scholarly journals Serologic antibody response to quadrivalent influenza vaccination in Polish elderly patients

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Dubiel ◽  
M Ganczak ◽  
M Drozd-Dąbrowska ◽  
E Hallmann-Szelińska ◽  
K Szymański ◽  
...  
Keyword(s):  
Antibody Response ◽  
Influenza Vaccine ◽  
Elderly Patients ◽  
Influenza Vaccination ◽  
Geometric Mean ◽  
Primary Care Clinic ◽  
The Elderly ◽  
Study Objective ◽  
Care Clinic ◽  
Quadrivalent Influenza Vaccine

Abstract Background The effectiveness of immunization with subunit inactivated quadrivalent influenza vaccine (QIV) in the elderly has not been sufficiently estimated. The study objective was to evaluate QIV-induced antibody response and influencing determinants in Polish elderly patients. Methods Consecutive patients ≥55 years old attending the Primary Care Clinic in Gryfino, Poland, received QIV (A/Michigan/45/2015 [A/H1N1/pdm09], A/Singapore/INFIMH-16-0019/2016 [A/H3N2/], B/Colorado/06/2017 [Victoria lineage], B/Phuket/3073/2013 [Yamagata lineage]) between October-December 2018. Hemagglutination-inhibition assays measured antibody response to vaccine strains before/after vaccination. Geometric mean titer (GMT)/titers ratio (GMTR), protection (PR) and response (RR) rates were calculated. Results Among 108 participants (45.4% females; age 55-85, median 67 years) the highest GMTR after vaccination was observed for A/H3N2/(61.5-fold) followed by Victoria lineage (10.3-fold), A/H1N1/pdm09 (8.4-fold) and Yamagata lineage (3.0-fold). Most participants had a post-QIV protection for A/H3N2/and Yamagata lineage vaccine strains (64.8%, 70.4% respectively); lower PR were observed for Victoria lineage (57.4%) and A/H1N1/pdm09 (41.8%). The RR was high for A/H3N2/(91.7%) and Victoria lineage (68.5%), however, not satisfactory for A/H1N1/pdm09 and Yamagata lineage (59.3%, 52.8% respectively). Patients who received influenza vaccination in the previous year presented lower response to the both B strains compared to those who did not (p < 0.0001 and p = 0.03 respectively). Conclusions Although vaccine-induced antibody response in the elderly Polish population was more effective against A/H3N2/and B Victoria, this introductory study supports the use of QIV. Prior season vaccination was associated with lower antibody response to the current vaccination; this was not consistent to vaccine strains. Further research to better investigate QIV effectiveness determinants in the elderly would be of value. Key messages Subunit inactivated quadrivalent influenza vaccine (QIV) is effective in elderly people and should be used. The response to vaccination is not consistent and depends on the strain of influenza virus.

scholarly journals Quadrivalent Influenza Vaccine-Induced Antibody Response and Influencing Determinants in Patients ≥ 55 Years of Age in the 2018/2019 Season

2019 ◽  
Vol 16 (22) ◽  
pp. 4489 ◽  
Author(s):  
Maria Ganczak ◽  
Paulina Dubiel ◽  
Marzena Drozd-Dąbrowska ◽  
Ewelina Hallmann-Szelińska ◽  
Karol Szymański ◽  
...  
Keyword(s):  
Antibody Response ◽  
Influenza Vaccine ◽  
Seroconversion Rate ◽  
Geometric Mean ◽  
Primary Care Clinic ◽  
Influenza B ◽  
Serum Samples ◽  
Care Clinic ◽  
B Lineage ◽  
Quadrivalent Influenza Vaccine

The effects of immunization with subunit inactivated quadrivalent influenza vaccine (QIV) are not generally well assessed in the elderly Polish population. Therefore, this study evaluated vaccine-induced antibody response and its determinants. Methods: Consecutive patients ≥ 55 years old, attending a Primary Care Clinic in Gryfino, Poland, received QIV (A/Michigan/ 45/2015(H1N1)pdm09, A/Singapore/INFIMH-16-0019/2016 (H3N2), B/Colorado/06/2017, B/Phuket/ 3073/2013) between October-December 2018. Hemagglutination inhibition assays measured antibody response to vaccine strains from pre/postvaccination serum samples. Geometric mean titer ratio (GMTR), protection rate (PR) and seroconversion rate (SR) were also calculated. Results: For 108 patients (54.6% males, mean age: 66.7 years) the highest GMTR (61.5-fold) was observed for A/H3N2/, then B/Colorado/06/2017 (10.3-fold), A/H1N1/pdm09 (8.4-fold) and B/Phuket/ 3073/2013 (3.0-fold). Most patients had post-vaccination protection for A/H3N2/ and B/Phuket/3073/ 2013 (64.8% and 70.4%, respectively); lower PRs were observed for A/H1N1/pdm09 (41.8%) and B/Colorado/06/ 2017 (57.4%). The SRs for A/H3N2/, A/H1N1/pdm09, B Victoria and B Yamagata were 64.8%, 38.0%, 46.8%, and 48.2%, respectively. Patients who received QIV vaccination in the previous season presented lower (p < 0.001 and p = 0.03, respectively) response to B Victoria and B Yamagata. Conclusions: QIV was immunogenic against the additional B lineage strain (B Victoria) without significantly compromising the immunogenicity of the other three vaccine strains, therefore, adding a second B lineage strain in QIV could broaden protection against influenza B infection in this age group. As the QIV immunogenicity differed regarding the four antigens, formulation adjustments to increase the antigen concentration of the serotypes that have lower immunogenicity could increase effectiveness. Prior season vaccination was associated with lower antibody response to a new vaccine, although not consistent through the vaccine strains.

scholarly journals Profile and correlates of functional status in elderly patients presenting at a primary care clinic in Nigeria

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Samuel A. Ajayi ◽  
Lawrence A. Adebusoye ◽  
Adetola M. Ogunbode ◽  
Joshua O. Akinyemi ◽  
Ayodeji M. Adebayo
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Functional Status ◽  
Functional Disability ◽  
Demographic Data ◽  
Primary Care Clinic ◽  
The Elderly ◽  
Personal Hygiene ◽  
Care Clinic ◽  
Family Unit

Background: Assessing the functional status of elderly patients is central in measuring their health outcome. Little is known about the functional status of elderly patients attending our primary care clinic in Nigeria.Objective: To assess the correlates of functional status in elderly patients presenting at the General Outpatient Clinic of the University College Hospital, Ibadan, Nigeria.Method: A cross-sectional study of 360 randomly selected patients aged 60 years and above was undertaken to assess their functional status by scoring their basic activities of daily living (BADL) using the Modified Bathel Index. An interviewer-administered questionnaire was used to obtain the socio-demographic data, anthropometric measurements and morbidities of each patient.Results: The mean age was 69.1 ± 6.6 years with a female-to-male ratio of 1.9: 1. The prevalence of overall functional disability (defined as when assistance was sought in the performance of at least one of the components of BADL) was 88.3%. The highest prevalence of functionaldisability was experienced in the area of personal hygiene and grooming (95.3%) and transferring from bed to chair (95.3%). Overall functional disability significantly increasedwith increasing age (χ2 for trend=14.004, p < 0.0001), living in a polygamous family unit (p = 0.025), and lack of formal education (p = 0.020).Conclusion: Functional disability was high amongst the elderly in this setting. Age, education, and living in a polygamous type of family unit had significant influence on the functional status. High premium should, therefore, be placed on considering these factors in reducing functional disability in the elderly.

scholarly journals Physician and Nurse Perspectives of an Interprofessional and Integrated Primary Care-Based Program for Seniors

2013 ◽  
Vol 3 (1) ◽  
Author(s):  
Ainsley Elizabeth Moore ◽  
Kalpana Nair ◽  
Christopher Patterson ◽  
Joy White ◽  
Shelly House ◽  
...  
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Primary Care Clinic ◽  
The Elderly ◽  
Major Theme ◽  
Integrated Models ◽  
Front Line ◽  
Care Clinic ◽  
Multidisciplinary Program ◽  
Primary Care Practitioners

Background: In Canada, primary care practitioners provide the majority of care for elderly patients. Increasing volume and complexity of care compounded by a shortage of specialized geriatric services has lead to problems of fragmented, inefficient,and often ineffective service for this population. Integrated models that bridge primary and secondary care have emerged as a major theme in health reform to address such challenges for care of the elderly. Although primary care practitioners are important stakeholders necessary for successful uptake and sustainability of such integrated models, this perspective has been largely unexplored. Methods and Findings: We used a qualitative thematic approach to bring forward front-line perspectives of nurses and physicians who referred their patients to a newly developed integrated, multidisciplinary program for seniors that was introduced into their primary care clinic. Referrers experienced improved care processes, improved quality of care, as well as an enhanced experience when managing their elderly patients. Unclear assignment of roles and responsibilities created confusion for referring practitioners and their patients.Conclusions: Understanding benefits, limitations, and changes to front-line practitioner experience provides insight into important factors contributing to buy-in and sustainability of integrated programming for the elderly in this setting.

scholarly journals Effect of Previous-Season Influenza Vaccination on Serologic Response in Children During 3 Seasons, 2013–2014 Through 2015–2016

2019 ◽  
Vol 9 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Huong Q McLean ◽  
Jennifer P King ◽  
Pamela Talley ◽  
Brendan Flannery ◽  
Sarah Spencer ◽  
...  
Keyword(s):  
Antibody Response ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Repeated Measures ◽  
Influenza A ◽  
Geometric Mean ◽  
Serologic Response ◽  
Previous Season ◽  
Influenza A H1n1 ◽  
Vaccination History

Abstract Background The effects of repeated influenza vaccination in children are not well understood. In this study, we evaluated previous vaccination effects on antibody response after vaccination with trivalent inactivated influenza vaccine (IIV) or quadrivalent live-attenuated influenza vaccine (LAIV) among school-aged children (5–17 years) across 3 seasons. Methods Children were enrolled in the fall of 2013, 2014, and 2015. The participants received IIV or LAIV according to parent preference (2013–2014) or our randomization scheme (2014–2015). All study children received IIV in 2015–2016. Hemagglutination-inhibition assays measured antibody response to egg-grown vaccine strains from prevaccination and postvaccination serum samples. Geometric mean titers (GMTs) and increases in GMTs from before to after vaccination (geometric mean fold rise [GMFR]) were estimated from repeated-measures linear mixed models. Results We enrolled 161 children in 2013–2014, 128 in 2014–2015, and 126 in 2015–2016. Among the IIV recipients, responses to the influenza A(H1N1)pdm09 and B vaccine strains were lowest among children who had received a previous-season IIV. The GMFRs for strains A(H1N1)pdm09 and B were 1.5 to 2.3 for previous-season IIV and 4.3 to 12.9 for previous-season LAIV or no previous vaccine. GMFRs were lower for strain A(H3N2), and differences according to previous-season vaccination history were smaller and not significant in most seasons. Most children had a post-IIV vaccination titer of ≥40 for vaccine strains in all seasons, regardless of previous-season vaccination history. Little to no increase in antibody levels was observed after vaccination with LAIV. Conclusions Serologic response to vaccination was greatest for IIV, but previous-season vaccination modified IIV response to A(H1N1)pdm09 and B. Influenza A(H3N2) responses were low in all groups, and LAIV generated minimal serologic response against all strains.

scholarly journals Determinants of influenza vaccination among Polish patients attending primary care clinics (PCCs)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Dubiel ◽  
M Drozd-Dąbrowska ◽  
D Biesiada ◽  
A Molas-Biesiada ◽  
M Ganczak
Keyword(s):  
Primary Care ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Family Doctor ◽  
Primary Care Clinic ◽  
Relevant Information ◽  
Fisher Exact Test ◽  
Study Objective ◽  
Care Clinic ◽  
Vaccination Uptake

Abstract Background Influenza vaccination uptake in Poland is one of the lowest in Europe. The study objective was to evaluate influenza vaccination coverage and influencing factors among PCCs patients. Methods The study was conducted (Dec 2019-Feb 2020) among patients ≥55 years of age attending three PCCs, located in Western Poland. The anonymous questionnaire was used. Determinants influencing vaccination uptake were compared using the Fisher exact test (p-value&lt;0.05). Results Among 363 participants (60.3% females, age 55-97 years, median 66 years), 27.8% had been vaccinated in the 2019/2020 season. The majority of vaccinated patients (61.6%) declared that their decision was based on the recommendation of a family doctor. The most commonly reported reason for not being vaccinated was a lack of belief in vaccination efficacy (43.3%). The percentage of vaccinated individuals was significantly higher among those: living in a rural area/a small town (p = 0.001), having been vaccinated in the previous season (p &lt; 0.00001) or anytime (p &lt; 0.00001), having a vaccinated family member (p &lt; 0.00001), considering themselves to be in a risk group (p &lt; 0.00001), who received information about influenza vaccination from a GP (p = 0.0007) and knowledgeable about influenza (p = 0.02). Vaccinated respondents were more likely to plan on being vaccinated the following season compared to those unvaccinated (p &lt; 0.00001). There were no statistically significant differences between vaccinated and unvaccinated patients regarding gender (p = 0.72), age (p = 0.48), health status (p = 0.63) and marital status (p = 0.53). Conclusions The vaccination uptake among Polish PPCs patients ≥55 years of age is disturbingly low. Future interventions related to maximizing vaccination coverage should be more tailored, focusing especially on patients living in big cities who have never been vaccinated against influenza. Providing patients with relevant information on vaccine effectiveness, guided by GPs, is urgently needed. Key messages The influenza vaccination uptake in primary care clinic patients ≥55 years of age needs to be improved in Poland. As the lack of belief in vaccination efficacy is the important barrier to immunization, providing patients with relevant information, guided by family doctors, is urgently needed.

scholarly journals Immunogenicity of high-dose influenza vaccination in patients with primary central nervous system malignancy

2018 ◽  
Vol 5 (3) ◽  
pp. 176-183
Author(s):  
Roy E Strowd ◽  
Gregory Russell ◽  
Fang-Chi Hsu ◽  
Annette F Carter ◽  
Michael Chan ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Influenza Vaccine ◽  
Elderly Patients ◽  
Influenza Vaccination ◽  
Standard Dose ◽  
High Grade Glioma ◽  
Cns Lymphoma ◽  
High Dose ◽  
Central Nervous System Malignancy

Abstract Background For cancer patients, rates of influenza-associated hospitalization and death are 4 times greater than that of the general population. Previously, we reported reduced immunogenicity to the standard-dose influenza vaccine in patients with central nervous system malignancy. In other poorly responding populations (eg, elderly patients), high-dose vaccination has improved efficacy and immunogenicity. Methods A prospective cohort study was designed to evaluate the immunogenicity of the Fluzone® high-dose influenza vaccine in brain tumor patients. Data on diagnosis, active oncologic treatment, and immunologic status (eg, CD4 count, CD8 count, CD4:CD8 ratio) were collected. All patients received the high-dose vaccine (180 µg). Hemagglutination inhibition titers were measured at baseline, day 28, and 3 months following vaccination to determine seroconversion (≥4-fold rise) and seroprotection (titer ≥1:40), which were compared to our prior results. Results Twenty-seven patients enrolled. Diagnoses included high-grade glioma (85%), CNS lymphoma (11%), and meningioma (4%). Treatment at enrollment included glucocorticoids (n = 8, 30%), radiation (n = 2, 7%), and chemotherapy (n = 9, 33%). Posttreatment lymphopenia (PTL, CD4 ≤ 200) was observed in 4 patients (15%). High-dose vaccination was well tolerated with no grade III-IV toxicity. Overall, seroconversion rates for the A/H1N1, A/H3N2, and B vaccine strains were significantly higher than in our prior study: 65% vs 37%, 69% vs 23%, and 50% vs 23%, respectively (all P < .04). Seroconversion was universally poor in patients with PTL. While seroprotection at 3 months declined in our prior study, no drop was observed following high-dose vaccination in this cohort. Conclusions The immunologic response to HD influenza vaccination was higher in this cohort than standard-dose influenza vaccination in our prior report. These findings mirror those in elderly patients where high-dose vaccination is the standard of care and raise the possibility of an immunosenescence phenotype.

scholarly journals Morbidity pattern amongst elderly patients presenting at a primary care clinic in Nigeria

2011 ◽  
Vol 3 (1) ◽  
Author(s):  
Lawrence A. Adebusoye ◽  
Modupe M. Ladipo ◽  
Eme T. Owoaje ◽  
Adetola M. Ogunbode
Keyword(s):  
Primary Care ◽  
Elderly Patients ◽  
Primary Care Clinic ◽  
Care Clinic

Time to earliest peak serum antibody response to influenza vaccine in the elderly.

1997 ◽  
Vol 4 (4) ◽  
pp. 491-492 ◽  
Author(s):  
P A Gross ◽  
C Russo ◽  
S Dran ◽  
P Cataruozolo ◽  
G Munk ◽  
...  
Keyword(s):  
Antibody Response ◽  
Influenza Vaccine ◽  
Serum Antibody ◽  
The Elderly ◽  
Peak Serum ◽  
Serum Antibody Response

scholarly journals The Effects of Imprinting and Repeated Seasonal Influenza Vaccination on Adaptive Immunity after Influenza Vaccination

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 663
Author(s):  
Amy C. Sherman ◽  
Lilin Lai ◽  
Mary Bower ◽  
Muktha S. Natrajan ◽  
Christopher Huerta ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Seasonal Influenza ◽  
Geometric Mean ◽  
Fold Change ◽  
Post Vaccination ◽  
Seasonal Influenza Vaccination ◽  
Vaccine Responses ◽  
Immune Factors ◽  
Antibody Secreting Cells

(1) Background: The influenza virus continues to cause significant annual morbidity and mortality. The overall efficacy of seasonal influenza vaccination is suboptimal, which is partly due to host immune factors. The effects of imprinting and repeated seasonal influenza vaccination were investigated to assess for immune factors and mechanisms that impact influenza vaccine responses. (2) Methods: Twenty participants were enrolled into a prospective pilot study based on birth cohort and seasonal influenza immunization history. Immunologic parameters were assessed over a six-month period after the seasonal influenza vaccine was administered. (3) Results: There was no significant imprinting effect, as measured by hemagglutination inhibition (HAI) fold change, HAI geometric mean titer (GMT) for Day 29 or Day 180 post-vaccination and antigen- specific antibody-secreting cells (ASC) for Day 8 post-vaccination. Individuals who had minimal prior seasonal influenza vaccination had a higher magnitude ASC response and a higher HAI fold change post-vaccination than individuals who were repeatedly vaccinated. (4) Conclusions: Repeated seasonal influenza vaccination resulted in a decreased fold change of the immune response, although individuals in this cohort tended to have high HAI titers at baseline that persisted after vaccination. Imprinting effects were not observed in this cohort. These host immune factors should be considered in the development of universal influenza vaccines. ClinicalTrials.gov Identifier: NCT03686514.

scholarly journals Seasonal Influenza Vaccination and Recommendation: The Difference between General Practitioners and Public Health Workers in China

Vaccines ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 265 ◽  
Author(s):  
Hongguo Rong ◽  
Xiaozhen Lai ◽  
Xiaochen Ma ◽  
Zhiyuan Hou ◽  
Shunping Li ◽  
...  
Keyword(s):  
Public Health ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
General Practitioners ◽  
Seasonal Influenza ◽  
Health Workers ◽  
The Elderly ◽  
Vaccine Uptake ◽  
Knowledge And Attitudes ◽  
Public Health Workers

Seasonal influenza vaccination for healthcare workers (HCWs) is critical to the protection of HCWs and their patients. This study examined whether the separation of public health workers and general practitioners could affect the influenza vaccine uptake and recommendation behaviors among HCWs in China. A survey was conducted from August to October 2019, and HCWs from 10 provinces in China were recruited. A self-administered and anonymous questionnaire was used to assess HCWs’ demographic information, knowledge, and attitudes toward influenza vaccination, as well as vaccine uptake and recommendation behaviors. The primary outcome was HCWs’ vaccination and recommendation status of seasonal influenza vaccine. Multivariate logistic regression models were used to identify the influence factors of influenza vaccine uptake and recommendation among HCWs. Of the 1159 HCWs in this study, 25.3% were vaccinated against influenza in the previous season. “No need to get vaccinated” was the primary reason for both unvaccinated public health workers and general practitioners. Multivariate logistic regression showed that public health workers were more likely to get vaccinated against influenza (OR = 2.20, 95% CI 1.59–3.05) and recommend influenza vaccination to children (OR = 2.10, 95% CI 1.57–2.80) and the elderly (OR = 1.69, 95% CI 1.26–2.25) than general practitioners. Besides, the knowledge and perceived risk of influenza can give rise to HCWs’ vaccination and recommendation behaviors, and HCWs who got vaccinated in the past year were more likely to recommend it to children and the elderly in their work. The influenza vaccine coverage and recommendation among HCWs are still relatively low in China, especially for general practitioners. Further efforts are needed to improve the knowledge and attitudes toward influenza and influenza vaccination among HCWs, and coherent training on immunization for both public health workers and general practitioners might be effective in the face of separated public health and clinical services in China.

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