Prime-boost, double-dose influenza vaccine immunity in COPD: a pilot observational study
Background COPD patients are more susceptible to viral respiratory infections and their sequelae, and have intrinsically weaker immune responses to vaccinations against influenza and other pathogens. Prime-boost, double-dose immunisation has been suggested as a general strategy to overcome weak humo...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2023-03-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/9/2/00641-2021.full |
| _version_ | 1827931457420525568 |
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| author | Gary P. Anderson Louis B. Irving Andrew Jarnicki Katherine Kedzierska Marios Koutsakos Stephen Kent Aeron C. Hurt Adam K. Wheatley Thi H.O. Nguyen Natale Snape John W. Upham |
| author_facet | Gary P. Anderson Louis B. Irving Andrew Jarnicki Katherine Kedzierska Marios Koutsakos Stephen Kent Aeron C. Hurt Adam K. Wheatley Thi H.O. Nguyen Natale Snape John W. Upham |
| author_sort | Gary P. Anderson |
| collection | DOAJ |
| description | Background
COPD patients are more susceptible to viral respiratory infections and their sequelae, and have intrinsically weaker immune responses to vaccinations against influenza and other pathogens. Prime-boost, double-dose immunisation has been suggested as a general strategy to overcome weak humoral response to vaccines, such as seasonal influenza vaccination, in susceptible populations with weak immunity. However, this strategy, which may also provide fundamental insights into the nature of weakened immunity, has not been formally studied in COPD.
Methods
We conducted an open-label study of seasonal influenza vaccination in 33 vaccine-experienced COPD patients recruited from established cohorts (mean age 70 (95% CI 66.9–73.2) years; mean forced expiratory volume in 1 s/forced vital capacity ratio 53.4% (95% CI 48.0–58.8%)). Patients received two sequential standard doses of the 2018 quadrivalent influenza vaccine (15 μg haemagglutinin per strain) in a prime-boost schedule 28 days apart. We measured strain-specific antibody titres, an accepted surrogate of likely efficacy, and induction of strain-specific B-cell responses following the prime and boost immunisations.
Results
Whereas priming immunisation induced the expected increase in strain-specific antibody titres, a second booster dose was strikingly ineffective at further increasing antibody titres. Similarly, priming immunisation induced strain-specific B-cells, but a second booster dose did not further enhance the B-cell response. Poor antibody responses were associated with male gender and cumulative cigarette exposure.
Conclusions
Prime-boost, double-dose immunisation does not further improve influenza vaccine immunogenicity in previously vaccinated COPD patients. These findings underscore the need to design more effective vaccine strategies for COPD patients for influenza. |
| first_indexed | 2024-03-13T06:51:52Z |
| format | Article |
| id | doaj.art-a5d119f8618a45ac92bd5a1942ed7bc7 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-13T06:51:52Z |
| publishDate | 2023-03-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-a5d119f8618a45ac92bd5a1942ed7bc72023-06-07T13:31:07ZengEuropean Respiratory SocietyERJ Open Research2312-05412023-03-019210.1183/23120541.00641-202100641-2021Prime-boost, double-dose influenza vaccine immunity in COPD: a pilot observational studyGary P. Anderson0Louis B. Irving1Andrew Jarnicki2Katherine Kedzierska3Marios Koutsakos4Stephen Kent5Aeron C. Hurt6Adam K. Wheatley7Thi H.O. Nguyen8Natale Snape9John W. Upham10 Lung Health Research Centre, Department of Biochemistry and Pharmacology, The University of Melbourne, Parkville, Australia Department of Respiratory Medicine, The Royal Melbourne Hospital, Parkville, Australia Lung Health Research Centre, Department of Biochemistry and Pharmacology, The University of Melbourne, Parkville, Australia Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Australia Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Australia Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity and ARC Centre for Excellence in Convergent Bio-Nano Science and Technology, The University of Melbourne, Parkville, Australia WHO Collaborating Centre for Reference and Research on Influenza, Victorian Infectious Diseases Reference Laboratory, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Australia Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, Australia Faculty of Medicine, The University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, Australia Faculty of Medicine, The University of Queensland Diamantina Institute, Translational Research Institute and Princess Alexandra Hospital, Woolloongabba, Australia Background COPD patients are more susceptible to viral respiratory infections and their sequelae, and have intrinsically weaker immune responses to vaccinations against influenza and other pathogens. Prime-boost, double-dose immunisation has been suggested as a general strategy to overcome weak humoral response to vaccines, such as seasonal influenza vaccination, in susceptible populations with weak immunity. However, this strategy, which may also provide fundamental insights into the nature of weakened immunity, has not been formally studied in COPD. Methods We conducted an open-label study of seasonal influenza vaccination in 33 vaccine-experienced COPD patients recruited from established cohorts (mean age 70 (95% CI 66.9–73.2) years; mean forced expiratory volume in 1 s/forced vital capacity ratio 53.4% (95% CI 48.0–58.8%)). Patients received two sequential standard doses of the 2018 quadrivalent influenza vaccine (15 μg haemagglutinin per strain) in a prime-boost schedule 28 days apart. We measured strain-specific antibody titres, an accepted surrogate of likely efficacy, and induction of strain-specific B-cell responses following the prime and boost immunisations. Results Whereas priming immunisation induced the expected increase in strain-specific antibody titres, a second booster dose was strikingly ineffective at further increasing antibody titres. Similarly, priming immunisation induced strain-specific B-cells, but a second booster dose did not further enhance the B-cell response. Poor antibody responses were associated with male gender and cumulative cigarette exposure. Conclusions Prime-boost, double-dose immunisation does not further improve influenza vaccine immunogenicity in previously vaccinated COPD patients. These findings underscore the need to design more effective vaccine strategies for COPD patients for influenza.http://openres.ersjournals.com/content/9/2/00641-2021.full |
| spellingShingle | Gary P. Anderson Louis B. Irving Andrew Jarnicki Katherine Kedzierska Marios Koutsakos Stephen Kent Aeron C. Hurt Adam K. Wheatley Thi H.O. Nguyen Natale Snape John W. Upham Prime-boost, double-dose influenza vaccine immunity in COPD: a pilot observational study ERJ Open Research |
| title | Prime-boost, double-dose influenza vaccine immunity in COPD: a pilot observational study |
| title_full | Prime-boost, double-dose influenza vaccine immunity in COPD: a pilot observational study |
| title_fullStr | Prime-boost, double-dose influenza vaccine immunity in COPD: a pilot observational study |
| title_full_unstemmed | Prime-boost, double-dose influenza vaccine immunity in COPD: a pilot observational study |
| title_short | Prime-boost, double-dose influenza vaccine immunity in COPD: a pilot observational study |
| title_sort | prime boost double dose influenza vaccine immunity in copd a pilot observational study |
| url | http://openres.ersjournals.com/content/9/2/00641-2021.full |
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