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Double dose vs. standard dose influenza vaccination in patients with heart failure: a pilot study
Author(s) -
Van Ermen Amy,
Hermanson Matthew P.,
Moran John M.,
Sweitzer Nancy K.,
Johnson Maryl R.,
Vardeny Orly
Publication year - 2013
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfs207
Subject(s) - medicine , heart failure , vaccination , antibody , hemagglutination , influenza vaccine , randomized controlled trial , immunology , hemagglutination assay , trivalent influenza vaccine , virus , gastroenterology , titer
Aims Influenza infection leads to increased morbidity and mortality in those with heart failure, and individuals with heart failure exhibit reduced antibody responses to influenza vaccine. We hypothesized that patients with heart failure randomized to double dose (DD) influenza vaccine will mount more vigorous humoral immune responses compared with those given standard dose (SD) vaccine. Methods and results We randomized 28 heart failure patients to DD (30 μg/strain) or SD (15 μg/strain) influenza vaccine. We assessed antibody production by haemagglutination inhibition assay (reported as log haemagglutination units) prior to, at 2–4 weeks and at 4–6 months following vaccination. Baseline antibody titres between DD ( n = 12, mean age 64 ± 10 years) and SD ( n = 16, mean age 63 ± 9 years) did not differ significantly. At 2–4 weeks, DD haemagglutination unit changes were significantly higher than those of SD (3.3 vs. 1.6 for A/H3N2, P < 0.001; 1.9 and 1.1 for A/H1N1, P = 0.009; and 1.7 and 1 for B‐type, P = 0.02). At 4–6 weeks, there were no differences in titres in any of the virus types between treatment groups and, although titres decreased, levels remained above the seroprotective threshold. Conclusions Higher influenza vaccine doses may elicit increased antibody‐mediated responses in patients with heart failure; further studies should assess whether clinical outcomes are improved with this strategy.