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Hum Vaccin Immunother. 2014;10(5):1195-203. doi: 10.4161/hv.28313. Epub 2014 Mar 10.

Influence of pre-existing hemagglutination inhibition titers against historical influenza strains on antibody response to inactivated trivalent influenza vaccine in adults 50-80 years of age.

Author information

Center for Vaccine Research; University of Pittsburgh; Pittsburgh, PA USA; Vaccine & Gene Therapy Institute of Florida; Port Saint Lucie, FL USA.
Department of Family Medicine; School of Medicine; University of Pittsburgh; Pittsburgh, PA USA.
Centers for Disease Control and Prevention; Influenza Division/NCIRD; Atlanta, GA USA.
Marshfield Clinic Research Foundation; Marshfield, WI USA.
Department of Pathobiological Sciences; University of Wisconsin School of Veterinary Medicine; Madison, WI USA; Wisconsin National Primate Research Center; Madison, WI USA.
UPMC St. Margaret's Family Medicine Residency, Pittsburgh, PA USA.



Concerns about influenza vaccine effectiveness in older adults and the role of influenza strains encountered earlier in life led to this study.


Antibody responses against antigens in the 2011-2012 influenza vaccine at 21 days post vaccination were analyzed in 264 individuals aged 50-80 years. At Days 0 and 21, sera were tested for hemagglutination-inhibition titers against these vaccine strains and at Day 0 against a panel of 15 historical seasonal strains.:


The proportions of participants with seroprotective titers ≥1:40 to the vaccine strains at Days 0 and 21, respectively, were 37% and 66% for A(H1N1) and 28% and 63% for A(H3N2). An increasing number of responses ≥1:40 against historical strains was associated with seroprotective responses after vaccination among participants with a titer<1:40 at Day 0 for A(H1N1) and A(H3N2) vaccine strains (P<0.01). In multivariable regression analyses among those with Day 0 titer<1:40, after controlling for age, sex, race, site and diabetes, Day 21 titers ≥ 1:40 for the vaccine A strains were significantly more likely as the number of seroprotective responses against historical strains increased (A(H1N1) odds ratio [OR] = 1.41, 95% confidence interval [CI] = 1.09-1.82 and A(H3N2) OR = 1.32, 95% CI = 1.07-1.62). The likelihood of seroconversion was significantly higher with an increasing number of responses to historical strains for A(H3N2) only (OR = 1.24, 95% CI = 1.01-1.52). Seroconversion was significantly less likely as Day 0 vaccine strain titers increased.


Seroprotective titers after influenza vaccination increased as the number of responses to historical strains increased.


Human influenza; antibodies; immune response; immunogenicity

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