Can Different Dosing Regimens Increase Effectiveness of the Flu Vaccine for Women Living with HIV?
BACKGROUND AND PURPOSE:
There is limited information regarding whether standard-dose, seasonal, trivalent, inactivated influenza vaccination is efficacious for women with HIV
Nunes et al. (The Lancet, 2020) examined the immunogenicity and safety of using different dosing schedules of inactivated influenza vaccine in pregnant women with HIV
Double-blind, randomized, controlled trial (RCT)
Pregnant women with HIV | 18 to 38 years of age
Gestational age 12 to 36 weeks
Women randomized (1:1:1) in to 3 groups to receive inactivated influenza vaccine with different regimens
Two single doses 1 month apart
Participants and study personnel were masked to group allocation
Hemagglutination-inhibition antibody responses were measured
For all groups in the mothers at enrollment
At 1 month after each vaccine dose
In the single-dose and double-dose groups within 7 days of birth in the neonates
Safety outcomes were assessed mothers and infants until 24 weeks postpartum and analyzed in all participants who received at least one dose of vaccine
Seroconversion rate to each of the vaccine strains in the mothers 1 month after completion of the dosing schedule
Frequency of local and systemic reactions
800 pregnant women with HIV were enrolled
266 were in the single-dose group | 265 in the double-dose group | 269 in the two-single-doses group
In the population analyzed, seroconversion rates were significantly higher in the double-dose group vs single-dose group (p≤0.019)
Double-dose group rates ranged from 29% to 65%
Single-dose group rates ranged from 18% to 49%
There was no difference in seroconversion rates in the two-single-doses group vs the single-dose group (p≥0.20)
Two-single-doses group rates ranged from 23% to 52%
Overall, safety outcomes were similar in the three groups
Injection-site reactions were increased in double-dose group
A double-dose of the influenza vaccine conferred higher immunogenicity compared to single-dose regimens in women with HIV
Immunogenicity even in the double-dose group remains lower than women without HIV
The authors conclude that
These findings emphasise the need for continued efforts to find an improved influenza vaccine or vaccination strategy for this population to improve protection of their infants, such as exploring the use of high-dose inactivated influenza vaccine that is currently approved for older adults in pregnant women with HIV
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan