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Safety and Immunogenicity of a Delayed Heterologous Avian Influenza A(H7N9) Vaccine Boost Following Different Priming Regimens: A Randomized Clinical Trial

Jul-23

Journal Article

Authors:

El Sahly, H. M.
Yildirim, I.
Frey, S. E.
Winokur, P.
Jackson, L. A.
Bernstein, D. I.
Creech, C. B.
Chen, W. H.
Rupp, R. E.
Whitaker, J. A.
Phadke, V.
Hoft, D. F.
Ince, D.
Brady, R. C.
Edwards, K. M.
Ortiz, J. R.
Berman, M. A.
Weiss, J.
Wegel, A.
Dmid Study Group

Journal:
J Infect Dis

PMID:
37466221

URL:
https://www.ncbi.nlm.nih.gov/pubmed/37466221

DOI:
10.1093/infdis/jiad276

Keywords:
avian influenza influenza A(H7N9) pandemic pandemic preparedness

Abstract:
<p>BACKGROUND: Influenza A (H7N9) has caused multiple disease waves with evidence of strain diversification. Optimal influenza A (H7N9) prime-boost vaccine strategies are unknown. METHODS: We recruited participants who had received monovalent inactivated A/Shanghai/2/2013 (H7N9) vaccine (MIV) approximately 5 years earlier, as follows: MIV with MF59 (MF59 x 2 Group), MIV with AS03 (AS03 x 2 Group), unadjuvanted MIV (No Adj Group), MIV with MF59 or AS03 followed by unadjuvanted MIV (Adjx1 Group), and A/H7-naive (Unprimed Group). Participants were randomized to receive one dose of AS03-adjuvanted or unadjuvanted A/Hong Kong/125/2017 (H7N9) MIV and were followed for safety and immunogenicity using hemagglutination inhibition (HAI) and neutralizing (Neut) antibody assays. RESULTS: We enrolled 304 participants: 153 received the adjuvanted boost, and 151 received the unadjuvanted boost. At 21 days post vaccination, the proportion of participants with HAI antibody titers against the boosting vaccine strain of &gt;/=40 in the adjuvanted and unadjuvanted arms, respectively, were: 88% and 49% in MF59 x 2 Group, 89% and 75% in AS03 x 2 Group, 59% and 20% in No Adj Group, 94% and 55% in Adjx1Group, and 9% and 11% in Unprimed Group. CONCLUSIONS: Serologic responses to a heterologous A(H7N9) MIV boost were highest in participants primed and boosted with adjuvant-containing regimens.</p>

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