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Antibody Response to Influenza Vaccination in Nursing Home Residents and Healthcare Workers During Four Successive Seasons in Niigata, Japan

Published online by Cambridge University Press:  21 June 2016

Mizuho Sato*
Affiliation:
Division of Public Health, Department of Infectious Disease Control and International Medicine
Reiko Saito
Affiliation:
Division of Public Health, Department of Infectious Disease Control and International Medicine
Naohito Tanabe
Affiliation:
Division of Public Health, Department of Infectious Disease Control and International Medicine
Makoto Nishikawa
Affiliation:
Niigata Prefectural Institute of Public Health and Environmental Sciences, Niigata, Japan
Asami Sasaki
Affiliation:
Division of Public Health, Department of Infectious Disease Control and International Medicine
Fumitake Gejyo
Affiliation:
Division of Clinical Nephrology, Rheumatology, Respiratory Medicine and Infection Control and Prevention, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan
Hiroshi Suzuki
Affiliation:
Division of Public Health, Department of Infectious Disease Control and International Medicine
*
Division of Public Health, Department of Infectious Disease Control and International Medicine, Niigata University, Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-dori, Niigata City, Niigata Prefecture, 951-8510, Japanmizuhrs@med.niigata-u.ac.jp

Abstract

Objective:

To evaluate the antibody response to influenza vaccines in nursing home residents and healthcare workers (HCWs) and its relation to residents' functional and chronic disease status during four successive seasons.

Design:

Before-after study.

Setting:

Nine nursing homes during the 1998-1999 season and two during the 1999-2000, 2000-2001, and 2001-2002 seasons.

Participants:

Two hundred fifty-nine residents and 79 HCWs during the 1998-1999 season; 180 and 71, respectively, during the 1999-2000 season; 162 and 71, respectively, during the 2000-2001 season; and 153 and 79, respectively, during the 2001-2002 season.

Results:

Multivariate analysis indicated that the mean fold increase in the geometric mean titers (GMTs) of hemagglutination inhibition (HI) antibodies and the response rate (the proportion of vaccinées resulting in a significant, at least fourfold increase in antibody titer) were good and no significant differences occurred for almost all strains in both residents and HCWs. The GMTs of HI antibodies and the protection rate (the proportion of participants with HI antibody titers & 40) were increased in both residents and HCWs, but were significantly lower for almost all strains in residents than in HCWs. Furthermore, multivariate analysis indicated that subdivision of residents into three groups by level of daily activities and into four groups according to underlying diseases revealed only minor differences in immune responses.

Conclusions:

Antibody responses to the influenza vaccine were lower in residents than in HCWs. However, residents showed similar antibody responses regardless of their level of daily activity or underlying diseases.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Barker, WH. Excess pneumonia and influenza associated hospitalization during influenza epidemics in the United States, 1970-78. Am J Public Health 1986;76:761765.Google Scholar
2.Lui, K-J, Kendal, AP. Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985. Am J Public Health 1987;77:712716.CrossRefGoogle ScholarPubMed
3.Simonsen, L, Fukuda, K, Schonberger, LB, Cox, NJ. The impact of influenza epidemics on hospitalizations. J Infect Dis 2000;181:831837.CrossRefGoogle ScholarPubMed
4.Centers for Diseases Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2002;51:131.Google Scholar
5.Govaert, TME, Thijs, CTMCN, Masurel, N, Sprenger, MJW, Dinant, GJ, Knottnerus, JA. The efficacy of influenza vaccination in elderly individuals. JAMA 1994;272:16611665.Google Scholar
6.Gross, PA, Hermogenes, AW, Sacks, HS, Lau, J, Levandowski, RA. The efficacy of influenza vaccine in elderly persons: a meta-analysis and review of the literature. Ann Intern Med 1995;123:518527.Google Scholar
7.Nordin, J, Mullooly, J, Poblete, S, et al.Influenza vaccine effectiveness in preventing hospitalizations and deaths in persons 65 years or older in Minnesota, New York, and Oregon: data from 3 health plans. J Infect Dis 2001;184:665670.Google Scholar
8.Oshitani, H, Saito, R, Seki, N, et al.Influenza vaccination levels and influenza-like illness in long-term-care facilities for elderly people in Niigata, Japan, during an influenza A(H3N2) epidemic. Infect Control Hosp Epidemiol 2000;21:728730.CrossRefGoogle ScholarPubMed
9.Saito, R, Suzuki, H, Oshitani, H, Sakai, T, Seki, N, Tanabe, N. The effectiveness of influenza vaccine against influenza A (H3N2) virus infections in nursing homes in Niigata, Japan, during the 1998-1999 and 1999-2000 seasons. Infect Control Hosp Epidemiol 2002;23:8286.CrossRefGoogle ScholarPubMed
10.Murasko, DM, Bernstein, ED, Gardner, EM, et al.Role of humoral and cell-mediated immunity in protection from influenza disease after immunization of healthy elderly. Exp Gerontol 2002;37:427439.CrossRefGoogle ScholarPubMed
11.Remarque, EJ, de Bruijn, IA, Boersma, WJA, Masurel, N, Ligthart, GJ. Altered antibody response to influenza H1N1 vaccine in healthy elderly people as determined by HI, ELISA, and neutralization assay. J Med Virol 1998;55:8287.Google Scholar
12.Brydak, LB, Machala, M. Humoral immune response to influenza vaccination in patients from high risk groups. Drugs 2000;60:3553.CrossRefGoogle ScholarPubMed
13.Glathe, H, Bigi, S, Grosche, A. Comparison of humoral immune responses to trivalent influenza split vaccine in young, middle-aged and elderly people. Vaccine 1993;11:702705.CrossRefGoogle ScholarPubMed
14.Zeit, T, Neri, M, Iorio, AM. Immunogenicity of trivalent subunit and split influenza vaccines (1989-90 winter season) in volunteers of different groups of age. Vaccine 1991;9:613617.Google Scholar
15.Govaert, TM, Sprenger, MJ, Dinant, GJ, Aretz, K, Masurel, N, Knottnerus, JA. Immune response to influenza vaccination of elderly people: a randomized double-blind placebo-controlled trail. Vaccine 1994;12:11851189.Google Scholar
16.Van Hoecke, C, Prikazsky, V, Uto, I, Menschikowski, C. Immunogenicity of an inactivated split influenza vaccine in institutionalized elderly patients. Gerontology 1996;42:190198.Google Scholar
17.Dorreil, L, Hassan, I, Marshall, S, Chakraventy, P, Ong, E. Clinical and serological responses to an inactivated influenza vaccine in adults with HIV infection, diabetes, obstructive airways disease, elderly adults and healthy volunteers. Int J STD AIDS 1997;8:776779.CrossRefGoogle Scholar
18.Gross, PA, Quinnan, GV, Weksler, ME, et al.Relation of chronic disease and immune response to influenza vaccine in the elderly. Vaccine 1989;7:303308.Google Scholar
19.Remarque, EJ, Cools, HJM, Boere, TJ, van der rais, RJ, Masurel, N, Ligthart, GJ. Functional disability and antibody response to influenza vaccine in elderly patients in a Dutch nursing home. BMJ 1996;312:1015.CrossRefGoogle Scholar
20.Potter, JM, O'Donnell, B, Carman, WF, Roberts, MA, Stott, DJ. Serological response to influenza vaccination and nutritional and functional status of patients in geriatric medical long-term care. Age Ageing 1999;28:141145.CrossRefGoogle ScholarPubMed
21.Department of Health and Welfare for the Elderly. Assessment Guidelines of Activities of Daily Life for Disabled Elderly. Tokyo, Japan: Department of Health and Welfare for the Elderly, Minister's Secretariat, Ministry of Health and Welfare; 1991.Google Scholar
22.Zambon, M. Laboratory diagnosis of influenza. In: Nicholson, KG, Webster, RG, Hay, AJ, eds. Text Book of Influenza. Oxford: Blackwell Science; 1998:291313.Google Scholar
23.Remarque, EJ. Influenza vaccination in elderly people. Exp Gerontol 1999;34:445452.Google Scholar
24.Castle, SC. Impact of age-related immune dysfunction on risk of infections. Z Gerontol Geriatr 2000;33:341349.Google Scholar
25.Beyer, WEP, Palache, AM, Baljet, M, Baljet, M, Masurel, N. Antibody induction by influenza vaccines in the elderly: a review of the literature. Vaccine 1989;7:385394.Google Scholar
26.Ennis, FA, Mayner, RE, Barry, DW, et al.Correlation of laboratory studies with clinical responses to A/New Jersey influenza vaccines. J Infect Dis 1977;136(suppl):S397S406.Google Scholar
27.Schild, GC, Wood, JM, Newmen, RW. A single-redial-immunodiffusion technique for the assay of influenza haemagglutinin antigen. Bull World Health Organ 1975;52:223230.Google Scholar
28.Bernstein, E, Kaye, D, Abrutyn, E, Gross, P, Dorfman, M, Murasko, DM. Immune response to influenza vaccination in a large healthy elderly population. Vaccine 1999;17:8294.Google Scholar
29.de Bruijn, IA, Remarque, E, Beyer, WEP, le Cessie, S, Masurel, N, Ligthart, GJ. Annually repeated influenza vaccination improves humoral responses to several influenza virus strains in healthy elderly. Vaccine 1997;15:13231329.CrossRefGoogle ScholarPubMed