A New MF59-Adjuvanted Influenza Vaccine Enhances the Immune Response in the Elderly with Chronic Diseases: Results from an Immunogenicity Meta-Analysis
A New MF59-Adjuvanted Influenza Vaccine Enhances the Immune
Response in the Elderly with Chronic Diseases: Results from an Immunogenicity
Meta-Analysis
Background: The elderly are at a higher risk of morbidity and mortality
associated with influenza infection than younger adults, but get less protection
from conventional vaccination. Objective: We conducted a meta-analysis of all
available data from clinical trials in the elderly on a recently introduced
MF59-adjuvanted influenza vaccine to determine its immunogenicity and safety in
subjects with underlying chronic disease who are at highest risk of influenza
infection. Methods: Data on immunogenicity and safety from 3,600 subjects
immunized with either the MF59-adjuvanted or conventional comparator influenza
vaccine in 13 clinical trials were analyzed by disease history. Geometric mean
haemagglutination inhibition titres (GMTs) and differences between the vaccine
groups were compared using two-way analysis of variance. Differences between
vaccine groups in the percentages with post-immunization reactions were assessed
using chi-squared test and Fischer's exact test. Results: At 28 days the
adjuvanted:comparator GMT ratio for the A/H3N2 antigen was 1.18 in healthy
elderly subjects and 1.43 in elderly subjects with chronic disease (p = 0.004).
The respective GMT ratios were 1.17 versus 1.37 for the B antigen (p = 0.065)
and 1.10 versus 1.17 for the A/H1N1 antigen (p = 0.41). Although
post-immunization reactions were more common in the group receiving the
adjuvanted vaccine, these were predominantly mild and transient, and none were
serious. Conclusions: The MF59-adjuvanted influenza vaccine is more immunogenic
in elderly subjects than conventional non-adjuvanted influenza vaccines and
especially so in those with chronic disease. Therefore, since its safety profile
is clinically acceptable, this adjuvanted vaccine represents an excellent option
for influenza immunization of elderly subjects at highest risk of complications.
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