Abstract
Background: Recent addition to vaccines of adjuvants has been actively used to enhance the immunogenicity. However, the use of adjuvants for the development of quadrivalent inactivated influenza vaccines (QIV) is currently limited. The aim of this study was to examine immunogenicity of adjuvanted QIV in healthy people and patients with primary immune deficiency—common variable immune deficiency (CVID).Methods: In total before the flu season 2018–2019 in the study were involved 32 healthy volunteers aged 18–52 years and 6 patients with a confirmed diagnosis of CVID aged 18–45 years. To evaluate antibody titers 21 days after vaccination against the influenza A and B strains a hemagglutination inhibition assay (HI) was used.Results: In healthy volunteers adjuvanted QIV has proved its immunogenicity to strains A/H1N1, A/H3N2, B/Phuket and B/Colorado in seroprotection (90, 97, 86, and 66%, respectively), seroconversion (50, 60, 52, and 45%, respectively), GMR (6.2, 5.7, 4.2, and 3.4, respectively). Statistically significant differences in the level of all criteria were revealed between groups of healthy and CVID patients regardless of the virus strain. Most patients with CVID showed an increase in post-vaccination antibody titer without reaching conditionally protective antibody levels.Conclusion: Immunization with single dose of adjuvanted QIV with decreased amount of hemagglutinin protein to all virus strains due to the use of azoximer bromide forms protective immunity in healthy people, but in patients with CVID the search for new vaccination schemes is the subject of further investigations, as well as the effectiveness of boosterization with adjuvant vaccines.
Highlights
Influenza virus infection, caused by single-stranded RNA viruses belonging to the Orthomyxoviridae family, is associated with significant morbidity and mortality worldwide, and affects risk groups such as patients with cardiopulmonary conditions, pregnant women and children, old people and immunocompromised patients
Seroprotection level to strain B/Colorado is 66% that is close to the threshold value. 3 months after vaccination in the group of healthy participants the seroprotection level remains the same or slightly lower than achieved a month after immunization; statistically significant decrease was not detected for any strain
The proportion of seropositive in the group of common variable immune deficiency (CVID) patients did not change statistically significant after vaccination, remaining at the level of 0% to strains B/Colorado and B/Phuket, 33–50% to strain A/H1N1 and 33–67% to strain A/H3N2
Summary
Influenza virus infection, caused by single-stranded RNA viruses belonging to the Orthomyxoviridae family, is associated with significant morbidity and mortality worldwide, and affects risk groups such as patients with cardiopulmonary conditions, pregnant women and children, old people and immunocompromised patients. It impacts all countries: every year, there are an estimated 1 billion cases, 3–5 million severe cases, and 290–650 000 influenza-related respiratory deaths worldwide [1]. The use of adjuvants for the development of quadrivalent inactivated influenza vaccines (QIV) is currently limited. The aim of this study was to examine immunogenicity of adjuvanted QIV in healthy people and patients with primary immune deficiency—common variable immune deficiency (CVID)
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