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Poor seroprotection but allosensitization after adjuvanted pandemic influenza H1N1 vaccine in kidney transplant recipients.
Transpl Infect Dis. 2012 Dec; 14(6):575-83.TI

Abstract

BACKGROUND

Seasonal and pandemic influenza virus infections in renal transplant patients are associated with poor outcomes. During the pandemic of 2009-2010, the AS03-adjuvanted monovalent H1N1 influenza vaccine was recommended for transplant recipients, although its immunogenicity in this population was unknown. We sought to determine the safety and immunogenicity of an adjuvant-containing vaccine against pandemic influenza A H1N1 2009 (pH1N1) administered to kidney transplant recipients.

METHODS

We prospectively enrolled 124 adult kidney transplant recipients in the fall of 2009 at two transplant centers. Cohort 1 (n = 42) was assessed before and after pH1N1 immunization, while Cohort 2 (n = 82) was only assessed post immunization. Humoral response was measured by the hemagglutination inhibition assay. Vaccine safety was assessed by adverse event reporting, graft function, and human leukocyte antigen (HLA) alloantibody measurements.

RESULTS

Cohort 1 had a low rate of baseline seroprotection to pH1N1 (7%) and a low rate of seroprotection after immunization (31%). No patient <6 months post transplant (n = 5) achieved seroprotection. Seroprotection rate was greater in patients receiving double as compared with triple immunosuppression (80% vs. 24%, P = 0.01). In Cohort 2, post-immunization seroprotection was 35%. In both cohorts, no confirmed cases of pH1N1 infection occurred. No difference was seen in estimated glomerular filtration rate before (54.3 mL/min/1.73 m(2)) and after (53.8 mL/min/1.73 m(2)) immunization, and no acute rejections had occurred after immunization at last follow-up. In Cohort 1, 11.9% of patients developed new anti-HLA antibodies.

CONCLUSION

An adjuvant-containing vaccine to pH1N1 provided poor seroprotection in renal transplant recipients. Receiving triple immunosuppression was associated with a poor seroresponse. Vaccination appeared safe, but some patients developed new anti-HLA antibodies post vaccination. Alternative strategies to improve vaccine responses are necessary.

Authors+Show Affiliations

Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada. tfairhead@toh.on.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22999005

Citation

Fairhead, T, et al. "Poor Seroprotection but Allosensitization After Adjuvanted Pandemic Influenza H1N1 Vaccine in Kidney Transplant Recipients." Transplant Infectious Disease : an Official Journal of the Transplantation Society, vol. 14, no. 6, 2012, pp. 575-83.
Fairhead T, Hendren E, Tinckam K, et al. Poor seroprotection but allosensitization after adjuvanted pandemic influenza H1N1 vaccine in kidney transplant recipients. Transpl Infect Dis. 2012;14(6):575-83.
Fairhead, T., Hendren, E., Tinckam, K., Rose, C., Sherlock, C. H., Shi, L., Crowcroft, N. S., Gubbay, J. B., Landsberg, D., Knoll, G., Gill, J., & Kumar, D. (2012). Poor seroprotection but allosensitization after adjuvanted pandemic influenza H1N1 vaccine in kidney transplant recipients. Transplant Infectious Disease : an Official Journal of the Transplantation Society, 14(6), 575-83. https://doi.org/10.1111/tid.12006
Fairhead T, et al. Poor Seroprotection but Allosensitization After Adjuvanted Pandemic Influenza H1N1 Vaccine in Kidney Transplant Recipients. Transpl Infect Dis. 2012;14(6):575-83. PubMed PMID: 22999005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Poor seroprotection but allosensitization after adjuvanted pandemic influenza H1N1 vaccine in kidney transplant recipients. AU - Fairhead,T, AU - Hendren,E, AU - Tinckam,K, AU - Rose,C, AU - Sherlock,C H, AU - Shi,L, AU - Crowcroft,N S, AU - Gubbay,J B, AU - Landsberg,D, AU - Knoll,G, AU - Gill,J, AU - Kumar,D, Y1 - 2012/09/24/ PY - 2012/01/17/received PY - 2012/04/20/revised PY - 2012/06/21/revised PY - 2012/07/04/accepted PY - 2012/9/25/entrez PY - 2012/9/25/pubmed PY - 2013/5/28/medline SP - 575 EP - 83 JF - Transplant infectious disease : an official journal of the Transplantation Society JO - Transpl Infect Dis VL - 14 IS - 6 N2 - BACKGROUND: Seasonal and pandemic influenza virus infections in renal transplant patients are associated with poor outcomes. During the pandemic of 2009-2010, the AS03-adjuvanted monovalent H1N1 influenza vaccine was recommended for transplant recipients, although its immunogenicity in this population was unknown. We sought to determine the safety and immunogenicity of an adjuvant-containing vaccine against pandemic influenza A H1N1 2009 (pH1N1) administered to kidney transplant recipients. METHODS: We prospectively enrolled 124 adult kidney transplant recipients in the fall of 2009 at two transplant centers. Cohort 1 (n = 42) was assessed before and after pH1N1 immunization, while Cohort 2 (n = 82) was only assessed post immunization. Humoral response was measured by the hemagglutination inhibition assay. Vaccine safety was assessed by adverse event reporting, graft function, and human leukocyte antigen (HLA) alloantibody measurements. RESULTS: Cohort 1 had a low rate of baseline seroprotection to pH1N1 (7%) and a low rate of seroprotection after immunization (31%). No patient <6 months post transplant (n = 5) achieved seroprotection. Seroprotection rate was greater in patients receiving double as compared with triple immunosuppression (80% vs. 24%, P = 0.01). In Cohort 2, post-immunization seroprotection was 35%. In both cohorts, no confirmed cases of pH1N1 infection occurred. No difference was seen in estimated glomerular filtration rate before (54.3 mL/min/1.73 m(2)) and after (53.8 mL/min/1.73 m(2)) immunization, and no acute rejections had occurred after immunization at last follow-up. In Cohort 1, 11.9% of patients developed new anti-HLA antibodies. CONCLUSION: An adjuvant-containing vaccine to pH1N1 provided poor seroprotection in renal transplant recipients. Receiving triple immunosuppression was associated with a poor seroresponse. Vaccination appeared safe, but some patients developed new anti-HLA antibodies post vaccination. Alternative strategies to improve vaccine responses are necessary. SN - 1399-3062 UR - https://www.unboundmedicine.com/medline/citation/22999005/Poor_seroprotection_but_allosensitization_after_adjuvanted_pandemic_influenza_H1N1_vaccine_in_kidney_transplant_recipients_ L2 - https://doi.org/10.1111/tid.12006 DB - PRIME DP - Unbound Medicine ER -