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Immunogenicity and safety of intradermal influenza vaccination in healthy older adults.
Clin Infect Dis. 2010 May 15; 50(10):1331-8.CI

Abstract

BACKGROUND

Influenza vaccine immunogenicity is suboptimal in older persons. Intradermal (ID) vaccination may be a promising alternative to intramuscular (IM) vaccination.

METHODS

This randomized trial compared the immunogenicity of 60% dose ID influenza vaccination to standard IM vaccination of full-dose or 60% dose vaccine. Pre- and postvaccination measurements in the hemagglutination inhibition antibody titer were compared. Participants who received reduced-dose vaccine were revaccinated with full-dose IM vaccine.

RESULTS

257 healthy adults aged 65 years received 1 of the following trivalent inactivated influenza vaccines: standard-dose (15 microg each of 3 hemagglutinin vaccine antigens in 0.5 mL) IM injection, reduced-dose (9 microg, 0.3 mL) IM injection, reduced-dose (9 microg, 0.3 mL) ID injection, or 2 reduced-dose (4.5 microg, 0.15 mL) ID injections. Respective seroprotection rates were 65.6%, 57.8%, 68.9%, and 67.2% against A/H1N1; 76.6%, 75.0%, 75.4%, and 75.0% against A/H3N2; and 26.6%, 17.2%, 16.4%, and 25.0% against influenza B. Subsequent full-dose IM vaccination of participants randomized to reduced-dose vaccine by either IM or ID routes did not improve seroprotection rates. Local reactions of redness, swelling, and itching were significantly more frequent among recipients of ID injections.

CONCLUSION

Influenza vaccine at 60% dose by either IM or ID route elicited antibody responses generally similar to full-dose IM vaccination among healthy elderly persons (ClinicalTrials.gov identifier: NCT00504231).

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Authors+Show Affiliations

Chi RC
University of Washington, Seattle, Washington, USA. rchi@u.washington.edu
Rock MT
No affiliation info available
Neuzil KM
No affiliation info available

MeSH

AgedAged, 80 and overAntibodies, ViralFemaleHemagglutination Inhibition TestsHumansInfluenza VaccinesInfluenza, HumanInjections, IntradermalInjections, IntramuscularMaleSkin Diseases

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

20377407

Clinical Trial Links

Clinical trial which this article describes

Citation

Chi, Ru-Chien, et al. "Immunogenicity and Safety of Intradermal Influenza Vaccination in Healthy Older Adults." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 50, no. 10, 2010, pp. 1331-8.
Chi RC, Rock MT, Neuzil KM. Immunogenicity and safety of intradermal influenza vaccination in healthy older adults. Clin Infect Dis. 2010;50(10):1331-8.
Chi, R. C., Rock, M. T., & Neuzil, K. M. (2010). Immunogenicity and safety of intradermal influenza vaccination in healthy older adults. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 50(10), 1331-8. https://doi.org/10.1086/652144
Chi RC, Rock MT, Neuzil KM. Immunogenicity and Safety of Intradermal Influenza Vaccination in Healthy Older Adults. Clin Infect Dis. 2010 May 15;50(10):1331-8. PubMed PMID: 20377407.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunogenicity and safety of intradermal influenza vaccination in healthy older adults. AU - Chi,Ru-Chien, AU - Rock,Michael T, AU - Neuzil,Kathleen M, PY - 2010/4/10/entrez PY - 2010/4/10/pubmed PY - 2010/7/10/medline SP - 1331 EP - 8 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 50 IS - 10 N2 - BACKGROUND: Influenza vaccine immunogenicity is suboptimal in older persons. Intradermal (ID) vaccination may be a promising alternative to intramuscular (IM) vaccination. METHODS: This randomized trial compared the immunogenicity of 60% dose ID influenza vaccination to standard IM vaccination of full-dose or 60% dose vaccine. Pre- and postvaccination measurements in the hemagglutination inhibition antibody titer were compared. Participants who received reduced-dose vaccine were revaccinated with full-dose IM vaccine. RESULTS: 257 healthy adults aged 65 years received 1 of the following trivalent inactivated influenza vaccines: standard-dose (15 microg each of 3 hemagglutinin vaccine antigens in 0.5 mL) IM injection, reduced-dose (9 microg, 0.3 mL) IM injection, reduced-dose (9 microg, 0.3 mL) ID injection, or 2 reduced-dose (4.5 microg, 0.15 mL) ID injections. Respective seroprotection rates were 65.6%, 57.8%, 68.9%, and 67.2% against A/H1N1; 76.6%, 75.0%, 75.4%, and 75.0% against A/H3N2; and 26.6%, 17.2%, 16.4%, and 25.0% against influenza B. Subsequent full-dose IM vaccination of participants randomized to reduced-dose vaccine by either IM or ID routes did not improve seroprotection rates. Local reactions of redness, swelling, and itching were significantly more frequent among recipients of ID injections. CONCLUSION: Influenza vaccine at 60% dose by either IM or ID route elicited antibody responses generally similar to full-dose IM vaccination among healthy elderly persons (ClinicalTrials.gov identifier: NCT00504231). SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/20377407/Immunogenicity_and_safety_of_intradermal_influenza_vaccination_in_healthy_older_adults_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/652144 DB - PRIME DP - Unbound Medicine ER -