Immunogenicity of aIIV3, MF59-adjuvanted seasonal trivalent influenza vaccine, in older adults ≥65 years of age: Meta-analysis of cumulative clinical experience

Int J Infect Dis. 2019 Aug:85S:S1-S9. doi: 10.1016/j.ijid.2019.03.026. Epub 2019 Mar 26.

Abstract

Objective: Compare the immunogenicity of MF59-adjuvanted trivalent inactivated influenza vaccine (aIIV3; Fluad™) versus conventional trivalent inactivated influenza vaccine (IIV3) in an integrated dataset using a meta-analysis.

Methods: In a meta-analysis, the immunogenicity of aIIV3 in subjects ≥65 years of age was compared with IIV3 immunogenicity using hemagglutination inhibition assay results from 23 phase I through III randomized controlled trials, including 16 first-dose vaccination studies and 7 revaccination studies assessing immunogenicity after second or third annual vaccination.

Results: The full analysis set consisted of 11,105 subjects (5869 aIIV3 and 5236 IIV3). In the revaccination studies, 822 individuals received 2 consecutive annual influenza vaccinations (492 aIIV3 and 330 IIV3), and 237 received 3 (150 aIIV3 and 87 IIV3). Overall, across all strains, the meta-analyzed point estimates for seroconversion (SC) and geometric mean titer (GMT) ratio were significantly higher for aIIV3 versus IIV3. The meta-analyzed percent differences in SC with corresponding 95% confidence intervals (CI) for A/H1N1, A/H3N2, and B strain were 9.5% (5.2-13.9), 10.5% (6.6-14.5), and 12.7% (8.6-16.8), respectively. The meta-analyzed GMT ratios with corresponding 95% CI for A/H1N1, A/H3N2, and B strain were 1.15 (1.01-1.31), 1.30 (1.18-1.44), 1.23 (1.15-1.31). Antibody responses against heterologous influenza strains were also significantly higher with aIIV3. Revaccination studies showed continued robust immune response to aIIV3 with repeated vaccination.

Conclusions: aIIV3 elicited a statistically significantly greater immune response compared to conventional IIV3 in older adults, increasing the breadth and duration of the immune response.

Keywords: Adjuvant; Elderly; Immunogenicity; Influenza vaccine; MF59.

Publication types

  • Meta-Analysis

MeSH terms

  • Adjuvants, Immunologic*
  • Aged
  • Antibodies, Viral / immunology
  • Antibody Formation
  • Female
  • Hemagglutination Inhibition Tests
  • Humans
  • Immunization, Secondary
  • Immunogenicity, Vaccine
  • Influenza A Virus, H1N1 Subtype / immunology
  • Influenza A Virus, H3N2 Subtype / immunology
  • Influenza Vaccines / immunology*
  • Influenza, Human / prevention & control
  • Male
  • Polysorbates*
  • Randomized Controlled Trials as Topic
  • Seasons
  • Seroconversion
  • Squalene*
  • Vaccines, Inactivated / immunology

Substances

  • Adjuvants, Immunologic
  • Antibodies, Viral
  • Influenza Vaccines
  • MF59 oil emulsion
  • Polysorbates
  • Vaccines, Inactivated
  • Squalene