Journal Article

A randomized controlled trial of antibody response to 2019–20 cell-based inactivated and egg-based live attenuated influenza vaccines in children and young adults

Patricia Nowalk, Mary, Zhai, Bo, Moehling Geffel, Krissy, Susick, Michael, Collins, Mark, Zimmerman, Richard K., Jaber Merranko, Amanda, Martin, Judith M., Williams, Katherine V., Nagg, Jennifer P., Levine, Min Z., Clarke, Karen S., Alcorn, John F., Kim, Sara S., Flannery, Brendan

2022

Overview

Hemagglutination inhibition (HAI) titers to the live-attenuated influenza vaccine (LAIV4) are typically lower than its counterpart egg-based inactivated influenza vaccines (IIV). Similar comparisons have not been made between LAIV4 and the 4-strain, cell-culture inactivated influenza vaccine (ccIIV4). We compared healthy children’s and young adults’ HAI titers against the 2019–2020 LAIV4 and ccIIV4. Participants aged 4–21 years were randomized 1:1 to receive ccIIV4 (n = 100) or LAIV4 (n = 98). Blood was drawn prevaccination and on day 28 (21–35) post vaccination. HAI assays against egg-grown A/H1N1, A/H3N2, both vaccine B strains and cell-grown A/H3N2 antigens were conducted. Primary outcomes were geometric mean titers (GMT) and geometric mean fold rise (GMFR) in titers. GMTs to A/H1N1, A/H3N2 and B/Victoria increased following both ccIIV and LAIV and to B/Yamagata following ccIIV (p < 0.05). The GMFR range was 2.4–3.0 times higher for ccIIV4 than for LAIV4 (p < 0.001). Within vaccine types, egg-grown A/H3N2 GMTs were higher (p < 0.05) than cell-grown GMTs [ccIIV4 day 28: egg = 205 (95% CI: 178–237); cell = 136 (95% CI:113–165); LAIV4 day 28: egg = 96 (95% CI: 83–112); cell = 63 (95% CI: 58–74)]. The GMFR to A/H3N2 cell-grown and egg-grown antigens were similar. Pre-vaccination titers inversely predicted GMFR. The HAI response to ccIIV4 was greater than LAIV4 in this study of mostly older children, and day 0 HAI titers inversely predicted GMFR for both vaccines. Lower prevaccination titers were associated with greater GMFR in both vaccine groups.

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Adolescent / Adults / Allergy and Immunology / Antibodies / Antibodies, Viral / Antibody Formation / Antibody response / Antigens / blood / Cell culture / Cell-culture-based inactivated influenza vaccine / Child / Children / Clinical trials / Consent / Deactivation / Egg-based live attenuated influenza vaccine / Eggs / Enrollments / Families & family life / Health facilities / hemagglutination / Hemagglutination inhibition / Hemagglutination inhibition assay / Hemagglutination Inhibition Tests / Humans / Influenza / Influenza A Virus, H1N1 Subtype / Influenza A Virus, H3N2 Subtype / Influenza vaccine / Influenza Vaccines / Influenza, Human - prevention & control / Laboratories / live vaccines / Mutation / Pediatrics / Primary care / randomized clinical trials / Randomized controlled trial / Sample size / vaccination / Vaccines / Vaccines, Attenuated / Vaccines, Inactivated / Viruses / Young Adult / Young adults