 5 N2 - Increased vaccine doses and mid-season boosting may increase the proportion of residents with protective immunity from influenza in long-term care facilities. In a multi-center study (1997-1998), 815 residents from 14 long-term care facilities were assigned at random to receive 15 or 30 microg of inactivated influenza vaccine, followed by a 15 microg booster vaccine or a placebo vaccine at Day 84. Seroresponses were re-analyzed by hemagglutination-inhibition (> or =4-fold titer increases, protective titer > or =40, geometric mean titers. Forty percent of the participants had pre-vaccination titers > or =40. At Day 25 after vaccination, this increased to 66.3% after a 15 microg dose versus 73.3% after a dose of 30 microg (P = 0.049). Participants receiving a 30 microg dose followed by a 15 microg booster showed more > or =4-fold titer increases at Day 109 (43.6% vs. 35.4%, P = 0.003) and protective titers > or =40 (74.2% vs. 64.6%, P = 0.041), compared to those receiving only a 15 microg dose. Differences were most apparent in participants with low pre-vaccination titers. Booster vaccination after an initial 15 microg dose of the vaccine did not increase the protective rate (61.9% vs. 63.9% after placebo). The number of participants needed to vaccinate to protect one additional resident by a dose of 15 microg was 4, by a dose of 30 microg 3, and 15 when using a 30 microg dose instead of 15 microg. Doubling the dose of influenza vaccine increased protection-related responses among residents of long-term care facilities, especially in those with low pre-vaccination titers. SN - 1096-9071 UR - https://www.unboundmedicine.com/medline/citation/19319953/Benefits_of_increasing_the_dose_of_influenza_vaccine_in_residents_of_long_term_care_facilities:_a_randomized_placebo_controlled_trial_ DB - PRIME DP - Unbound Medicine ER -