Higher-dose and adjuvanted seasonal influenza vaccines can improve immunogenicity in people with HIV
Date of Award
7-2024
Document Type
Dissertation
Degree Name
Doctor of Medical Science (DMSc)
Abstract
Background- People with HIV have proportionally higher mortality and morbidity from seasonal influenza and have a reduced immune response to seasonal influenza vaccines. Improvement of their immune response to influenza vaccines may lead to improved health outcomes.
Methods- CINAHL and Medline were searched using the terms “high dose influenza AND HIV”, “high antigen AND influenza vaccine”, “influenza vaccine AND HIV AND immunogenicity”, “influenza vaccine AND HIV AND adjuvant”, and “adjuvanted influenza vaccine AND HIV”. Articles were selected based on criteria of investigating higher-dose (30μg or higher) or adjuvanted influenza vaccines in people with HIV, using control groups of people with HIV who received standard-dose 15μg influenza vaccines without adjuvant, and reporting on seroprotection and seroconversion.
Results- A total of eight articles were found that met criteria, five that investigated higher-dose vaccines and three that investigated adjuvanted vaccines. For higher-dose vaccines there was a statistically significant improvement in seroprotection for at least one strain in two of four studies that reported p-values and seroconversion for at least one strain in four of four studies. The H1N1 strain of influenza had the most frequent improvements in seroprotection and seroconversion. The studies on adjuvanted vaccines showed an improvement in seroprotection and seroconversion for H1N1 in one of three studies and H3N2 in one of three studies. The vaccines were generally well tolerated, with the higher-dose vaccines having less frequent increases in adverse events compared to adjuvanted vaccines.
Conclusion- Both higher-dose and adjuvanted influenza vaccines show the possibility for improved immunogenicity in people with HIV, with higher-dose vaccines showing more frequent improvements in immunogenicity, and less frequent increases in adverse events than adjuvanted vaccines. The most frequent increases in immunogenicity were seen against H1N1 influenza strains.
Recommended Citation
Gladhill, Ethan; Rollins, Heather; Justice, Heather; and Brumitt, J., "Higher-dose and adjuvanted seasonal influenza vaccines can improve immunogenicity in people with HIV" (2024). Doctor of Medical Science (DMSc). 50.
https://digitalcommons.georgefox.edu/dmsc/50