Masurel, N.

Annually repeated influenza vaccination improves humoral responses to several influenza virus strains in healthy elderly (Article)

1997-08-01T00:00:00Z

The benefit of annually repeated influenza vaccination on antibody formation is still under debate. In this study the effect of annually repeated influenza vaccination on haemagglutination inhibiting (HI) antibody formation in the elderly is investigated. Between 1990 and 1993 healthy young and elderly, both selected by the SENIEUR protocol, were vaccinated consecutively with commercially available influenza vaccines. The elderly had a lower HI antibody response after one vaccination as compared to the young against the A/Taiwan/1/86 (HINI), B/Yamagata/16/88 and B/Panama/45/90 strains. Annually repeated vaccination did not result in a decrease of the HI antibody titres against the A and B vaccine strains in both age groups. Moreover, the elderly had a significantly higher HI titre against the B strains after the second vaccination as compared to the first, resulting in comparable HI titres for young and elderly. Thus, annually repeated vaccination has a beneficial effect on the antibody titre against influenza virus and can contribute to a better antibody-response in the elderly.

Gender differences in local and systemic reactions to inactivated influenza vaccine, established by a meta-analysis of fourteen independent studies (Article)

1996-02-21T00:00:00Z

In order to determine whether there is a difference between genders in reported adverse reactions to inactivated influenza vaccine, a computerized database of serological studies was investigated. A standardized questionnaire was used to evaluate vaccine reactogenicity. A total of 1,800 vaccinees in 14 studies were analyzed separately for two age groups ( < 60 and > or = 60 years of age). Females reported significantly more local reactions than males. The pooled odds ratio for the outcome measure "any local reaction" was 0.32 (95% confidence interval, 0.26-0.40, significant) and 0.54 (95% Cl, 0.41-0.70, significant) for young and elderly adults, respectively. Similar results were obtained for the outcome measure "any systemic reaction." Previous exposure to influenza or influenza vaccine had no influence on reactogenicity. There were no gender differences in sero-responses. In conclusion, gender should be regarded as a predictor of reported reactions to influenza vaccine in both young and elderly adults and should be addressed in future study designs.

Influenza in het seizoen 1993-94; vaccinsamenstelling voor het seizoen 1994-95. (Article)

1994-01-01T00:00:00Z

The influenza season 1993/'94 in the Netherlands and the rest of Northwestern Europe was marked by an influenza A/H3N2 epidemic. The morbidity of this epidemic was moderate, but a high mortality rate was observed. The epidemic viruses, represented by A/Netherlands/241/93 (H3N2), were characterised by haemagglutination inhibition assays and nucleotide sequence analysis. The viruses were related to A/Beijing/32/92 (H3N2), the vaccine strain for 1993/'94, but clear antigenic differences were detected. Therefore, the WHO has recommended a new A/H3N2 component, A/Shangdong/9/93, for the vaccine of 1994/'95. The onset of the epidemic was unusually early in the influenza season. An increase in the influenza activity was already noticed in the second week of November and it reached its peak in week 49. As a result of the early epidemic, the influenza vaccination programme had not been completed yet. Therefore, the point of time for vaccinating people at risk may have to be reconsidered and moved up in order to complete the vaccination programme earlier.

Impact of influenza on mortality in relation to age and underlying disease, 1967-1989 (Article)

1993-04-01T00:00:00Z

Based on data from the Dutch Central Bureau of Statistics, the impact of influenza on mortality in The Netherlands was estimated for a 22.5-year period (1967-1989) in four age groups and three entities of disease, using Poisson regression techniques. Our analysis suggests that, on average, more than 2000 people died from influenza in The Netherlands each year, but in only a fraction of these deaths was influenza recognized as the cause of death. For each case of death registered as caused by influenza (registered influenza mortality), 2.6 additional cases of death registered as due to causes other than influenza, nevertheless, were influenza-related (non-registered influenza mortality). Therefore, the overall impact of influenza on mortality is estimated to be greater than registered influenza mortality by a factor of 3.6. Those under 60 years of age accounted for 5% of all non-registered influenza deaths, whereas people aged 60-69, 70-79 years and > 80 years accounted for 12%, 29% and 54% of such deaths, respectively. When extrapolating the figures for the Dutch population of 1989, we could attribute, on average per season-year, 82 deaths per 100,000 people > 60 years, 143 in people > 70 years, and 280 in people > 80 years. Of all non-registered influenza cases of death, 47% were estimated to occur in people with heart disease as a primarily reported cause of death, 23% in those with lung disease, and 30% in those with other diseases. This study stresses the serious effects of influenza, mainly in the elderly (95% of non-registered influenza mortality)...

Antibody response after influenza immunization with various vaccine doses (Article)

1993-03-19T00:00:00Z

The dose effect (0, 10, 20 and 60 micrograms) of influenza subunit vaccine on the antibody response was investigated in nursing-home residents and young controls. The vaccine antigens were: A/Taiwan/1/86 (H1N1), A/Sichuan/2/87 (H3N2) and B/Beijing/1/87. For the influenza B antigen, the post-GMT and the 'percentage protective titre' increased significantly both in the young controls and nursing-home residents. No dose effect was observed for the A/Taiwan, and a minor dose effect for A/Sichuan. All vaccine doses were well tolerated by both groups. We conclude from our data that higher vaccine doses may result in a better antibody response against some antigens but not against others. Therefore, in general, increasing the vaccine dose is no adequate method to improve the antibody response.

Influenza-epidemie in een verpleeghuis door een virus dat niet in het vaccin was opgenomen (Article)

1993-01-01T00:00:00Z

In the autumn of 1992 two-thirds of the population of a nursing home in Amsterdam was vaccinated against influenza. However, in March 1993 an outbreak of an influenza like illness occurred with a morbidity rate of 49% and a mortality rate of 10%. There was sufficient serological evidence to show that the vaccine as such had induced adequate immunity. As the causative agent an influenza A/H3N2 virus was identified. The failing activity of the vaccine in this instance was apparently caused by the absence of sufficient antigen similarity between the A/H3N2 vaccine component and the epidemic virus ('vaccine mismatch').

Influenza-related excess mortality in The Netherlands 1989/90 (Letter To Editor)

1990-08-01T00:00:00Z

Antibody induction by influenza vaccines in the elderly: a review of the literature (Article)

1989-10-01T00:00:00Z

Conflicting results have been reported concerning the association between high age and response to influenza vaccines. Some authors have found a reduced response in aged subjects, others have found no difference or even better results as compared with younger control subjects. Seventeen papers were selected from international literature published in the period 1968-1988 for a review of the anti-haemagglutinin-IgG sero-response following vaccination: among 30 cases in which vaccine components could be studied independently, ten revealed a better immune response in young subjects than in the elderly, four found more favourable results in the elderly, and 16 could not detect any significant between-group-differences, the latter most probably because of a high type-2-error. Nine of these 16 cases tended to favour young subjects. These results were relativated by the finding that each paper had at least one of three methodological limitations: (1) the failure to exclude subjects with illnesses or using drugs influencing the immune system, (2) the failure to exclude subjects with previous vaccinations against influenza, (3) the failure to exclude subjects with high prevaccination antibody titres. The direction of these biases is such that failure to address any one issue will lead to an underestimate of the response of aged subjects. In view of the failure to control these biases, it was not surprising that the papers reviewed presented a heterogeneous picture. Thus, the association between high age per se and response to influenza vaccines, if any, has not yet been established. Suggestions are made for future studies in which admission criteria should control health state and previous exposure to influenza antigens.

Influenzaseizoen 1988/'89; vaccinsamenstelling voor seizoen 1989/'90 (Article)

1989-03-01T00:00:00Z

De eerste influenza A-virussen van dit seizoen werden ongebruikelijk vroegtijdig geïsoleerd. reeds medio oktober 1988 werden in de regio Eindhoven drie kinderen opgenomen met ernstige luchtweginfecties. Bij één werd influenza A-H3N2-virus gekweekt uit keel- en neusuitstrijken, en bij de twee anderen werd deze stam serologisch aangetoond. Deze vroege fase van de epidemie leek eerst beperkt te blijven tot Brabant. Vanaf november 1988 werden ook in andere delen van het land isolaties verricht, maar pas half november begon de landelijke index van influenza-achtige ziektebeelden (IAZ) pas te stijgen (figuur). De epidemie bereikte een hoogtepunt in de weken 50 en 51 van 1988, waarbij een opmerkelijk regionaal verschil ...

Influenza in de winter 1986/'87; wijziging van het influenzavaccin voor het seizoen 1987/'88 (Article)

1987-11-01T00:00:00Z

Influenzavirussen van het subtype A(H1N1) werden reeds vroeg in het winterseizoen 1986/‘87 in Nederland geïsoleerd, en wel voor het eerst uit keelwatten van rekruten gelegerd bij Arnhem die op 9 december 1986 een influenza-achtige aandoening hadden (Nationaal Influenza Centrum, Rotterdam). Enkele dagen nadien werden isolaties, eveneens van het subtype H1N1 verricht uit patiëntenmateriaal van jonge militairen gelegerd in Havelte/Steenwijk. Influenza zorgde hier voor een aanzienlijke morbiditeit (> 20%) met meestal korte en zonder complicaties verlopende ziektebeelden. Het prototype isolaat A/Nederland/401/86 van het subtype H1N1 is antigeen nauw verwant aan de Taiwan/Singapore-variant die in de zomer van 1986 voor het eerst in Zuidoost-Azië influenza had veroorzaakt en die ...

Humoral immune response and delayed type hypersensitivity to influenza vaccine in patients with diabetes mellitus (Article)

1987-06-01T00:00:00Z

The antibody response and delayed type hypersensitivity reaction to commercially available trivalent influenza vaccine in 159 patients with diabetes mellitus was compared with response and reaction in 28 healthy volunteers. A correction for prevaccination titres was made. No differences were found between diabetic patients and control subjects with respect to antibody response to the three vaccine strains as measured by the difference between geometric mean titres of post- and prevaccination sera. In Type 1 (insulin-dependent) diabetic patients the incidence of non-responders to two vaccine components was significantly increased (p less than 0.05). The delayed type hypersensitivity reaction to influenza antigen was significantly decreased in patients with high concentrations of glycosylated haemoglobin (p less than 0.01). These findings suggest a role for impaired immune response in the increased influenza morbidity and mortality in patients with diabetes mellitus. Implications for therapy and vaccination strategy are discussed.

Trivalent influenza vaccine in patients on haemodialysis: impaired seroresponse with differences for A-H3N2 and A-H1N1 vaccine components (Article)

1987-03-01T00:00:00Z

One hundred and one patients on haemodialysis, 21 patients on peritoneal dialysis and 30 healthy controls received a trivalent split vaccine containing 15 micrograms haemagglutinin of a recent influenza A-H3N2, influenza A-H1N1 and influenza B strain, respectively. Antibody production after four weeks was determined by the haemagglutination-inhibition test and expressed as response rate, protection rate and overall mean fold increase. The patients on haemodialysis revealed a diminished seroresponse, as compared to patients on peritoneal dialysis and controls. For influenza A-H3N2, this was less distinct than for the other two antigens. In patients on haemodialysis the protection rate was 66% against the A-H3N2 vaccine component (versus 85% in controls, not significant), but only 25% against A-H1N1 and 27% against B (versus 84 and 77% in controls, p less than 0.001). Duration of haemodialysis up to eight years did not affect seroresponse. Patients on haemodialysis who were primed for influenza A-H1N1 in the period 1947-1957, reacted markedly better to the A-H1N1 vaccine component than subjects of other priming periods. A booster injection of the same vaccine dosage four weeks after the first immunization, performed in 98 patients on haemodialysis, was of little value: it had virtually no effect with regard to influenza A-H1N1 and influenza B, and showed, though significantly better, still poor results for A-H3N2. The differences in seroresponse between the A-H3N2 and A-H1N1 vaccine component suggest a major defect of primary, and a minor defect of secondary humoral response in patients on haemodialysis. The consequences for vaccine policy in these patients are discussed.

Value of booster immunisation with influenza vaccine in patients undergoing haemodialysis (Article)

1987-02-01T00:00:00Z

Drift van het influenza A(H1N1)-virus; wijziging van het influenzavaccin voor het seizoen 1986/'87 (Article)

1986-10-01T00:00:00Z

Beslissingen over de meest juiste samenstelling van vaccins tegen influenza zijn altijd moeilijk. Dit is te wijten aan de gedragingen van de epidemische influenza A- en B-virussen. In het influenzavaccin zijn virussen opgenomen die in voorgaande epidemieën influenza hebben veroorzaakt, maar de virale mantelcomponenten hemagglutinine en neuraminidase wijzigen zich onder druk van antistoffen die tijdens die epidemieën zijn ontstaan. Hierdoor behoudt het virus zijn invasieve vermogen bij de mens. Dit probleem wordt onderkend door de Wereldgezondheidsorganisatie (WHO), die sinds 1947 een netwerk van nationale influenzacentra in het leven heeft geroepen. Deze centra houden in hun regio de vinger aan de pols ten aanzien van antigeenwijzigingen van geïsoleerde influenzavirussen ...

Influenza virus strains with a fusion threshold of pH 5.5 or lower are inhibited by amantadine. Brief report (Article)

1986-01-01T00:00:00Z

Nineteen influenza virus strains were examined for susceptibility to amantadine-HCl (AMT) and for pH-thresholds of haemagglutinin-induced haemolysis. Whereas pH-thresholds below 5.5 were not seen in AMT-resistant strains, AMT-sensitive strains showed pH-thresholds either below or above 5.5.