1. Influenza A/Singapore (H3N2) component vaccine in systemic lupus erythematosus: A distinct pattern of immunogenicity
- Author
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Artur Capão, Victor Adriano de Oliveira Martins, Leila Antonangelo, Adriana Coracini Tonacio de Proença, Margarete Borges Galhardo Vendramini, Eloisa Bonfa, Sandra Gofinet Pasoto, Tatiana do Nascimento Pedrosa, Débora Cordeiro do Rosário, Emily Figueiredo Neves Yuki, Francisco Fellipe Claudino Formiga, Leticia Maria Kolachinski Raposo Brandão, Ricardo Fuller, Eduardo Ferreira Borba, Nadia E. Aikawa, Cristiana C. Garcia, Clovis A. Silva, and Ana Marli Christovam Sartori
- Subjects
Adult ,Male ,medicine.medical_specialty ,Antibodies, Viral ,Gastroenterology ,Virus ,Immunogenicity, Vaccine ,Rheumatology ,Internal medicine ,Influenza, Human ,medicine ,Humans ,Lupus Erythematosus, Systemic ,Longitudinal Studies ,Prospective Studies ,Seroconversion ,Adverse effect ,business.industry ,Immunogenicity ,Influenza A Virus, H3N2 Subtype ,Influenza a ,Middle Aged ,Vaccination ,Titer ,Immunization ,Influenza Vaccines ,Female ,business - Abstract
Introduction Influenza A (H3N2) virus is the most important cause of seasonal influenza morbidity and mortality in the last 50 years, surpassing the impact of H1N1. Data assessing immunogenicity and safety of this virus component are lacking in systemic lupus erythematosus (SLE) and restricted to small reports with other H3N2 strains. Objective This study aims to evaluate short-term immunogenicity and safety of influenza A/Singapore (H3N2) vaccine in SLE. Methods 81 consecutive SLE patients and 81 age- and sex-matched healthy controls (HC) were vaccinated with the influenza A/Singapore/INFIMH-16-0019/2016(H3N2)-like virus. Seroprotection (SP) and seroconversion (SC) rates, geometric mean titers(GMT), and factor increase in GMT(FI-GMT) and adverse events were assessed before and 4 weeks post-vaccination. Disease activity and therapies were also evaluated. Results Before immunization, SLE and HC groups had high SP rates (89% vs 77%, p = 0.061) and elevated GMT titer with higher levels in SLE (129.1(104.1–154.1) vs 54.8(45.0–64.6), p < 0.001). Frequency of two previous years’ influenza vaccination was high and comparable in SLE and HC (89% vs 90%, p = 1.000). Four weeks post-vaccination, median GMT increased for both groups and remained higher in SLE compared to HC (239.9(189.5–290.4) vs 94.5(72.6–116.4), p < 0.0001) with a comparable FI-GMT (2.3(1.8–2.9) vs 1.9(1.5-2.3), p = 0.051). SC rates were low and comparable for both groups (16% vs 11%, respectively, p = 0.974). Disease activity scores remained stable throughout the study ( p = 1.000) and severe adverse events were not identified. Conclusion Influenza A/Singapore (H3N2) vaccine has an adequate safety profile. The distinct immunogenicity pattern from other influenza A components characterized by a remarkably high pre- and post-vaccination SP rate and high GMT levels may be associated with previous influenza A vaccination. ( www.clinicaltrials.gov , NCT03540823).
- Published
- 2021