Dr. Manuel is the recipient of a transplant infectious diseases fellowship from The Transplantation Society/Hoffman-LaRoche.
Immunogenicity and Safety of an Intradermal Boosting Strategy for Vaccination Against Influenza in Lung Transplant Recipients
Article first published online: 9 OCT 2007
American Journal of Transplantation
Volume 7, Issue 11, pages 2567–2572, November 2007
How to Cite
Manuel, O., Humar, A., Chen, M. H., Chernenko, S., Singer, L. G., Cobos, I. and Kumar, D. (2007), Immunogenicity and Safety of an Intradermal Boosting Strategy for Vaccination Against Influenza in Lung Transplant Recipients. American Journal of Transplantation, 7: 2567–2572. doi: 10.1111/j.1600-6143.2007.01982.x
- Issue published online: 9 OCT 2007
- Article first published online: 9 OCT 2007
- Received 13 June 2007, revised 20 July 2007 and accepted for publication 30 July 2007
- Influenza vaccine;
- intradermal route;
- lung transplantation
The immunogenicity of influenza vaccine is suboptimal in lung transplant recipients. Use of a booster dose and vaccine delivery by the intradermal rather than intramuscular route may improve response. We prospectively evaluated the immunogenicity and safety of a 2-dose boosting strategy of influenza vaccine. Sixty lung transplant recipients received a standard intramuscular injection of the 2006–2007 inactivated influenza vaccine, followed 4 weeks later by an intradermal booster of the same vaccine. Immunogenicity was assessed by measurement of geometric mean titer of antibodies after both the intramuscular injection and the intradermal booster. Vaccine response was defined as 4-fold or higher increase of antibody titers to at least one vaccine antigen. Thirty-eight out of 60 patients (63%) had a response after intramuscular vaccination. Geometric mean titers increased for all three vaccine antigens following the first dose (p < 0.001). However, no significant increases in titer were observed after the booster dose for all three antigens. Among nonresponders, 3/22 (13.6%) additional patients responded after the intradermal booster (p = 0.14). The use of basiliximab was associated with a positive response (p = 0.024). After a single standard dose of influenza vaccine, a booster dose given by intradermal injection did not significantly improve vaccine immunogenicity in lung transplant recipients.