Download Vaccine Antibody response to influenza vaccination in the elderly

Vaccination Info
Journal of immunology
• Vaccination of HCWs was associated with reductions in
total patient mortality from 17% to 10% (odds ratio
[OR], 0.56; 95% confidence interval [CI], 0.40–0.80) and
in influenza-like illness (OR, 0.57; 95% CI, 0.34–0.94).
Vaccination of patients was not associated with
significant effects on mortality (OR, 1.15; 95% CI, 0.81–
1.64). Results of this study support recommendations
for vaccination against influenza of HCWs in long-term
geriatric care. Vaccination of frail elderly long-termcare patients may not give clinically worthwhile
benefits.
Setting Two large teaching hospitals in Baltimore, Md.
Participants 264 hospital-based health care professionals without chronic medical problems
were recruited; 49 participated for 2 seasons; 24 participated for 3 seasons. The mean age was
28.4 years, 75% were resident physicians, and 57% were women.
Intervention Participants were randomly assigned to receive either an influenza vaccine or a
control (meningococcal vaccine, pneumococcal vaccine, or placebo). Serum samples for
antibody assays were collected at the time of vaccination, 1 month after vaccination, and at
the end of the influenza season. weekly surveillance for illness was conducted Main Outcome
Measures Serologically defined influenza infection (4-fold increase in antibodies), days of
respiratory illness, and days absent from work.
Results We conducted 359 person-winters of serologic surveillance (99.4% follow-up) and
4746 person-weeks of illness surveillance (100% follow-up). Twenty-four (13.4%) of 179
control subjects and 3 (1.7%) of 180 influenza vaccine recipients had serologic evidence of
influenza type A or B infection during the study period. Vaccine efficacy against serologically
defined infection was 88% for influenza A (95% confidence interval [CI], 47%-97%; P=.001) and
89% for influenza B (95% CI, 14%-99%; P=.03). Conclusions Influenza vaccine is effective in
preventing infection by influenza A and B in health care professionals and may reduce
reported days of work absence and febrile respiratory illness. These data support a policy of
annual influenza vaccination of health care professionals.
• JAMA
Vaccine
Antibody response to influenza vaccination in
the elderly: A quantitative review
• Abstract
• We performed a quantitative review of 31 vaccine antibody
response studies conducted from 1986 to 2002 and compared
antibody responses to influenza vaccine in groups of elderly versus
younger adults. We did a weighted analysis of the probability of
vaccine response (measured as seroconversion and seroprotection)
for each vaccine component (H1, H3 and B antigens). Using a
multiple regression model, we adjusted for factors that might affect
the vaccine response. The adjusted odds-ratio (OR) of responses in
elderly versus young adults ranged from 0.24 to 0.59 in terms of
seroconversion and seroprotection to all three antigens. The CDC
estimates of 70–90% clinical vaccine efficacy in young adults and
these estimates suggest a corresponding clinical efficacy in the
elderly of 17–53% depending on circulating viruses. We conclude
that the antibody response in the elderly is considerably lower than
in younger adults. This highlights the need for more immunogenic
vaccine formulations for the elderly.
CDC
• *TODAY, THE ONLY CHILDHOOD VACCINES USED ROUTINELY IN
THE UNITED STATES THAT CONTAIN THIMEROSAL (MERCURY) ARE
FLU VACCINES IN MULTI-DOSE VIALS. THESE VIALS HAVE VERY
TINY AMOUNTS OF THIMEROSAL AS A PRESERVATIVE. THIS IS
NECESSARY BECAUSE EACH TIME AN INDIVIDUAL DOSE IS DRAWN
FROM A MULTI-DOSE VIAL WITH A NEW NEEDLE AND SYRINGE,
THERE IS THE POTENTIAL TO CONTAMINATE THE VIAL WITH
HARMFUL MICROBES (TOXINS).
• THERE IS NO EVIDENCE THAT THE SMALL AMOUNTS OF
THIMEROSAL IN FLU VACCINES CAUSES ANY HARM, EXCEPT FOR
MINOR REACTIONS LIKE REDNESS AND SWELLING AT THE
INJECTION SITE. ALTHOUGH NO EVIDENCE SUGGESTS THAT THERE
ARE SAFETY CONCERNS WITH THIMEROSAL, VACCINE
MANUFACTURERS HAVE STOPPED USING IT AS A PRECAUTIONARY
MEASURE. FLU VACCINES THAT DO NOT CONTAIN THIMEROSAL
ARE AVAILABLE (IN SINGLE DOSE VIALS).
CDC
• Can the flu vaccine give me the flu?
• No, a flu vaccine cannot cause flu illness. Flu vaccines that
are administered with a needle are currently made in two
ways: the vaccine is made either with a) flu vaccine viruses
that have been ‘inactivated’ and are therefore not
infectious, or b) with no flu vaccine viruses at all (which is
the case for recombinant influenza vaccine). The nasal
spray flu vaccine does contain live viruses. However, the
viruses are attenuated (weakened), and therefore cannot
cause flu illness. The weakened viruses are cold-adapted,
which means they are designed to only cause infection at
the cooler temperatures found within the nose. The viruses
cannot infect the lungs or other areas where warmer
temperatures exist.
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Different side effects can be associated with the flu shot and nasal spray flu
vaccines. These side effects are mild and short-lasting, especially when compared
to symptoms of influenza infection.
The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get
the flu from a flu shot. Some minor side effects that could occur are:
Soreness, redness, or swelling where the shot was given
Fever (low grade)
Aches
The nasal spray: The viruses in the nasal spray vaccine are weakened and do not
cause severe symptoms often associated with influenza illness. In children, side
effects from the nasal spray can include:
Runny nose
Wheezing
Headache
Vomiting
Muscle aches
Fever
• igher humidity levels indoors can significantly
reduce the infectivity of influenza virus
particles released by coughing, according to
research published February 27 in the open
access journal PLOS ONE by John Noti and
colleagues from the National Institute for
Occupational Safety and Health, Centers for
Disease Control and Prevention.
• They found that an hour after being released
in a room at a relative humidity of 23% or less,
70-77% of viral particles retained their
infectious capacity, but when humidity was
increased to about 43%, only 14% of the virus
particles were capable of infecting cells.
• Most of this inactivation occurred within the
first fifteen minutes of the viral particles being
released in the high-humidity condition.
Effects of Vitamin D