Information from the abstract
Background Solid organ transplant (SOT) recipients are at increased risk of influenza-related complications and often exhibit suboptimal vaccine responses. While both high-dose (HD) and double-dose (DD) quadrivalent inactivated influenza vaccines (QIIV) aim to enhance immunogenicity compared to the standard dose, access to HD QIIV may be limited in resource-constrained settings. We evaluated whether DD QIIV could serve as a practical alternative. Methods We conducted open-label randomized controlled trial comparing the 2023 Southern Hemisphere HD QIIV containing 60 μg of antigen per strain with a double dose of standard QIIV containing 30 μg per strain in adult kidney transplant (KT) recipients. Pre- and 4-week post-vaccination sera were tested using strain-specific hemagglutination inhibition assays. Safety was also assessed. Findings Eighty-eight KT recipients were randomized and 84 were eligible for analysis (42 per group); 59.5% were male, with a mean age of 46 ± 11 years, and 60.7% received deceased donor kidneys. Seroconversion (SC) to ≥1 strain was significantly higher in the HD group (95.2%) than in the DD group (69%) (P = 0.002). The absolute difference in response rate was 0.26 (95% CI, 0.12–0.40). SC rates were numerically higher in the HD group for all strains. Injection site pain and myalgia were less common in the HD group, with P=0.040 and P=0.043, respectively. Interpretation HD QIIV demonstrated more favorable immunogenicity and tolerability than DD QIIV. These findings suggest that HD QIIV may be a preferable option for this population when available. Funding This study was supported by the Research grant from Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Related topics: Influenza Virus Research Studies · SARS-CoV-2 and COVID-19 Research · Respiratory viral infections research
Thai researcher and institutional participation
Thanachote Arayanumas · Kobporn Boonnak · Surasak Kantachuvesiri · Sarinya Boongird · Sasisopin Kiertiburanakul · Jackrapong Bruminhent · Mahidol University · Ramathibodi Hospital · Siriraj Hospital
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