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Adjuvanted influenza a ( H 1 N 1) 2009 vaccine in patients with hematological diseases: good safety and immunogenicity even in chemotherapy‐treated patients
Author(s) -
Cherif Honar,
Höglund Martin,
Pauksens Karlis
Publication year - 2013
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12094
Subject(s) - medicine , immunogenicity , seroconversion , vaccination , influenza vaccine , immunology , pandemic , live attenuated influenza vaccine , trivalent influenza vaccine , antibody , hematopoietic stem cell transplantation , virology , transplantation , covid-19 , disease , infectious disease (medical specialty)
Background Patients with hematological malignancies are more susceptible to viral infections including influenza. In 2009, the W orld H ealth O rganization classified the novel influenza A ( H 1 N 1) virus as pandemic. The potential impact of this pandemic for patients with hematological disorders was unknown. Institutional guidelines recommended two doses of AS 03‐adjuvanted influenza A ( H 1 N 1) 2009 pandemic vaccine for these patients. Objectives We aimed to determine the safety, immunogenicity, and clinical efficacy of this vaccine in patients with hematological diseases. Furthermore, we compared the immunological responses to that obtained by the non‐adjuvanted trivalent seasonal influenza vaccine ( TIV ). Methods All included patients received adjuvanted pandemic vaccine and the majority received TIV . Serum for antibody analyses was collected at five time points. Results Thirty‐one patients with different hematological diseases were included. After the second vaccine dose, a total of 25 (81%) reached both protective levels of antibodies and seroconversion response. Antibody titers ≥ 1 : 40 persisted for 50% of responding patients at 1 yr. Seroconversion was observed in 69% of 14 patients who had undergone hematopoietic stem cell transplantation and in all (9/9) patients with myeloma (five with ongoing treatment including high‐dose corticosteroids) . After vaccination with TIV , seroconversions against the three included strains were detected in 28%, 40%, and 20%. Response to the adjuvanted pandemic vaccine was superior ( P < 0.009). Conclusions A substantial proportion of patients with hematological malignancies including patients undergoing chemotherapy mounted a good response to the adjuvanted pandemic vaccine. This vaccine had superior immunogenicity as compared to the non‐adjuvanted TIV .