Does repeated influenza vaccination attenuate effectiveness? A systematic review and meta-analysis

Jones-Gray, Elenor; Robinson, Elizabeth; Kucharski, Adam J.; Fox, Annette; Sullivan, Sheena G.

doi:10.1016/s2213-2600(22)00266-1

Cited by 39 publications

(23 citation statements)

References 125 publications

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“…Interestingly, individuals stratified as non-responders received influenza vaccinations more frequently in previous years as compared to responders (information derived from medical questionnaire, see Table S1). This is in line with a systemic meta-analysis reporting that repeated vaccination attenuates vaccine effectiveness 55 . According to the theory of antigenic sin, vaccination history might contribute to differences in vaccine responsiveness.…”

Section: Discussionsupporting

confidence: 88%

Distinct immunological and molecular signatures underpinning influenza vaccine responsiveness in the elderly

et al. 2022

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Seasonal influenza outbreaks, especially in high-risk groups such as the elderly, represent an important public health problem. Prevailing inadequate efficacy of seasonal vaccines is a crucial bottleneck. Understanding the immunological and molecular mechanisms underpinning differential influenza vaccine responsiveness is essential to improve vaccination strategies. Here we show comprehensive characterization of the immune response of randomly selected elderly participants (≥ 65 years), immunized with the adjuvanted influenza vaccine Fluad. In-depth analyses by serology, multi-parametric flow cytometry, multiplex and transcriptome analysis, coupled to bioinformatics and mathematical modelling, reveal distinguishing immunological and molecular features between responders and non-responders defined by vaccine-induced seroconversion. Non-responders are specifically characterized by multiple suppressive immune mechanisms. The generated comprehensive high dimensional dataset enables the identification of putative mechanisms and nodes responsible for vaccine non-responsiveness independently of confounding age-related effects, with the potential to facilitate development of tailored vaccination strategies for the elderly.

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Section: Discussionsupporting

confidence: 88%

Distinct immunological and molecular signatures underpinning influenza vaccine responsiveness in the elderly

et al. 2022

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“…The majority of the reported cases were vaccinated, which indicates that although it does provide protection, the efficacy of the vaccine is not perfect. Previous studies on vaccine effectiveness reported the negative impact of repeated vaccination in children without prior history of natural infection [45][46][47][48] . The type of influenza vaccine may also play a role, since Japan uses the inactivated influenza vaccine while other countries (for example: UK) 42,49 use live attenuated influenza vaccine (LAIV).…”

Section: Discussionmentioning

confidence: 99%

Transmission Dynamics of Seasonal Influenza in a Remote Island Population

et al. 2022

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“…The observed differences in practical significance in seroconversion between the vaccination strains and circulating strains could explain the seasonal variability of the influence of vaccination history on observed vaccine effectiveness. [42,43] Future model development will incorporate the influence of the antigenic distance between successive vaccinating and circulating strains into the antibody kinetics framework. This could be done by using existing metrics of antigenic advance or considering the influence of vaccination on boosting HAI titres across various strain landscapes.…”

Section: Discussionmentioning

confidence: 99%

Quantifying the impact of pre-vaccination titre and vaccination history on influenza vaccine immunogenicity

Hodgson,

Sánchez-Ovando,

Carolan

et al. 2024

Preprint

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Epidemiological studies suggest that heterogeneity in influenza vaccine antibody response is associated with host factors, including pre-vaccination immune status, age, gender, and vaccination history. However, the pattern of reported associations varies between studies. To better understand the underlying influences on antibody responses, we combined host factors and vaccine-induced in-host antibody kinetics from a cohort study conducted across multiple seasons with a unified analysis framework. We developed a flexible Bayesian model to estimate associations and interactions between host factors, including pre-vaccine HAI titre, age, sex, vaccine history and study setting, and vaccine-induced HAI titre antibody boosting and waning. We applied the model to derive population-level and individual effects of post-vaccine antibody kinetics for vaccinating and circulating strains for A(H1N1) and A(H3N2) influenza subtypes. We found that post-vaccine HAI titre dynamics were significantly influenced by pre-vaccination HAI titre and vaccination history. In addition, we find the common heuristic of a four-fold rise in titre is valid for detecting seroconversion in an infrequently vaccinated cohort (<2 vaccines in last 5 years) within six months of vaccination if their pre-vaccination HAI titres are equal to or below 1:20. The same heuristic only works for a frequently vaccinated population (2 or more vaccines in last 5 years) for up to 3 months post-vaccination providing their pre-vaccination HAI titres are equal to or below 1:20. In future, seroepidemiological studies should ensure the impact of pre-vaccine HAI and prior vaccination status on vaccine-induced fold-rises is properly quantified, as these significantly influence an individual's post-vaccination antibody kinetics.

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Does repeated influenza vaccination attenuate effectiveness? A systematic review and meta-analysis

Cited by 39 publications

References 125 publications

Distinct immunological and molecular signatures underpinning influenza vaccine responsiveness in the elderly

Distinct immunological and molecular signatures underpinning influenza vaccine responsiveness in the elderly

Transmission Dynamics of Seasonal Influenza in a Remote Island Population

Quantifying the impact of pre-vaccination titre and vaccination history on influenza vaccine immunogenicity

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