Improving Immunogenicity and Effectiveness of Influenza Vaccine in Older Adults

Weiping Cao; Jin Hyang Kim; Tatiana Chirkova; Adrian J Reber; Renata Biber; David K Shay; Suryaprakash Sambhara


Expert Rev Vaccines. 2011;10(11):1529-1537. 

In This Article

Increasing Vaccine Antigen Dose

Increasing the vaccine dose from the conventional 15 µg of HA per virus strain has been shown to enhance the level of protective antibodies.[78–81] In older adults, vaccines containing 60-µg of HA for each viral strain generated significantly higher hemagglutination-inhibition and neutralizing antibody titers than the conventional dose vaccines.[79] While the high-dose vaccines were well tolerated, a dose-related increase in adverse reaction at the injection site was observed in the studies. A recent study by Chen et al. demonstrated similar findings using a 60 µg dose influenza vaccine.[81] While the high-dose vaccine in this study did not increase responses to the level observed in younger volunteers, the number of nonresponders in the older adult group was significantly reduced.[81] In December 2009, the US FDA granted a license to Sanofi Pasteur for Fluzone® High-Dose, a trivalent, inactivated influenza vaccine containing 60 µg of HA for each of the viral strains.[82,105] After review of data generated during the first year, the Advisory Committee on Immunization Practices (ACIP) acknowledged the vaccine's favorable immunogenicity and safety.[83]