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- Title
Safety and immunogenicity of influenza A H5 subunit vaccines: effect of vaccine schedule and antigenic variant.
- Authors
Belshe RB; Frey SE; Graham I; Mulligan MJ; Edupuganti S; Jackson LA; Wald A; Poland G; Jacobson R; Keyserling HL; Spearman P; Hill H; Wolff M; National Institute of Allergy and Infectious Diseases-Funded Vaccine and Treatment Evaluation Units; Belshe, Robert B; Frey, Sharon E; Graham, Irene; Mulligan, Mark J; Edupuganti, Srilatha; Jackson, Lisa A
- Abstract
<bold>Background: </bold>The current US national stockpile of influenza H5 vaccine was produced using the antigen from the strain A/Vietnam/1203/2004 (a clade 1 H5 virus). Recent H5 disease has been caused by antigenically divergent H5 viruses, including A/Indonesia/05/2005 (a clade 2 H5 virus).<bold>Methods: </bold>The influence of schedule on the antibody response to 2 doses of H5 vaccines (one a clade 1 hemagglutinin protein [HA] vaccine and one a clade 2 HA vaccine) containing 90 μg of antigen was evaluated in healthy adults 18-49 years of age.<bold>Results: </bold>Two doses of vaccine were required to induce antibody titers ≥ 1:10 in most subjects. Accelerated schedules were immunogenic, and antibody developed after vaccinations on days 0 and 7, 0 and 14, and 0 and 28, with the day 0 and 7 schedule inducing lower titers than those induced with the other schedules. With mixed vaccine schedules of clade 1 followed by clade 2 vaccine administration, the first vaccination primed for a heterologous boost. The heterologous response was improved when the second vaccination was given 6 months after the first, compared with the response when the second vaccination was given after an interval of 1 month.<bold>Conclusions: </bold>An accelerated vaccine schedule of injections administered at days 0 and 14 was as immunogenic as a vaccine schedule of injections at days 0 and 28, but both schedules were inferior to a vaccine schedule of injections administered at 0 and 6 months for priming for heterologous vaccine boosting. Clinical Trial Registry Number: NCT00703053.
- Publication
Journal of Infectious Diseases, 2011, Vol 203, Issue 5, p666
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiq093