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Poor Immunogenicity, Not Vaccine Strain Egg Adaptation, May Explain the Low H3N2 Influenza Vaccine Effectiveness in 2012-2013.

Publication ,  Journal Article
Cobey, S; Gouma, S; Parkhouse, K; Chambers, BS; Ertl, HC; Schmader, KE; Halpin, RA; Lin, X; Stockwell, TB; Das, SR; Landon, E; Tesic, V ...
Published in: Clin Infect Dis
July 18, 2018

BACKGROUND: Influenza vaccination aims to prevent infection by influenza virus and reduce associated morbidity and mortality; however, vaccine effectiveness (VE) can be modest, especially for subtype A(H3N2). Low VE has been attributed to mismatches between the vaccine and circulating influenza strains and to the vaccine's elicitation of protective immunity in only a subset of the population. The low H3N2 VE in the 2012-2013 season was attributed to egg-adaptive mutations that created antigenic mismatch between the actual vaccine strain (IVR-165) and both the intended vaccine strain (A/Victoria/361/2011) and the predominant circulating strains (clades 3C.2 and 3C.3). METHODS: We investigated the basis of low VE in 2012-2013 by determining whether vaccinated and unvaccinated individuals were infected by different viral strains and by assessing the serologic responses to IVR-165, A/Victoria/361/2011, and 3C.2 and 3C.3 strains in an adult cohort before and after vaccination. RESULTS: We found no significant genetic differences between the strains that infected vaccinated and unvaccinated individuals. Vaccination increased titers to A/Victoria/361/2011 and 3C.2 and 3C.3 representative strains as much as to IVR-165. These results are consistent with the hypothesis that vaccination boosted cross-reactive immune responses instead of specific responses against unique vaccine epitopes. Only approximately one-third of the cohort achieved a ≥4-fold increase in titer. CONCLUSIONS: In contrast to analyses based on ferret studies, low H3N2 VE in 2012-2013 in adults does not appear to be due to egg adaptation of the vaccine strain. Instead, low VE might have been caused by low vaccine immunogenicity in a subset of the population.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

July 18, 2018

Volume

67

Issue

3

Start / End Page

327 / 333

Location

United States

Related Subject Headings

  • Seasons
  • Phylogeny
  • Mutation
  • Microbiology
  • Influenza, Human
  • Influenza Vaccines
  • Influenza A Virus, H3N2 Subtype
  • Immunogenicity, Vaccine
  • Humans
  • High-Throughput Nucleotide Sequencing
 

Citation

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Cobey, S., Gouma, S., Parkhouse, K., Chambers, B. S., Ertl, H. C., Schmader, K. E., … Grad, Y. H. (2018). Poor Immunogenicity, Not Vaccine Strain Egg Adaptation, May Explain the Low H3N2 Influenza Vaccine Effectiveness in 2012-2013. Clin Infect Dis, 67(3), 327–333. https://doi.org/10.1093/cid/ciy097
Cobey, Sarah, Sigrid Gouma, Kaela Parkhouse, Benjamin S. Chambers, Hildegund C. Ertl, Kenneth E. Schmader, Rebecca A. Halpin, et al. “Poor Immunogenicity, Not Vaccine Strain Egg Adaptation, May Explain the Low H3N2 Influenza Vaccine Effectiveness in 2012-2013.Clin Infect Dis 67, no. 3 (July 18, 2018): 327–33. https://doi.org/10.1093/cid/ciy097.
Cobey S, Gouma S, Parkhouse K, Chambers BS, Ertl HC, Schmader KE, et al. Poor Immunogenicity, Not Vaccine Strain Egg Adaptation, May Explain the Low H3N2 Influenza Vaccine Effectiveness in 2012-2013. Clin Infect Dis. 2018 Jul 18;67(3):327–33.
Cobey, Sarah, et al. “Poor Immunogenicity, Not Vaccine Strain Egg Adaptation, May Explain the Low H3N2 Influenza Vaccine Effectiveness in 2012-2013.Clin Infect Dis, vol. 67, no. 3, July 2018, pp. 327–33. Pubmed, doi:10.1093/cid/ciy097.
Cobey S, Gouma S, Parkhouse K, Chambers BS, Ertl HC, Schmader KE, Halpin RA, Lin X, Stockwell TB, Das SR, Landon E, Tesic V, Youngster I, Pinsky BA, Wentworth DE, Hensley SE, Grad YH. Poor Immunogenicity, Not Vaccine Strain Egg Adaptation, May Explain the Low H3N2 Influenza Vaccine Effectiveness in 2012-2013. Clin Infect Dis. 2018 Jul 18;67(3):327–333.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

July 18, 2018

Volume

67

Issue

3

Start / End Page

327 / 333

Location

United States

Related Subject Headings

  • Seasons
  • Phylogeny
  • Mutation
  • Microbiology
  • Influenza, Human
  • Influenza Vaccines
  • Influenza A Virus, H3N2 Subtype
  • Immunogenicity, Vaccine
  • Humans
  • High-Throughput Nucleotide Sequencing