Vaccination activity of live influenza vaccine in different seasons of the year

Reactogenicity, immunogenicity and viability of the vaccine virus were studied during vaccination of adults with live allantoic influenza vaccines of the types A (H1N1), A (H3N2) and B in different seasons of the year. Seasonal oscillations of reactogenicity of the vaccines (minimum in summer, maximum in winter) were demonstrated. A decrease in the re-isolation rate of vaccine viruses and in their content in the secretions of the upper respiratory passages was observed in summer. Seasonal oscillations of immunogenicity of the commercial live allantoic influenza vaccine with a marked reduction in its activity in summer were established. The administration of moderately attenuated influenza vaccine viruses in summer results in the production of antibodies up to the level observed in other seasons of the year. Theoretical problems and practical aspects of seasonal oscillations of vaccination activity of live influenza vaccines were studied in connection with the necessity of investigation new vaccine strains in varying seasons of the year.     

Interferon-induced 2-5A synthetase activity in human peripheral blood mononuclear cells after immunization with influenza virus and rubella virus vaccines.

The interferon-induced enzyme 2-5A synthetase can be a sensitive indicator of activation of the human interferon system during viral infection or interferon therapy. To determine the response of the human interferon system to viral antigens, the level of 2-5A synthetase activity was monitored in peripheral blood mononuclear cells of healthy adults before and after immunization with influenza or rubella virus vaccine. The influenza virus-vaccinated individuals demonstrated increases in enzyme activity on days 1 and 11 in vivo, whereas those vaccinated with rubella virus vaccine showed an increase only on day 11. The difference in the day 1 in vivo 2-5A synthetase response in the two vaccinated groups could be demonstrated by in vitro incubations of peripheral blood mononuclear cells isolated approximately 90 days postvaccination with the two vaccines. The day 11 increase of enzyme activity in the rubella virus group showed a positive correlation with an increase in serum antibody titer, suggesting activation of the interferon system during antibody production in vivo after human exposure to virus antigens. The demonstration of increased 2-5A synthetase activity at specific times postimmunization in this investigation indicates that the interferon system is involved in the human in vivo response to virus vaccination.     

Stabilization of Influenza Vaccine Enhances Protection by Microneedle Delivery in the Mouse Skin

Background

Simple and effective vaccine administration is particularly important for annually recommended influenza vaccination. We hypothesized that vaccine delivery to the skin using a patch containing vaccine-coated microneedles could be an attractive approach to improve influenza vaccination compliance and efficacy.

Methodology/Principal Findings

Solid microneedle arrays coated with inactivated influenza vaccine were prepared for simple vaccine delivery to the skin. However, the stability of the influenza vaccine, as measured by hemagglutination activity, was found to be significantly damaged during microneedle coating. The addition of trehalose to the microneedle coating formulation retained hemagglutination activity, indicating stabilization of the coated influenza vaccine. For both intramuscular and microneedle skin immunization, delivery of un-stabilized vaccine yielded weaker protective immune responses including viral neutralizing antibodies, protective efficacies, and recall immune responses to influenza virus. Immunization using un-stabilized vaccine also shifted the pattern of antibody isotypes compared to the stabilized vaccine. Importantly, a single microneedle-based vaccination using stabilized influenza vaccine was found to be superior to intramuscular immunization in controlling virus replication as well as in inducing rapid recall immune responses post challenge.

Conclusions/Significance

The functional integrity of hemagglutinin is associated with inducing improved protective immunity against influenza. Simple microneedle influenza vaccination in the skin produced superior protection compared to conventional intramuscular immunization. This approach is likely to be applicable to other vaccines too.     

The effectiveness of using the Vaxigrip vaccine from the firm of Pasteur Mérieux Connaught for influenza prevention in organized groups of adults

The results of the study of the effectiveness of using vaccine Vaxigrip for the prophylaxis of influenza in organized groups of adults are presented. The vaccine was found to have high epidemiological effectiveness (the epidemiological index was 2.6), moderate reactogenicity and pronounced immunological activity (the protection level was 89.0-100.0%). The vaccine may be recommended for the prophylaxis of influenza among adults.     

A Mechanistic Study on the Destabilization of Whole Inactivated Influenza Virus Vaccine in Gastric Environment

Oral immunization using whole inactivated influenza virus vaccine promises an efficient vaccination strategy. While oral vaccination was hampered by harsh gastric environment, a systematic understanding about vaccine destabilization mechanisms was not performed. Here, we investigated the separate and combined effects of temperature, retention time, pH, and osmotic stress on the stability of influenza vaccine by monitoring the time-dependent morphological change using stopped-flow light scattering. When exposed to osmotic stress, clustering of vaccine particles was enhanced in an acidic medium (pH 2.0) at ≥25°C. Fluorescence spectroscopic studies showed that hyper-osmotic stress at pH 2.0 and 37°C caused a considerable increase in conformational change of antigenic proteins compared to that in acidic iso-osmotic medium. A structural integrity of membrane was destroyed upon exposure to hyper-osmotic stress, leading to irreversible morphological change, as observed by undulation in stopped-flow light scattering intensity and transmission electron microscopy. Consistent with these analyses, hemagglutination activity decreased more significantly with an increasing magnitude of hyper-osmotic stress than in the presence of the hypo- and iso-osmotic stresses. This study shows that the magnitude and direction of the osmotic gradient has a substantial impact on the stability of orally administrated influenza vaccine.     

Evaluation of influenza vaccine Vaxigrip in the combined immunization of conscripts during influenza seasons of 2002-2003

The immunization properties of the influenza vaccine Vaxigrip, used in combination with vaccines against pneunococcal infection and hepatitis A (respectively, Pneumo 23 and Avaxim), were evaluated. In Central Russia in one of the units of the internal forces of the RF Ministry of Internal Affairs 3 groups totaling 755 servicemen were formed, depending on the complex of the introduced vaccines. Active medical observation and the registration of the complaints of the vaccinees at the postvaccinal period did not reveal unusual reactions and complications in none of the groups under observation. In the evaluation of the level of specific antibodies to the circulating influenza viruses prior to vaccination the low level of collective protection to influenza B virus was determined: protective antibody levels were registered only in 14-18% of the servicemen, while the corresponding data with respect of influenza viruses A(H1N1) and A(H3N2) were 45-50% and 56-63% respectively. At the same time, in seronegative persons the vaccine Vaxigrip exhibited high immunogenic activity with respect of all 3 influenza strains; seroconversion to them was determined in 84-92% of the vaccines, and the level of protective antibody titers before the beginning of the epidemic season was 86-99% in the whole of the group. The characteristics of the prophylactic effectiveness of the vaccine Vaxigrip in relation to the influenza virus infection level 1 were 4.7 (index) and 79% (coefficient). In addition, the frequency of influenza cases, clinically pronounced and confirmed by laboratory methods, in patients who had been immunized with 3 vaccines was 6.7%, which was 10.3 times less frequent than number of cases in the groups of comparison (68.2% on the average). The coefficient of epidemiological effectiveness of the prophylaxis of influenza was 90.2%. The complex use of 3 preparations did not affect the immunization properties of the vaccine Vaxigrip.     

Involvement of Endocrinologists in the 2009 to 2010 H1N1 Vaccination Effort

ObjectiveTo assess the level of participation of endo crinologists in the United States in the 2009 to 2010 H1N1 vaccination campaign and explore their perspectives on H1N1 vaccination.MethodsWe conducted a cross-sectional, mailed survey of a national sample of 1,991 endocrinologists in June through September 2010. The extent of the response and the survey responses are reported and analyzed.ResultsThe overall response rate was 59%. The majority of endocrinologists strongly recommended H1N1 vaccine for children, whereas about a third did so for both nonelderly adults and seniors. Just over half (52%) of the responding endocrinologists had agreed to participate in the 2009 to 2010 H1N1 vaccine campaign and received vaccine, in comparison with 73% who offered seasonal influenza vaccine. The supply of H1N1 vaccine was a sig nificant challenge, but otherwise endocrinologists reported few major problems with administration of H1N1 vaccine. Overall, less than half of the respondents thought that they would be “very likely” to provide vaccine in the event of a future influenza pandemic, with a much higher proportion among those endocrinologists who offered seasonal influenza vaccine and H1N1 vaccine.ConclusionAlthough the experiences of endocri nologists who provided H1N1 vaccine were generally positive, many did not offer the vaccine and indicated that they are hesitant about providing vaccine during a future influenza pandemic. Approaches to increase their participation in future pandemics in an effort to reach persons at high risk for influenza and its complications, such as those with diabetes, should be further explored. (Endocr Pract. 2012;18:464-471)     

Enhancement of the Immunogenicity and Protective Efficacy of a Mucosal Influenza Subunit Vaccine by the Saponin Adjuvant GPI-0100

Identification of safe and effective adjuvants remains an urgent need for the development of inactivated influenza vaccines for mucosal administration. Here, we used a murine challenge model to evaluate the adjuvant activity of GPI-0100, a saponin-derived adjuvant, on influenza subunit vaccine administered via the intranasal or the intrapulmonary route. Balb/c mice were immunized with 1 µg A/PR/8 (H1N1) subunit antigen alone or in combination with varying doses of GPI-0100. The addition of GPI-0100 was required for induction of mucosal and systemic antibody responses to intranasally administered influenza vaccine and significantly enhanced the immunogenicity of vaccine administered via the intrapulmonary route. Remarkably, GPI-0100-adjuvanted influenza vaccine given at a low dose of 2×1 µg either in the nares or directly into the lungs provided complete protection against homologous influenza virus infection.     

Influenza-specific T cells from older people are enriched in the late effector subset and their presence inversely correlates with vaccine response

T cells specific for persistent pathogens accumulate with age and express markers of immune senescence. In contrast, much less is known about the state of T cell memory for acutely infecting pathogens. Here we examined T cell responses to influenza in human peripheral blood mononuclear cells from older (>64) and younger (<40) donors using whole virus restimulation with influenza A (A/PR8/34) ex vivo. Although most donors had pre-existing influenza reactive T cells as measured by IFNγ production, older donors had smaller populations of influenza-responsive T cells than young controls and had lost a significant proportion of their CD45RA-negative functional memory population. Despite this apparent dysfunction in a proportion of the older T cells, both old and young donors' T cells from 2008 could respond to A/California/07/2009 ex vivo. For HLA-A2+ donors, MHC tetramer staining showed that a higher proportion of influenza-specific memory CD8 T cells from the 65+ group co-express the markers killer cell lectin-like receptor G1 (KLRG1) and CD57 compared to their younger counterparts. These markers have previously been associated with a late differentiation state or immune senescence. Thus, memory CD8 T cells to an acutely infecting pathogen show signs of advanced differentiation and functional deterioration with age. There was a significant negative correlation between the frequency of KLRG1(+)CD57(+) influenza M1-specific CD8 T cells pre-vaccination and the ability to make antibodies in response to vaccination with seasonal trivalent inactivated vaccine, whereas no such trend was observed when the total CD8(+)KLRG1(+)CD57(+) population was analyzed. These results suggest that the state of the influenza-specific memory CD8 T cells may be a predictive indicator of a vaccine responsive healthy immune system in old age.     

Epidemiological effectiveness of an inactivated three-component flu vaccine with an increased concentration of hemagglutinin in the inoculation dose]

The work presents the results of the evaluation of mass immunization of working adults with inactivated trivalent influenza vaccine under the conditions of an epidemic caused by influenza viruses A (H1N1), A (H3N2) and B. This immunization produced no effect on influenza morbidity in the groups of vaccinees in comparison with those of nonvaccinated persons. The index of effectiveness was 1.0 and less. The ineffectiveness of mass immunization was due to a high level of natural immunity to influenza and the extensive use of influenza vaccine in past years.     

Liposomes as a Mucosal Adjuvant System: An Intranasal Liposomal Influenza Subunit Vaccine and the Role of IgA in Nasal Anti-Influenza Immunity

Abstract

Liposomes exhibit potent immunoadjuvant activity in a variety of experimental vaccine formulations. We have investigated the mucosal adjuvant activity of liposomes in an influenza subunit vaccine. Mice were immunized intranasally (I.N.) with the major surface antigen of influenza virus, hemagglutinin (HA), mixed with negatively charged liposomes. Inclusion of the liposomes in the vaccine resulted in a marked stimulation of the serum IgG response against the antigen. In addition, the liposomal preparation, but not the antigen alone, induced a significant secretory IgA (s-IgA) response, not only in the lungs and nasal cavity, but also at the mucosa of the urogenital tract. The adjuvant activity of the liposomes appeared to be independent of a physical association of the antigen with the liposomes: Stimulation of antibody responses was observed even when liposomes and antigen were administered separately in time. Serum IgG and local s-IgA responses to I.N. immunization with the liposomal vaccine were comparable to the corresponding responses induced by an influenza infection. Mice immunized with the liposomal vaccine or mice recovered from an influenza infection were completely protected from (re)infection. Protection from nasal infection was abrogated by treatment of the mice with an anti-IgA antiserum, while anti-IgG had no effect, indicating that s-IgA plays an essential role in nasal anti-influenza immunity.     

Experimental and epidemiological estimation of seasonal and climato-geographical features of non-specific resistance of the organism to influenza

One and the same series of live influenza vaccine from the strains B/Dushanbe/66 and B/Leningrad/67 or A2/Moscow/21/65 administered intranasally to non-immune persons in Leningrad and 'krasnodar in winter caused an increase in body temperature in 6.7-8% of vaccinated subjects, but in summer in 0.8%. In the transitional seasons of the year (in May and in October), 6.3-16.8% of reactions were observed in Murmansk and 0.1% in Krasnodar. An increase in antibodies in the vaccinated in Leningrad and Arkhangelsk in winter was observed 1.5 times more frequently than in summer. In Krasnodar, seroconversion occurred in only 5.7% in May and october, but in 31.3% in January; in Murmansk in 41.2-48% in May and in 75.6-78.8% in October. The seasonal as well as latitudinal and climatic differences in reactogenicity and antigenic activity of the vaccine can be explained by seasonal oscillations in non-specific resistance of people of influenza viruses. The importance of this factor in the mechanism of seasonal occurrence of influenza is discussed.     

Effect of vaccination against pneumococcal infection and influenza in children with asthma

Assessment of clinical course of asthma and IgG response in children with asthma immunized with pneumococcal polysaccharide vaccine (Pneumo 23) and influenza vaccine (Vaxigrip). 78 children aged 4 - 17 years old were allocated to two groups. Children from the 1st group were immunized against pneumococcal infection and influenza; children from 2nd group were immunized against pneumococcal infection only. Rate of asthma exacerbations in the 1st group of children decreased by 1.7 times compared with the period before vaccination, whereas the same rate in the 2nd group of children decreased by 1.5 times. It was accompanied by the increase of IgG level to antigens of pneumococcalvaccine in blood, which was observed in both groups. Vaccination did not result in increase of IgE levels. Immunization of children with asthma against pneumococcal infection with polysaccharide vaccine or combined immunization against pneumococcal infection and influenza reduced rate of asthma exacerbations and led to formation of immunity to vaccine strains of Streptococcus pneumoniae. Vaccination did not lead to sensitization of children.     

Effect of Molecular Weight and Degree of Acetylation on Adjuvantive Properties of Chitosan Derivatives

The hemostatic and immunostimulating activity and cytotoxicity were determined for a number of chitosans differing in molecular weight (from 3 to 510 kDa) and degree of acetylation (from 1 to 25 mol%) that were used as adjuvants in inactivated poliomyelitic, influenza, and live influenza vaccines. It has been shown that the hemostatic activity of chitosan increased sharply with an increase in its molecular weight. In oligochitosan with a molecular weight of <16 kDa, it was smaller by a factor of 15–100 than in chitosan with a molecular weight of 20–510 kDa. The level of increase in the immunogenicity of vaccines containing oligochitosan as adjuvants was not lower than that for the vaccine including high-molecular chitosan. However, the immunostimulatory activity of oligochitosan depended on the degree of acetylation, reaching a maximum value at 6 mol%. It was shown that all oligochitosans and chitosans with a molecular mass below ~50 kDa showed almost no cytotoxicity at a concentration of ≤2.5 mg/mL, which enable their use as adjuvants for inactivated and live vaccines at the optimal ratio of molecular weight to the degree of acetylation.     

A Single Mutation at PB1 Residue 319 Dramatically Increases the Safety of PR8 Live Attenuated Influenza Vaccine in a Murine Model without Compromising Vaccine Efficacy

The live attenuated influenza vaccine (LAIV) is preferentially recommended for use in most children yet remains unsafe for the groups most at risk. Here we have improved the safety of a mouse-adapted live attenuated influenza vaccine containing the same attenuating amino acid mutations as in human LAIV by adding an additional mutation at PB1 residue 319. This results in a vaccine with a 20-fold decrease in protective efficacy and a 10,000-fold increase in safety.     

Maternal influenza immunization and reduced likelihood of prematurity and small for gestational age births: a retrospective cohort study

Background

Infections during pregnancy have the potential to adversely impact birth outcomes. We evaluated the association between receipt of inactivated influenza vaccine during pregnancy and prematurity and small for gestational age (SGA) births.

Methods and Findings

We conducted a cohort analysis of surveillance data from the Georgia (United States) Pregnancy Risk Assessment Monitoring System. Among 4,326 live births between 1 June 2004 and 30 September 2006, maternal influenza vaccine information was available for 4,168 (96.3%). The primary intervention evaluated in this study was receipt of influenza vaccine during any trimester of pregnancy. The main outcome measures were prematurity (gestational age at birth <37 wk) and SGA (birth weight <10th percentile for gestational age). Infants who were born during the putative influenza season (1 October–31 May) and whose mothers were vaccinated against influenza during pregnancy were less likely to be premature compared to infants of unvaccinated mothers born in the same period (adjusted odds ratio [OR] = 0.60; 95% CI, 0.38–0.94). The magnitude of association between maternal influenza vaccine receipt and reduced likelihood of prematurity increased during the period of at least local influenza activity (adjusted OR = 0.44; 95% CI, 0.26–0.73) and was greatest during the widespread influenza activity period (adjusted OR = 0.28; 95% CI, 0.11–0.74). Compared with newborns of unvaccinated women, newborns of vaccinated mothers had 69% lower odds of being SGA (adjusted OR = 0.31; 95% CI, 0.13–0.75) during the period of widespread influenza activity. The adjusted and unadjusted ORs were not significant for the pre-influenza activity period.

Conclusions

This study demonstrates an association between immunization with the inactivated influenza vaccine during pregnancy and reduced likelihood of prematurity during local, regional, and widespread influenza activity periods. However, no associations were found for the pre-influenza activity period. Moreover, during the period of widespread influenza activity there was an association between maternal receipt of influenza vaccine and reduced likelihood of SGA birth. Please see later in the article for the Editors'' Summary     

异型流感病毒感染小鼠肺细胞因子水平变化

为了制备能够抵御不同型别流感病毒感染的疫苗,揭示机体对异型流感病毒感染交叉免疫保护作用的主要机制,用流感病毒疫苗免疫小鼠后分别感染同型、异型流感病毒,另设使用免疫增强剂IL-2后感染异型流感病毒组,观察小鼠的一般状况和肺指数,并用ELISA方法测定肺匀浆中细胞因子IFN-γ、IL-2、IL-4及IL-10的含量。结果显示,异型免疫组和异型免疫加强组病毒感染后细胞因子IFN-γ含量明显高于感染前（P〈0.05）。研究表明,异型病毒感染后IFN-γ水平明显增高,此细胞因子可能在流感病毒异型间交叉保护免疫反应中起重要作用,其机制有待进一步研究确定。     

Evaluation of the antimicrobial potential of immune sera

The inhibiting activity of blood sera obtained from 20 volunteers immunized with the multi-component vaccine "PYOPOL", 25 nonimmune donors and 7 lots of human antistaphylococcal immunoglobulin with respect to Staphylococcus aureus, Escherichia coli, Proteus vulgaris and Pseudomonas aeruginosa has been studied in the liquid nutrient medium with the use an automated microbiological analyzer. The sera of donors immunized with the vaccine "PYOPOL" have been found to possess high antimicrobial activity, comparable with the definite concentration of the antiseptic agent "Myramistin". The proposed method may be recommended for the evaluation of the bacteriostatic activity of different immuno- biological preparations.     

Regulation of antinucleoprotein IgG by systemic vaccination and its effect on influenza virus clearance

Seasonal influenza epidemics recur due to antigenic drift of envelope glycoprotein antigens and immune evasion of circulating viruses. Additionally, antigenic shift can lead to influenza pandemics. Thus, a universal vaccine that protects against multiple influenza virus strains could alleviate the continuing impact of this virus on human health. In mice, accelerated clearance of a new viral strain (cross-protection) can be elicited by prior infection (heterosubtypic immunity) or by immunization with the highly conserved internal nucleoprotein (NP). Both heterosubtypic immunity and NP-immune protection require antibody production. Here, we show that systemic immunization with NP readily accelerated clearance of a 2009 pandemic H1N1 influenza virus isolate in an antibody-dependent manner. However, human immunization with trivalent inactivated influenza virus vaccine (TIV) only rarely and modestly boosted existing levels of anti-NP IgG. Similar results were observed in mice, although the reaction could be enhanced with adjuvants, by adjusting the stoichiometry among NP and other vaccine components, and by increasing the interval between TIV prime and boost. Importantly, mouse heterosubtypic immunity that had waned over several months could be enhanced by injecting purified anti-NP IgG or by boosting with NP protein, correlating with a long-lived increase in anti-NP antibody titers. Thus, current immunization strategies poorly induce NP-immune antibody that is nonetheless capable of contributing to long-lived cross-protection. The high conservation of NP antigen and the known longevity of antibody responses suggest that the antiviral activity of anti-NP IgG may provide a critically needed component of a universal influenza vaccine.     

Mathematical Modeling of Influenza A Virus Dynamics within Swine Farms and the Effects of Vaccination

Influenza A virus infections are widespread in swine herds across the world. Influenza negatively affects swine health and production, and represents a significant threat to public health due to the risk of zoonotic infections. Swine herds can act as reservoirs for potentially pandemic influenza strains. In this study, we develop mathematical models based on experimental data, representing typical breeding and wean-to-finish swine farms. These models are used to explore and describe the dynamics of influenza infection at the farm level, which are at present not well understood. In addition, we use the models to assess the effectiveness of vaccination strategies currently employed by swine producers, testing both homologous and heterologous vaccines. An important finding is that following an influenza outbreak in a breeding herd, our model predicts a persistently high level of infectious piglets. Sensitivity analysis indicates that this finding is robust to changes in both transmission rates and farm size. Vaccination does not eliminate influenza throughout the breeding farm population. In the wean-to-finish herd, influenza infection may persist in the population only if recovered individuals become susceptible to infection again. A homologous vaccine administered to the entire wean-to-finish population after the loss of maternal antibodies eliminates influenza, but a vaccine that only induces partial protection (heterologous vaccine) has little effect on influenza infection levels. Our results have important implications for the control of influenza in swine herds, which is crucial in order to reduce both losses for swine producers and the risk to public health.