Relation of chronic disease and immune response to influenza vaccine in the elderly
Identifieur interne : 002145 ( Main/Exploration ); précédent : 002144; suivant : 002146Relation of chronic disease and immune response to influenza vaccine in the elderly
Auteurs : Peter A. Gross [États-Unis] ; Gerald V. Quinnan Jr. [États-Unis] ; Marc E. Weksler [États-Unis] ; Usha Setia [États-Unis] ; R. Gordon Douglas Jr. [États-Unis]Source :
- Vaccine [ 0264-410X ] ; 1989.
English descriptors
- Teeft :
- Absolute lymphocyte count, Ambulatory, Arteriosclerotic heart disease, Bergen pines hospital, Cerebrovascular disease, Chronic disease, Chronic health evaluation, Chronic health evaluation component, Chronic health evaluation scores, Chronic health score, Chronic illness, Congestive heart failure, Current study, Diabetes mellitus, Different degrees, Elderly, Elderly adults, Elderly patients, Elderly people, Elderly persons, Elderly subjects, Haemagglutination, Haemagglutination inhibition, Health evaluation score, Health status, Immune, Immune response, Immunization, Increase number, Influenza, Influenza antigens, Influenza immunization, Influenza strain, Influenza vaccine, Influenza vaccine strains, Initial test dilution, Monovalent, Monovalent vaccine, More drugs, Numerous efforts, Personal communication, Pneumococcal vaccine, Poor responders, Previous influenza vaccination, Previous influenza vaccine, Protective levels, Public health service, Serum antibody, Serum haemagglutination inhibition, Serum haemagglutination inhibition antibody titres, Severe restriction, Significant differences, Split virus vaccine formulation, Standard dose, Titre, Trivalent, Trivalent influenza vaccine, Trivalent vaccine, Vaccination, Vaccination status, Vaccine, Vaccine doses, Vaccine strain, Vaccine strains.
Abstract
Abstract: The ability of elderly patients to mount an adequate immune response to influenza vaccine has been debated. We studied the serum haemagglutination inhibition (HI) antibody response in elderly persons to determine whether different degrees of chronic illness were a critical factor in immune response. In autumn 1986, trivalent split virus vaccine was used to immunize 87 healthy ambulatory elderly adults and 53 institutionalized elderly adults. The pre-vaccination health status of the healthy elderly group was significantly better as measured by the incidence of chronic disorders and drug use (p < 0.02) and by the Chronic Health Evaluation component of the APACHE severity of disease classification (p < 0.001). No group differences were observed in serum HI antibody after immunization with the trivalent influenza vaccine. However, in 28 patients from each group who received the monovalent A/Taiwan/86 (H1N1) vaccine 1 month after the trivalent vaccine, the percentage with a postvaccination HI titre ⩾40 was 57% (16 of 28) for the healthy elderly vs 7% (2 of 28) for the institutionalized elderly (p = < 0.001). Geometric mean postvaccination HI titres were 31 and 13, respectively (p = 0.004). We concluded that the institutionalized elderly in our study mounted an inferior immune response against the new heterotypic influenza A/Taiwan strain when compared to healthy elderly adults. The Chronic Health Evaluation score may be an effective predictor of a poor immune response to new influenza vaccine strains in the elderly. Increasing age per se and lack of a history of prior influenza immunization did not adversely affect the development of protective levels of serum antibody. The immune response to the trivalent vaccine, however, was satisfactory in the elderly patients studied.
Url:
DOI: 10.1016/0264-410X(89)90190-4
Affiliations:
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Gross</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Hackensack Medical Center, Hackensack, NJ and New Jersey Medical School, UMDNJ, Newark, NJ</wicri:regionArea><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Quinnan Jr, Gerald V" sort="Quinnan Jr, Gerald V" uniqKey="Quinnan Jr G" first="Gerald V." last="Quinnan Jr.">Gerald V. Quinnan Jr.</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Office of Biologics Research and Review, CDB, FDA, Bethesda, MD</wicri:regionArea><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Weksler, Marc E" sort="Weksler, Marc E" uniqKey="Weksler M" first="Marc E." last="Weksler">Marc E. 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Gordon Douglas Jr.</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Hackensack Medical Center, Hackensack, NJ and New Jersey Medical School, UMDNJ, Newark, NJ</wicri:regionArea><placeName><region type="state">New Jersey</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Vaccine</title><title level="j" type="abbrev">JVAC</title><idno type="ISSN">0264-410X</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1989">1989</date><biblScope unit="volume">7</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="303">303</biblScope><biblScope unit="page" to="308">308</biblScope></imprint><idno type="ISSN">0264-410X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0264-410X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Absolute lymphocyte count</term><term>Ambulatory</term><term>Arteriosclerotic heart disease</term><term>Bergen pines hospital</term><term>Cerebrovascular disease</term><term>Chronic disease</term><term>Chronic health evaluation</term><term>Chronic health evaluation component</term><term>Chronic health evaluation scores</term><term>Chronic health score</term><term>Chronic illness</term><term>Congestive heart failure</term><term>Current study</term><term>Diabetes mellitus</term><term>Different degrees</term><term>Elderly</term><term>Elderly adults</term><term>Elderly patients</term><term>Elderly people</term><term>Elderly persons</term><term>Elderly subjects</term><term>Haemagglutination</term><term>Haemagglutination inhibition</term><term>Health evaluation score</term><term>Health status</term><term>Immune</term><term>Immune response</term><term>Immunization</term><term>Increase number</term><term>Influenza</term><term>Influenza antigens</term><term>Influenza immunization</term><term>Influenza strain</term><term>Influenza vaccine</term><term>Influenza vaccine strains</term><term>Initial test dilution</term><term>Monovalent</term><term>Monovalent vaccine</term><term>More drugs</term><term>Numerous efforts</term><term>Personal communication</term><term>Pneumococcal vaccine</term><term>Poor responders</term><term>Previous influenza vaccination</term><term>Previous influenza vaccine</term><term>Protective levels</term><term>Public health service</term><term>Serum antibody</term><term>Serum haemagglutination inhibition</term><term>Serum haemagglutination inhibition antibody titres</term><term>Severe restriction</term><term>Significant differences</term><term>Split virus vaccine formulation</term><term>Standard dose</term><term>Titre</term><term>Trivalent</term><term>Trivalent influenza vaccine</term><term>Trivalent vaccine</term><term>Vaccination</term><term>Vaccination status</term><term>Vaccine</term><term>Vaccine doses</term><term>Vaccine strain</term><term>Vaccine strains</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: The ability of elderly patients to mount an adequate immune response to influenza vaccine has been debated. We studied the serum haemagglutination inhibition (HI) antibody response in elderly persons to determine whether different degrees of chronic illness were a critical factor in immune response. In autumn 1986, trivalent split virus vaccine was used to immunize 87 healthy ambulatory elderly adults and 53 institutionalized elderly adults. The pre-vaccination health status of the healthy elderly group was significantly better as measured by the incidence of chronic disorders and drug use (p < 0.02) and by the Chronic Health Evaluation component of the APACHE severity of disease classification (p < 0.001). No group differences were observed in serum HI antibody after immunization with the trivalent influenza vaccine. However, in 28 patients from each group who received the monovalent A/Taiwan/86 (H1N1) vaccine 1 month after the trivalent vaccine, the percentage with a postvaccination HI titre ⩾40 was 57% (16 of 28) for the healthy elderly vs 7% (2 of 28) for the institutionalized elderly (p = < 0.001). Geometric mean postvaccination HI titres were 31 and 13, respectively (p = 0.004). We concluded that the institutionalized elderly in our study mounted an inferior immune response against the new heterotypic influenza A/Taiwan strain when compared to healthy elderly adults. The Chronic Health Evaluation score may be an effective predictor of a poor immune response to new influenza vaccine strains in the elderly. Increasing age per se and lack of a history of prior influenza immunization did not adversely affect the development of protective levels of serum antibody. The immune response to the trivalent vaccine, however, was satisfactory in the elderly patients studied.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Maryland</li><li>New Jersey</li></region></list><tree><country name="États-Unis"><region name="New Jersey"><name sortKey="Gross, Peter A" sort="Gross, Peter A" uniqKey="Gross P" first="Peter A." last="Gross">Peter A. Gross</name></region><name sortKey="Douglas Jr, R Gordon" sort="Douglas Jr, R Gordon" uniqKey="Douglas Jr R" first="R. Gordon" last="Douglas Jr.">R. Gordon Douglas Jr.</name><name sortKey="Quinnan Jr, Gerald V" sort="Quinnan Jr, Gerald V" uniqKey="Quinnan Jr G" first="Gerald V." last="Quinnan Jr.">Gerald V. Quinnan Jr.</name><name sortKey="Setia, Usha" sort="Setia, Usha" uniqKey="Setia U" first="Usha" last="Setia">Usha Setia</name><name sortKey="Weksler, Marc E" sort="Weksler, Marc E" uniqKey="Weksler M" first="Marc E." last="Weksler">Marc E. 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