The Immunogenicity and Safety of Influenza Vaccines among Indonesian Older adult

Authors

  • Lazuardhi Dwipa Department of Internal Medicine, Geriatric Division, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia https://orcid.org/0000-0002-0416-3822
  • Stefanie Yuliana Usman Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia
  • Alif Bagus Rakhimullah Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia; Management Postgraduate Program, Universitas Islam, Bandung, Indonesia
  • Kuswandewi Mutyara Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
  • Agnes Rengga Indrati Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia
  • Nur Atik Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia https://orcid.org/0000-0001-5951-4733
  • Rini Muliasari Department of Clinical Trial, Biofarma, Bandung, Indonesia
  • Cissy Kartasasmita Department of Pediatric, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia; Infectious Disease Study Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia https://orcid.org/0000-0003-4832-0444

DOI:

https://doi.org/10.3889/oamjms.2022.9034

Keywords:

Frailty, Influenza, Influenza vaccine, Older adults, Sarcopenia, Vitamin D

Abstract

BACKGROUND: Immunosenescence, frailty, sarcopenia, and Vitamin D deficiency were thought of having a negative influence on adequate immune response following vaccination. Epidemiological data related to influenza vaccination and its immunogenicity and safety in Indonesia are still scarce.

AIM: This study aimed to assess the immunogenicity and safety of the influenza vaccine in older adults in Indonesia and common related conditions.

METHODS: This study was a one-group, pre-test, post-test, quasi-experimental study. The vaccine used was a trivalent type. Immunogenicity was assessed according to rate of seropositivity and seroconversion based on hemagglutination inhibition antibody titer. Immunization safety was assessed according to adverse events following immunization (AEFI).

RESULTS: A total of 227 subjects were involved in this study. Antibody titers were significantly increased after 28-day influenza vaccination for all strains (p < 0.001). Seropositive rate in 28-day post-vaccination for A/H1N1, A/H3N2, and influenza B was 98.7%, 99.1%, and 97.4%, respectively. Meanwhile, the seroconversion rate for A/H1N1, A/H3N2, and influenza B strains was 54.2%, 66.1%, and 60.4%, respectively. The conditions of the frailty status, sarcopenia, and Vitamin D level were not associated with either seroconversion or seropositive status, both at baseline and endpoint. AEFI was occurred on seven subjects (3.08%) with pain at the injection site and one subject (0.44%) with arm tenderness.

CONCLUSION: Influenza vaccination showed adequate immune response and safety regardless of the frailty status, sarcopenia, or Vitamin D level. This result strengthened the importance of influenza vaccine administration in Indonesia older adults.

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References

Kosasih H, Roselinda, Nurhayati, Klimov A, Xiyan X, Lindstrom S, et al. Surveillance of influenza in Indonesia, 2003–2007. Influenza Other Respir Viruses. 2013;7(3):312-20. https://doi.org/10.1111/j.1750-2659.2012.00403.x PMid:22804910 DOI: https://doi.org/10.1111/j.1750-2659.2012.00403.x

Saha S, Chadha M, Al Mamun A, Rahman M, Sturm-Ramirez K, Chittaganpitch M, et al. Influenza seasonality and vaccination timing in tropical and subtropical areas of southern and south-eastern Asia. Bull World Health Organ. 2014;92(5):318- 30. https://doi.org/10.2471/BLT.13.124412 PMid:24839321 DOI: https://doi.org/10.2471/BLT.13.124412

Weinberger B. Vaccines for the elderly: Current use and future challenges. J Immun Ageing. 2018;15(1):3. https://doi.org/10.1186/s12979-017-0107-2 PMid:29387135 DOI: https://doi.org/10.1186/s12979-017-0107-2

Badan Pusat Statistik. Indeks Pembangunan Manusia. Jakarta: Badan Pusat Statistik; 2019.

Cavallazzi R, Ramirez JA. Influenza and viral pneumonia. Clin Chest Med. 2018;39(4):703-21. https://doi.org/10.1016/j.ccm.2018.07.005 PMid:30390743 DOI: https://doi.org/10.1016/j.ccm.2018.07.005

Xu X, Blanton L, Elal AI, Alabi N, Barnes J, Biggerstaff M, et al. Update: Influenza activity in the United States during the 2018- 19 season and composition of the 2019-20 influenza vaccine. MMWR Morb Mortal Wkly Rep. 2019;68(24):544-51. https://doi.org/10.15585/mmwr.mm6824a3 PMid:31220057 DOI: https://doi.org/10.15585/mmwr.mm6824a3

Nichols MK, Andrew MK, Hatchette TF, Ambrose A, Boivin G, Bowie W, et al. Influenza vaccine effectiveness to prevent influenza-related hospitalizations and serious outcomes in Canadian adults over the 2011/12 through 2013/14 influenza seasons: A pooled analysis from the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS Network). Vaccine. 2018;36(16):2166-75. https://doi.org/10.1016/j.vaccine.2018.02.093 PMid:29548608 DOI: https://doi.org/10.1016/j.vaccine.2018.02.093

Iuliano AD, Roguski KM, Chang HH, Muscatello DJ, Palekar R, Tempia S, et al. Estimates of global seasonal influenza-associated respiratory mortality: A modelling study. Lancet. 2018;391(10127):1285-300. https://doi.org/10.1016/S0140-6736(17)33293-2 PMid:29248255 DOI: https://doi.org/10.1016/S0140-6736(17)33293-2

Ciabattini A, Nardini C, Santoro F, Garagnani P, Franceschi C, Medaglini D. Vaccination in the elderly: The challenge of immune changes with aging. Semin Immunol. 2018;40:83-94. https://doi.org/10.1016/j.smim.2018.10.010 PMid:30501873 DOI: https://doi.org/10.1016/j.smim.2018.10.010

Wilson D, Jackson T, Sapey E, Lord JM. Frailty and sarcopenia: The potential role of an aged immune system. Ageing Res Rev. 2017;36:1-10. https://doi.org/10.1016/j.arr.2017.01.006 PMid:28223244 DOI: https://doi.org/10.1016/j.arr.2017.01.006

Remelli F, Vitali A, Zurlo A, Volpato S. Vitamin D deficiency and sarcopenia in older persons. Nutrients. 2019;11(12):2861. https://doi.org/10.3390/nu11122861 PMid:31766576 DOI: https://doi.org/10.3390/nu11122861

Sullivan SG, Price OH, Regan AK. Burden, effectiveness and safety of influenza vaccines in elderly, paediatric and pregnant populations. Ther Adv Vaccines Immunother. 2019;7:2515135519826481. https://doi.org/10.1177/2515135519826481 PMid:30793097 DOI: https://doi.org/10.1177/2515135519826481

Jefferson T, Rivetti D, Rivetti A, Rudin M, Di Pietrantonj C, Demicheli VJ. Efficacy and effectiveness of influenza vaccines in elderly people: A systematic review. Lancet. 2005;366(9492):1165-74. https://doi.org/10.1016/ S0140-6736(05)67339-4 PMid:16198765 DOI: https://doi.org/10.1016/S0140-6736(05)67339-4

Osterholm MT, Kelley NS, Sommer A, Belongia EA. Efficacy and effectiveness of influenza vaccines: A systematic review and meta-analysis. Lancet Infect Dis. 2012;12(1):36-44. https://doi.org/10.1016/S1473-3099(11)70295-X PMid:22032844 DOI: https://doi.org/10.1016/S1473-3099(11)70295-X

Hirve S, World Health Organization. Seasonal Influenza Vaccine Use in Low and Middle Income Countries in the Tropics and Subtropics: A Systematic Review. Geneva: World Health Organization; 2015. p. 2015.

Setiati S, Laksmi PW, Aryana IG, Sunarti S, Widajanti N, Dwipa L, et al. Frailty state among Indonesian elderly: Prevalence, associated factors, and frailty state transition. BMC Geriatr. 2019;19(1):182. https://doi.org/10.1186/s12877-019-1198-8 PMid:31269921 DOI: https://doi.org/10.1186/s12877-019-1198-8

Andrew MK, Bowles SK, Pawelec G, Haynes L, Kuchel GA, McNeil SA, et al. Influenza vaccination in older adults: Recent innovations and practical applications. Drugs Aging. 2019;36(1):29-37. https://doi.org/10.1007/s40266-018-0597-4 PMid:30411283 DOI: https://doi.org/10.1007/s40266-018-0597-4

Dwipa L, Apandi M., Utomo PP, Hasmirani M, Rakhimullah AB, Yulianto FA, et al. Adaptation and Validation of the Indonesian Version of the FRAIL Scale and SARC-F in Older Adults. Asian J Gerontol Geriatr 2021;16(1):40-7. DOI: https://doi.org/10.12809/ajgg-2020-436-oa

WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157-63. https://doi.org/10.1016/S0140-6736(03)15268-3 PMid:14726171 DOI: https://doi.org/10.1016/S0140-6736(03)15268-3

Hobson D, Curry RL, Beare AS, Ward-Gardner A. The role of serum haemagglutination-inhibiting antibody in protection against challenge infection with influenza A2 and B viruses. J Hyg (Lond). 1972;70(4):767-77. https://doi.org/10.1017/s0022172400022610 PMid:4509641 DOI: https://doi.org/10.1017/S0022172400022610

Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911-30. https://doi.org/10.1210/jc.2011-0385 PMid:21646368 DOI: https://doi.org/10.1210/jc.2011-0385

Goodwin K, Viboud C, Simonsen L. Antibody response to influenza vaccination in the elderly: A quantitative review. Vaccine. 2006;24(8):1159-69. https://doi.org/10.1016/j.vaccine.2005.08.105 PMid:16213065 DOI: https://doi.org/10.1016/j.vaccine.2005.08.105

Skowronski DM, Tweed SA, Tweed SA, De Serres G. Rapid decline of influenza vaccine – Induced antibody in the elderly: Is it real, or is it relevant? J Infect Dis. 2008;197(4):490-502. https://doi.org/10.1086/524146 PMid:18275271 DOI: https://doi.org/10.1086/524146

Padilla-Quirarte HO, Lopez-Guerrero DV, Gutierrez-Xicotencatl L, Esquivel-Guadarrama F. Protective antibodies against influenza proteins. Front Immunol. 2019;10:1677. https://doi.org/10.3389/fimmu.2019.01677 PMid:31379866 DOI: https://doi.org/10.3389/fimmu.2019.01677

Alonso WJ, Yu C, Viboud C, Richard SA, Schuck-Paim C, Simonsen L, et al. A global map of hemispheric influenza vaccine recommendations based on local patterns of viral circulation. Sci Rep. 2015;5(1):17214. https://doi.org/10.1038/srep17214 PMid:26621769 DOI: https://doi.org/10.1038/srep17214

Yu Z, Ruan Q, D’ Onofrio G, Greco A. From Sarcopenia to Frailty: The Pathophysiological Basis and Potential Target Molecules of intervention. In: Dionyssiotis Y. Editor. Frailty and Sarcopenia; IntechOpen. 2017;3:55-69 DOI: https://doi.org/10.5772/intechopen.69639

Nelke C, Dziewas R, Minnerup J, Meuth S, Ruck T. Skeletal muscle as potential central link between sarcopenia and immune senescence. EBioMedicine. 2019;49. https://doi.org/10.1016/j.ebiom.2019.10.034 PMid:31662290 DOI: https://doi.org/10.1016/j.ebiom.2019.10.034

Hazeldine J, Lord JM. Innate immunesenescence: underlying mechanisms and clinical relevance. Biogerontology. 2015;16(2):187-201. https://doi.org/10.1007/s10522-014-9514-3 PMid:25009085 DOI: https://doi.org/10.1007/s10522-014-9514-3

Narang V, Lu Y, Tan C, Camous XF, Nyunt SZ, Carre C, et al. Influenza vaccine-induced antibody responses are not impaired by frailty in the community-dwelling elderly with natural influenza exposure. Front Immunol. 2018;9:2465. https://doi.org/10.3389/fimmu.2018.02465 PMid:30405641 DOI: https://doi.org/10.3389/fimmu.2018.02465

Koesnoe S, Habibah U, Wahyudi ER, Abdullah M. The Association between Frailty Status and Seroconversion and Seroprotection of Influenza Vaccine in the Older Adult Population. J Int Med Indonesia. 2016;3(4):212-7. DOI: https://doi.org/10.7454/jpdi.v3i4.55

Laksmi PW. Challenges in screening and diagnosing frailty syndrome: Which tool to be used? Act Med Indones. 2016;47(3):181-2. PMid:26586382

Setiati S. Vitamin D status among Indonesian elderly women living in institutionalized care units. Acta Med Indones. 2008;40:78-83. PMid:19054885

Lang PO, Samaras D. Aging adults and seasonal influenza: Does the vitamin d status (h)arm the body? J Aging Res. 2012;2012:806198. https://doi.org/10.1155/2012/806198 PMid:22162810 DOI: https://doi.org/10.1155/2012/806198

Sundaram ME, Talbot HK, Zhu Y, Griffin MR, Spencer S, Shay DK, et al. Vitamin D is not associated with serologic response to influenza vaccine in adults over 50 years old. Vaccine. 2013;31(16):2057-61. https://doi.org/10.1016/j.vaccine.2013.02.028 PMid:23453766 DOI: https://doi.org/10.1016/j.vaccine.2013.02.028

Chadha MK, Fakih M, Muindi J, Tian L, Mashtare T, Johnson CS, et al. Effect of 25-hydroxyvitamin D status on serological response to influenza vaccine in prostate cancer patients. Prostate. 2011;71(4):368-72. https://doi.org/10.1002/pros.21250 PMid:20812224 DOI: https://doi.org/10.1002/pros.21250

Goncalves-Mendes N, Talvas J, Dualé C, Guttmann A, Corbin V, Marceau G, et al. Impact of vitamin D supplementation on influenza vaccine response and immune functions in deficient elderly persons: A randomized placebo-controlled trial. Front Immunol. 2019;10:65. https://doi.org/10.3389/fimmu.2019.00065 PMid:30800121 DOI: https://doi.org/10.3389/fimmu.2019.00065

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Published

2022-04-15

How to Cite

1.
Dwipa L, Usman SY, Rakhimullah AB, Mutyara K, Indrati AR, Atik N, Muliasari R, Kartasasmita C. The Immunogenicity and Safety of Influenza Vaccines among Indonesian Older adult. Open Access Maced J Med Sci [Internet]. 2022 Apr. 15 [cited 2024 Nov. 21];10(B):1332-9. Available from: https://oamjms.eu/index.php/mjms/article/view/9034

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