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Response of Influenza Vaccines Against Heterovariant Influenza Virus Strains in Adults with Chronic Diseases

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The ability of influenza vaccination to provide cross-protection against heterovariant influenza strains was evaluated in a double-blind, randomized, trial in north-east Italy during the winter of 2005–2006. Of 238 adult subjects with underlying chronic diseases, 120 received MF59-adjuvanted subunit vaccine (Sub/MF59) and 118 received a conventional subunit vaccine (Subunit). Immunogenicity was measured for A/H3N2 and B influenza strains against both the homologous vaccine strains (A/New York/55/2004 and B/Jiangsu/10/2003), and the heterovariant strains recommended for the 2006–2007 season (A/Wisconsin/67/2005 and B/Malaysia/2506/2004). Although both vaccines conferred serological protection against the homologous vaccine strains and the 2006–2007 heterovariant A/H3N2 strain for a majority of subjects, the antibody response was highest in the Sub/MF59 vaccine group. For example, MF59-adjuvanted vaccination conferred significantly greater (P = 0.002) protection against the heterovariant A/H3N2 strain than the conventional subunit vaccine (79.2% vs. 61.0% of subjects, respectively). In conclusion, these results demonstrate that protection provided by influenza vaccination in adults affected by chronic diseases is lower against heterovariant strains than for homologous strains. However, addition of MF59 adjuvant to a subunit vaccine enhances immunogenicity against the A/H3N2 heterovariant strain, conferring broader protection than a conventional subunit vaccine in this population, who are at higher risk of influenza-related complications.

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ACKNOWLEDGMENTS

The Family Medicine Group of Pianiga, Venice, Italy, consisted of the following Medical Practitioners: G. Angiolelli, C. Barolo, A. M. Carraro, C. Garzotto, P. Marcato, and I. Mattiello. The authors wish to acknowledge Mrs. Monica Riondato for the technical support and are grateful to Dr. Calogero Terregino from National Reference Laboratory for Newcastle Disease and Avian Influenza, Istituto Zooprofilattico Sperimentale delle Venezie, for his availability in HI characterization.

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Authors and Affiliations

  1. Department of Environmental Medicine and Public Health, Institute of Hygiene, University of Padua, Padua, Italy

    V. Baldo, T. Baldovin & R. Trivello

  2. Department of Surgical and Gastroenterological Sciences, University of Padua, Padua, Italy

    A. Floreani

  3. Clinical Research Development and Medical Affairs, Novartis Vaccine, Siena, Italy

    E. Fragapane

  4. Department of Environmental Medicine and Public Health, Institute of Hygiene, University of Padua, Via Loredan 18, 35131, Padua, Italy

    V. Baldo

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  1. V. Baldo
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  2. T. Baldovin
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  5. R. Trivello
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The Family Medicine Group

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Correspondence to V. Baldo.

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V. Baldo and T. Baldovin contributed equally to the manuscript

The Family Medicine Group of Pianiga (Venice, Italy) consisted of the following Medical Practitioners: Angiolelli G, Barolo C, Carraro AM, Garzotto C, Marcato P, and Mattiello I

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Baldo, V., Baldovin, T., Floreani, A. et al. Response of Influenza Vaccines Against Heterovariant Influenza Virus Strains in Adults with Chronic Diseases. J Clin Immunol 27, 542–547 (2007). https://doi.org/10.1007/s10875-007-9100-4

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  • DOI: https://doi.org/10.1007/s10875-007-9100-4

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