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Influenza vaccine response in community-dwelling German prefrail and frail individuals

机译：居住在德国的脆弱个体和脆弱个体中的流感疫苗反应

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BackgroundThe age-related dysregulation of the immune system in older persons results in reduced responses to vaccination and greater susceptibility to infection, especially in frail individuals who suffer the greatest of morbidity and mortality due to infection. Recently, significantly reduced anti-influenza antibody titers and increased rates of influenza infection after vaccination were reported in community-dwelling American frail older adults. The aim of our study was to further assess the relative impact of frailty and of each individual Fried frailty criterion on influenza vaccine response. Prefrail and frail community-dwelling German persons aged ≥70?years were recruited for a nutritional randomized double-blind placebo-controlled clinical trial conducted during the 2014–2015 influenza season. Herein, we present a sub-analysis study of the placebo group to compare 76 prefrail and frail participants. ResultsPrevious seasonal influenza vaccination rate was relatively high (77.6%) in the 76 volunteers aged from 70 to 93?years. Of these participants, 65.8% were diagnosed as prefrail and 34.2% as frail according to the Fried frailty criteria. In both prefrail and frail groups, elevated levels of pre-vaccination seroprotection were observed to all vaccine strains (H1N1: 54% and 32%, H3N2: 60% and 72%, B: 10% and 16%). Post-vaccination, similar increases in haemagglutination-inhibiting antibody titers were observed for the three vaccine strains in both prefrail and frail groups. No significant difference in geometric mean titer (GMT) ratios and in rates of seroconversion or seroprotection were observed between prefrail and frail groups. Regarding the five Fried frailty criteria, only participants with low physical activity had significantly lower GMT to the strains H3N2 (55.4 vs 103.7, p =?0.001) and B (13.9 vs 20.0, p =?0.06), as compared to those having normal physical activity. ConclusionsInfluenza vaccine response was not significantly affected by the frail phenotype, as defined by Fried frailty criteria, in community-dwelling German individuals. However, low physical activity may be a relevant predictor of lower serological response in vaccinated older individuals. Trial registration Clinicaltrials.gov NCT02262091 (October 8, 2013).
机译：背景老年人与年龄有关的免疫系统失调导致对疫苗接种的反应减少，对感染的敏感性更高，特别是在脆弱人群中，由于感染而发病率和死亡率最高。最近，据报道，居住在社区的美国体弱的老年人中，抗流感抗体的效价显着降低，接种疫苗后流感感染率增加。我们研究的目的是进一步评估虚弱和每个个体虚弱标准对流感疫苗反应的相对影响。招募了年龄≥70岁的体弱者和体弱的德国人参加2014-2015年流感季节期间进行的营养随机双盲安慰剂对照临床试验。在这里，我们提出了一项安慰剂组的亚分析研究，以比较76名体弱者和体弱者。结果76名年龄在70至93岁的志愿者中，以前的季节性流感疫苗接种率相对较高（77.6％）。在这些参与者中，根据弗里德（Fried）虚弱标准，被诊断为虚弱和64.2％为虚弱。在脆弱人群和脆弱人群中，所有疫苗株的疫苗接种前血清保护水平均升高（H1N1：54％和32％，H3N2：60％和72％，B：10％和16％）。疫苗接种后，在脆弱人群和脆弱人群中观察到三种疫苗株的血凝抑制抗体效价都有相似的增加。脆弱和脆弱人群之间的几何平均滴度（GMT）比和血清转化率或血清保护率没有显着差异。关于五项脆弱的脆弱标准，与正常人相比，只有低体力活动的参与者的GMT显着低于H3N2菌株（55.4 vs 103.7，p =？0.001）和B（13.9 vs 20.0，p =？0.06）。体力活动。结论在德国社区居民中，Fried脆弱标准定义的脆弱表型并未显着影响流感疫苗的反应。但是，低运动量可能是接种疫苗的老年人血清反应降低的一个相关预测因素。试用注册Clinicaltrials.gov NCT02262091（2013年10月8日）。

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