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Instituto Nacional de Salud Pública

2005, Number 2

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salud publica mex 2005; 47 (2)

Immunogenicity and safety of the influenza vaccine, in a population older than 55-years in Mexico

Ayala-Montiel O, Mascareñas C, García-Hernández D, Rendón-Muñiz J, López I, Montaño LF, Zenteno I, Franco-Paredes C

Language: Spanish
References: 46
Page: 155-162
PDF size: 101.71 Kb.


ABSTRACT

Objective. To confirm the immunogenicity and tolerance of the inactivated, fractionated, and purified influenza vaccine‚ in a Mexican adult population aged 55 and older, medically served at a Petróleos Mexicanos Hospital (Pemex, Mexican Oil Company). Material and Methods. The study was conducted between November and December, 2000, among ninety adult subjects aged 55 years and older who were seen at the Hospital Central Sur Pemex. The primary endpoints regarding immunogenicity were the percentage of individuals with protective antibodies targeting hemagglutinins higher than or equal to 1:40, and the percentage of subjects who seroconverted as measured by a four-fold increase in protective antibody production. Secondary endpoints included the frequency of local and systemic reactions to the vaccine. An additional criterion that was evaluated included antigen-antibody affinity assays to measure the polyclonal antibody response to the vaccine and the specific generation of high-affinity antibodies to viral proteins, before and after vaccination. Results. The antibody protection rate was 95.6% against the H1N1 strain, 98.9% against the H3N2 strain, and a 100% against the B/Yamanashi strain. Seroconversion to the H1N1 strain was elicited in 74.4% of subjects, to the H3N2 strain in 88.9%, and to the B / Yamanashi strain in 82.2%. Eighteen (20%) subjects developed local reactions; 17 (18.8%) developed a systemic reaction post vaccination at day 5 and nine subjects (10%) at day 28. Local reactions consisted of pain in 10 (11.1%) subjects, redness in 8 (8.8%), and induration in 6 (6.6%). General malaise, headache, and fever were identified in 10, 8.8, and 0% of subjects, respectively, at day 5, and in 4.4, 6.6, and 0%, respectively, at day 28. Conclusions. Influenza vaccine was highly immunogenic in a healthy Mexican adult population aged 55 years and older. The generation of high-affinity antibodies to the virus after vaccination was also demonstrated. Local and systemic adverse reactions to the vaccine identified in our study were similar to those in previous reports. The results of this study can be extrapolated to other health institutions serving this adult population to increase influenza vaccine coverage rates.


REFERENCES

  1. Pregliasco F, Mensi C, Serpilli W, Speccher L, Masella P, Belloni A. Immunogenicity and safety of three commercial influenza vaccines in institutionalized elderly. Aging Clin Exp Res 2001; 13: 38-43.

  2. Monto AS. Influenza vaccines for the elderly. N Engl J Med 1994; 331: 807-808.

  3. Nichol KL, Margolis KL, Wuorenna J, Von Stenberg T. The efficacy and cost-effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med 1994; 331: 778-784.

  4. Cate TR. Clinical manifestations and consequences of influenza. Am J Med 1987; 82 (SS6A): 15-19.

  5. Glezen WP. Serious morbidity and mortality associated with influenza epidemics. Epidemiol Rev 1993; 4: 25-44.

  6. Kohn RP. Cause of death in very old people. JAMA 1982; 247: 2793-2797.

  7. Sistema Nacional de Vigilancia Epidemiológica. Boletín Epidemiológico 1999;16(44): Semana 44.

  8. Barker WH, Mullooly JP. Influenza vaccination of elderly persons: Reduction in pneumonia and influenza hospitalizations and death. JAMA 1980; 244: 2547-2549.

  9. Nichol KL. The efficacy, effectiveness and cost-effectiveness of inactivated influenza virus vaccines. Vaccine 2003; 21:1769-1775.

  10. Centers for Disease Control and Prevention. Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices. MMWR 2004; 53(RR-6): 1-40.

  11. McBean AM, Babish JD, Warren JL. The impact and cost of influenza in the elderly. Arch Intern Med 1993; 153: 2105-2111.

  12. Hak E, Nordin J, Wei F, Mullooly J, Poblete S, Strikas R et al. Influence of high-risk medical conditions on the effectiveness of influenza vaccination among elderly members of 3 large managed-care organizations. Clin Infect Dis 2002; 35: 370-377.

  13. Centers for Disease Control and Prevention. Prevention and control influenza: A study of vaccine safety and immunogenicity. J Rheumatol 1994; 21: 1203-1206.

  14. Scheiblauer H, Reinacher M, Tashiro M, Rott R. Interactions between bacteria and influenza. A virus in the development of influenza pneumonia. J Infect Dis 1992; 166: 783-791.

  15. Schwarzmann SW, Adler JL, Sullivan RF Jr, Marine WM. Bacterial pneumonia during the Hong Kong influenza epidemic of 1968-1969. Arch Intern Med 1971; 127: 1037-1041.

  16. Govaert TM, Thijs CT, Masurel N, Sprenger MJ, Dinant GJ, Knottnerus JA. The efficacy of influenza vaccination in elderly individuals. A randomized double-blind placebo-controlled trial. JAMA 1994; 272: 1661-1665.

  17. Mulloolly JP, Bennet MD, Hornbrook MC, Barker WH, Williams WW, Patriarca PA et al. Influenza vaccination programs for elderly persons: Cost-effectiveness in a health maintenance organization. Ann Intern Med 1994; 121: 947-952.

  18. Foster DA, Talsma A, Furumoto-Dawson A, Ohmit SE, Margulies JR, Arden NH et al. Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly. Am J Epidemiol 1992; 136: 296-307.

  19. Ohmit SE, Monto AS. Influenza vaccine effectiveness in preventing hospitalizations among the elderly during influenza type A and type B seasons. Int J Epidemiol 1995; 24: 1240-1248.

  20. Nichol KL, Wuornema J, von Sternberg T. Benefits of influenza vaccination for low-, intermediate, and high-risk senior citizens. Arch Intern Med 1998; 158: 1769-1776.

  21. Ahmed AE, Nicholson KG, Nguyen-Van-Tam JS, Pearson JC. Effectiveness of influenza vaccination in reducing hospital admissions during the epidemic of 1989-1990. Epidemiol Infect 1997; 118: 27-33.

  22. Ahmed AE, Nicholson KG, Nguyen-Van-Tam JS. Reduction in mortality associated with influenza vaccine during 1989-1990 epidemic. Lancet 1995; 346: 591-595.

  23. Stamboulian D, Bonvehi PE, Nacinovich FM, Ruttimann RW. Immunization against influenza in the elderly: The Argentinean experience, 1993-1997. Vaccine 1999; 17 Suppl 1:S53-S56.

  24. Wang CS, Want ST, Chou P. Efficacy and cost-effectiveness of influenza vaccination of the elderly in a densely populated and unvaccinated community. Vaccine 2002; 20: 2494-2499.

  25. Gross PA, Hermogenes AW, Sacks HS, Lau J, Levandowski RA. The efficacy of influenza vaccine in elderly persons: A meta-analysis and review of the literature. Ann Intern Med 1995; 123:518-527.

  26. LaMontagne JR, Noble GR, Quinnan GV, Curlin GT, Blackwelder WC Smith JL et al. Summary of clinical trials of inactivated influenza vaccine-1978. Rev Infect Dis 1983; 5: 723-736.

  27. Cate TR, Coudh RB, Parker D, Baxter B. Reactogenicity, immunogenicity, and antibody persistence in adults given inactivated influenza virus vaccines – 1978. Rev Infect Dis 1983; 5: 737-747.

  28. Beyer WE, Palache AM, Baljet M, Masurel N. Antibody induction by influenza vaccines in the elderly: A review of the literature. Vaccine 1989; 7(5):385-394.

  29. Fagiolo U, Amadori A, Cozzi E, Bendo R, Lama M, Douglas A et al. Humoral and cellular immune response to influenza virus vaccination in aged humans. Aging 1993; 5: 451-458.

  30. Panamerican Health Organization, Word Health Organization, Centers for Disease Control and Prevention. Diagnosis of influenza and other respiratory viruses. Course Manual; April 21-25; Santiago, Chile; 1997.

  31. Panamerican Health Organization, Centers for Disease Control. Serologic diagnosis of influenza viruses infections by hemaglutination inhibition. Course Manual; 2004 May 03-07; Atlanta, Georgia, EUA.

  32. Centers for Disease Control and Prevention. Epidemiology and prevention of vaccine-preventable diseases. Seventh Edition. Atlanta (GA): CDC; 2002: 190-204.

  33. Nichol KL, Goodman M. Cost-effectiveness of influenza vaccination for healthy persons between ages 65 and 74 years. Vaccine 2002;20 Suppl 2:S21-S24.

  34. Nichol KL. Clinical effectiveness and cost-effectiveness of influenza vaccination among healthy working adults. Vaccine 1999; 17 Suppl 1:S67-S73.

  35. Vu T, Farish S, Jenkins M, Kelly H. A meta-analysis of effectiveness of influenza vaccine in persons aged 65 years and over living in the community. Vaccine 2002; 20(13-14):1831-1836.

  36. Treanor J. Influenza virus. En: Mandell GL, Bennett SE, Odin R, ed. Douglas, and Bennett’s. Principles and practice of infectious diseases. 5th Ed. Nueva York (NY): Churchill Livingstone; 2000: 1823-1849.

  37. Pabico RC, Douglas RG, Betts RF, McKenna BA, Freeman RB. Influenza vaccination of patients with glomerular disease: Effects on creatinine clearance, urinary protein excretion, and antibody response. Ann Intern Med 1974; 81: 171-174.

  38. Osanloo EO, Berlin BS, Popli S, Ing TS, Cummings JE, Gandhi VC et al. Antibody responses to influenza vaccination in patients with chronic renal failure. Kidney Int 1978; 14: 614-618.

  39. Jordan MC, Rousseau WE, Tegtmeier GE, Noble GR, Muth RG, Chin TD. Immunogenicity of inactivated influenza virus vaccine in chronic renal failure. Ann Intern Med 1973; 14: 614-618.

  40. Chalmers A, Scheifele D, Patterson C, Williams D, Weber J, Shuckett R et al. Immunization of patients with rheumatoid arthritis against

  41. Ruben FL. Prevention and control of influenza: Role of vaccine. Am J Med 1987; 82 (6A): 31-34.

  42. Kubiet MA, González-Rothi RJ, Cottey R, Bender BS. Serum antibody response to influenza vaccine in pulmonary patients receiving corticosteroids. Chest 1996; 110: 367-370.

  43. Nichol KL, Lind A, Margolis KL, Murdoch M, McFadden R, Hauge M et al. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med 1995; 333(14): 891-895.

  44. Spila-Alegiani S, Salmaso S, Rota MC, Tossi AE, Raschetti R. Reactogenicity in the elderly of nine commercial influenza vaccines: Results from the Italian SVEVA Study. Vaccine 1999; 17: 1898-1904.

  45. Szucs TD. Medical economics in the field of influenza—Past, present, and future. Virus Res 2004; 103(1-2): 25-30.

  46. Nichol KL, Mendelman PL. Influence of clinical case definitions with differing levels of sensitivity and specificity on estimates of the relative and absolute health benefits of influenza vaccines among healthy adult workers and implications for economic analyses. Virus Res 2004; 103(1-2): 3-8. influenza. Recommendations of the Advisory Committee on Immunizations Practices (ACIP). MMWR 2003; 52 (RR-8): 1-34.




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