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J Am Geriatr Soc. 1992 Feb;40(2):163-7.

Reduced infectivity of cold-adapted influenza A H1N1 viruses in the elderly: correlation with serum and local antibodies.

Author information

1
Gerontology Research Education and Clinical Center, Saint Louis Veterans Administration Medical Center, Missouri.

Abstract

OBJECTIVE:

To compare young and elderly adults in terms of their immune responses and rates of infection following intranasal vaccination with a live attenuated influenza virus.

DESIGN:

Time series, comparing outcomes in young and elderly convenience sample.

METHOD:

Retrospective laboratory analysis of serum and nasal wash specimens collected during prior studies in which young or elderly volunteers had been inoculated with cold-adapted influenza A/Kawasaki/86 (H1N1) reassortant virus.

SETTING:

Johns Hopkins Center for Immunization Research.

PARTICIPANTS:

Healthy young and elderly adults with pre-vaccination serum hemagglutination inhibition (HAI) antibody titers less than or equal to 1:8.

OUTCOME MEASUREMENTS:

Antibody responses in serum and nasal washes.

MAIN RESULTS:

The proportion of vaccinees who developed any serum or local antibody response was higher in young compared with elderly subjects (20/20 vs 5/14, P less than 0.0005). Resistance to infection with cold-adapted virus correlated with pre-vaccination levels of serum immunoglobulin G (IgG), serum IgA, and nasal wash IgA antibody to whole virus antigen. Age was highly correlated with a lack of response to vaccine by simple regression, but not when data were adjusted for pre-existing antibody levels.

CONCLUSIONS:

Cold-adapted reassortant influenza A H1N1 viruses achieve lower rates of infection in elderly than young adults, primarily due to age-related differences in preexisting levels of immunity which may not be reflected by HAI titer.

[Indexed for MEDLINE]

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