Safety and Immunogenicity of an 8 Year Interval Heterologous Prime-Boost Influenza A/H7N7-H7N9 Vaccination

Publication Type
Journal Article
Year of Publication
2019
Authors
El Sahly, Hana M; Atmar, Robert L; Patel, Shital M; Bellamy, Abbie; Liu, Liwei; Hong, Wenshan; Zhu, Huachen; Guan, Yi; Keitel, Wendy A; DMID 13-0033 Vaccine Study Group
Secondary
Vaccine
Volume
37
Start Page
2561
Pagination
2561-2568
Date Published
05/2019
Keywords
Avian; influenza; Influenza A/H7N9; pandemic; prime-boost; Vaccines
Abstract

BACKGROUND: Influenza A/H7N9 viruses are undergoing antigenic drift since their emergence in 2013, and vaccination strategies are needed for pandemic preparedness. Two doses of adjuvanted monovalent inactivated influenza A/H7N9 vaccine (IIV1 A/H7N9) are needed for optimal serological responses. However, administering 2 doses in a pandemic setting might be challenging. We evaluated the immunogenicity of "boosting" with IIV1 A/H7N9 in subjects "primed" 8 years previously with IIV1 A/H7N7.

METHODS: We administered 1 booster dose containing 45 mcg of IIV1 A/H7N9 hemagglutinin to 17 recipients of 2 prior doses of IIV1 A/H7N7, and to 10 influenza A/H7-naïve subjects. We tested their post-boosting sera for antibodies (Ab) against homologous influenza A/H7N9 using a hemagglutination inhibition assay; and compared their Ab titers to those in stored sera from recipients of AS03-adjuvanted IIV1 A/H7N9 against 9 strains of influenza A/H7N9 viruses.

RESULTS: The percentage of subjects with Ab titers ≥40 on Days 9 and 29 post boosting, respectively, was 65% and 41% in primed subjects and 10% and 0% in unprimed subjects. The Ab titers in recipients of AS03-adjuvanted IIV1 A/H7N9 were higher than those in the prime-boost group against a panel of influenza A/H7N9 viruses, except for 2 highly pathogenic strains.

CONCLUSIONS: Priming with IIV1 A/H7 results in serological responses following a delayed boost with 1 dose of unadjuvanted IIV1 A/H7N9, despite lack of antibody response after the prime. Optimizing prime-boost approaches would benefit pandemic preparedness. ClinicalTrials.gov identifier: NCT02586792.