The Immunizing Effect of Influenza A/New Jersey/76 (Hsw1N1) Virus Vaccine Administered Intradermally and Intramuscularly to Adults

Abstract

2The immunogenicity and reactogenicity of inactivated influenza A/New Jersey/76 (Hsw1N1) whole-virus vaccine administered intradermally (40 chick cell-agglutinating units/0.1-ml dose) and intramuscularly (im; 200 chick cell-agglutinating units/0.5-ml dose) to human adults were evaluated. Among 18-24-year-old persons initially free of detectable antibody, intradermal vaccination induced lower titers of hemagglutination-inhibiting antibodies than did im vaccination, and a sequence of intradermal and im vaccinations did not offer any serologic advantage over one im dose. In contrast, persons over the age of 24 who initially lacked detectable antibody had as good a serologic response to intradermal vaccination as to im vaccination. Among individuals who had antibody before vaccination, immunization by either route induced greater increases in titers of hemagglutination-inhibiting antibody than occurred in initially antibody-negative persons, even when the latter were given two doses of vaccine. Somewhat fewer systemic reactions occurred after intradermal than after im vaccination, but the intradermal route was associated with local reactions in almost all vaccinees and with some residual pigmentary changes. These results suggest that intradermal vaccination should be used only in very selected circumstances.

Preclinical Evaluation of Microneedle Technology for Intradermal Delivery of Influenza Vaccines

“…The potential to spare dose by i.d. administration was suggested over 25 years ago (10,20,24) and has received renewed attention recently (8,29,31). However, the lack of a reproducible and easy-to-use i.d.…”

“…delivery of a low dose (e.g., 0.1 ml) of influenza vaccine to i.m. or subcutaneous injection of a high dose (e.g., 0.5 ml), but did not conduct direct head-to- head comparisons of the two methods of delivery at the lower dosage level (6,8,10,20,24,29). Here, we conducted dose titration studies in animals in which i.m.…”

“…delivery exceeded levels required for influenza vaccine licensure by the European Committee for Proprietary Medicinal Products. One factor that may influence the magnitude of the i.d.-enabled dose-sparing effect is the level of preexisting antibodies at the time of immunization (6,10,24). Thus, it will be of interest to examine microneedle delivery systems in various age groups and in subjects both with and without preexisting antibodies against the vaccine strains.…”

“…delivery have been reported. Intradermal delivery of influenza vaccine was investigated in humans in the late 1970s using monovalent and bivalent vaccine preparations (10,20,24). In these early studies, i.d.…”

New technologies for influenza vaccines

“…Some studies clearly showed that intradermal vaccination with low-dose monovalent or bivalent influenza vaccines induced antibody titers comparable to or higher than those induced by the full-dose intramuscular vaccination. 117,118 Interestingly, however, the beneficial effect of the intradermal route was less evident in subjects aged over 50 y, suggesting a potential role of aging in diminishing the immune response triggered by intradermal vaccination. 118 More recently, a substantial number of clinical studies have evaluated intradermal administration of influenza vaccine to individuals of all ages, including the elderly.…”