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Chen J, Jiang F, Zhao C, Chai J, Li L, Guan Q, Li X, Wang F, Li A, Gao H, Wang M, Fu L, Nie F, Ling W, Deng H, Zhou L. Immunogenicity and safety of the quadrivalent inactivated split-virion influenza vaccine in populations aged ≥ 3 years: A phase 3, randomized, double-blind, non-inferiority clinical trial. Hum Vaccin Immunother 2023; 19:2245721. [PMID: 37587615 PMCID: PMC10438852 DOI: 10.1080/21645515.2023.2245721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/19/2023] [Accepted: 08/03/2023] [Indexed: 08/18/2023] Open
Abstract
This study aimed to evaluate the immunogenicity non-inferiority and safety of the quadrivalent inactivated split-virion influenza vaccine in participants ≥ 3 years old. A total of 3,328 participants were enrolled. Participants 3-8 years old were administered one or two doses of the investigational vaccine or one dose of the control vaccine, whereas the other participants were administered only one dose of the investigational or control vaccine. The immunogenicity and occurrence of adverse events (AEs) after 30 days of full-course vaccination and serious adverse events (SAEs) within 6 months after full-course vaccination were assessed. The sero-conversion rates (SCRs) of anti-H1N1, H3N2, B(Y), and B(V) antibodies in the test group were 74.64%, 87.40%, 82.66%, and 78.89%, respectively, and their geometric mean titers were 1:250.13, 1:394.54, 1:200.84, and 1:94.91, respectively, which were non-inferior to those in the control group. The SCRs and sero-protection rates in the two-dose group of participants 3-8 years old were greater than those in the one-dose group. The incidences of total AEs and adverse reactions in the test group were 31.6% and 21.7%, respectively, which were close to those in the control group. In the two-dose group, the incidence of adverse reactions was considerably lower in the second dose (5.5%) than in the first dose (14.7%). Most AEs were grade 1 in severity, and no SAEs were recorded. The investigational vaccine had immunogenicity non-inferior to the control vaccine, and two doses were more effective than one dose in participants 3-8 years old, with a good overall safety.Trial registration: CTR20200715.
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Affiliation(s)
- Jianmin Chen
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Feng Jiang
- Institute of Immunization Program, Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Chenyan Zhao
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control (NIFDC), Beijing, China
| | - Jing Chai
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Lanshu Li
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control (NIFDC), Beijing, China
| | - Qinghu Guan
- Institute of Immunization Program, Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Xiaoyu Li
- Division of HIV/AIDS and Sex-Transmitted Virus Vaccines, National Institutes for Food and Drug Control (NIFDC), Beijing, China
| | - Feiyu Wang
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Ansheng Li
- Influenza Vaccine Production Workshop, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Hongxia Gao
- Quality Control Department, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Minghui Wang
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Liandi Fu
- Influenza Vaccine Production Workshop, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Fei Nie
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
| | - Weijun Ling
- Scientific Affairs Department, Simoon Record Beijing Co Ltd, Beijing, China
| | - Haobin Deng
- Department of Bases Development, Simoon Record Beijing Co Ltd, Beijing, China
| | - Lei Zhou
- Economic and Technological Development Zone, Dalian Aleph Biomedical Co Ltd, Dalian, China
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Abstract
PURPOSE OF REVIEW Influenza vaccines are the most useful strategy for preventing influenza illness, especially in the setting of the COVID-19 pandemic. For the coming year (2021/2022) all vaccines will be quadrivalent and contain two influenza A strains [(H1N1)pdm09-like and (H3N2)-like viruses] and two influenza B strains (Victoria lineage-like and Yamagata lineage-like viruses). However, the currently licensed have suboptimal efficacy due to the emergence of new strains and vaccine production limitations. In this review, we summarize the current recommendations as well as new advancements in influenza vaccinations. RECENT FINDINGS Recent advances have been aimed at moving away from egg-based vaccines and toward cell culture and recombinant vaccines. This removes egg adaptations that decrease vaccine efficacy, removes the reliance on egg availability and decreases the time necessary to manufacture vaccines. However, even more radical changes are needed if we are to reach the ultimate goal of a universal vaccine capable of providing long-lasting protection against all or at least most influenza strains. We discuss various strategies, including using more stable influenza antigens such as the hemagglutinin stalk and internal proteins as well as new adjuvants, new vaccine formulations, and DNA/RNA-based vaccines that are currently being developed. SUMMARY The currently available vaccines have suboptimal efficacy and do not provide adequate protection against drifted and shifted strains. Thus, the development of a universal influenza vaccine that induces long-lasing immunity and protects against a broad range of strains is crucial.
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Affiliation(s)
- Nadim Khalil
- Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Division of Infectious Diseases, Department Pediatrics, London Health Sciences Centre, London, Ontario, Canada
| | - David I Bernstein
- Division of Pediatric Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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