I2. Pediatric Vaccines
Abstract Submission
Jennifer E. Schuster, MD
Assistant Professor
Children's Mercy Hospital
Kansas City, Missouri
Disclosure: Merck, Sharpe, and Dohme: Research Grant
Andrew Speaker, PhD
Assistant Professor of Biostatistics
Vanderbilt University Medical Center
Nashville, TN
Disclosure: Nothing to disclose
Lubna Hamdan, MD
Postdoctoral Fellow
Vanderbilt University Medical Center
Nashville, TN
Disclosure: Nothing to disclose
Einas Batarseh, MD
Postdoctoral Research Fellow
Vanderbilt University Medical Center
Nashville, TN
Disclosure: Nothing to disclose
Laura S. Stewart, PhD
Research Coordinator
Vanderbilt University Medical Center
Nashville, TN
Disclosure: Nothing to disclose
Daniel Dulek, MD
Assistant Professor
Vanderbilt University Medical Center
Nashville, TN
Disclosure: Nothing to disclose
Carrie L. Kitko, MD
Dr
Vanderbilt University Medical Center
Nashville, TN
Disclosure: Nothing to disclose
Flor M. Munoz, MD
Associate Professor of Pediatrics
Baylor College of Medicine
Houston, TX
Disclosure: Biocryst: Grant/Research Support
CDC: Research Grant
Moderna: Other Financial or Material Support, Safety Monitoring Board Member/Chair
NIH: Research Grant
Novavax: Research Grant
UP to Date: Author and Editor - Royalties, Other Financial or Material Support
Claire Bocchini, MD
Assistant Professor of Pediatrics
Baylor College of Medicine
Houston, TX
Disclosure: Nothing to disclose
Lara Danziger-Isakov, MD, MPH
Professor of Pediatrics
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio
Disclosure: Ansun: Research Grant
Astellas: Grant/Research Support
GlaxoSmithKline: Advisory Board
Merck: Consultant, Grant/Research Support
Shire: Grant/Research Support
Viracor: Grant/Research Support
Michael Grimley, MD
Associate Professor of Clinical Pediatrics
Cincinnati Children's Hospital Medical Center
Cincinnati, OH
Disclosure: Nothing to disclose
Rakesh Goyal, MD, MRCP
Chief BMT and Professor of Pediatrics
Children's Mercy Hospital
Kansas City, MO
Disclosure: Nothing to disclose
Susan E. Coffin, MD, MPH
Dr
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania
Disclosure: Merck: Member of DSMB
Jason L. Freedman, MD, MSCE
Assistant Professor of Clinical Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, PA
Disclosure: Massive Bio: Consultant
Janet A. Englund, MD
Professor
Seattle Children's Hospital/Univ. of Washington
Seattle, Washington
Disclosure: AstraZeneca: Grant/Research Support
Chimerix: Grant/Research Support
GlaxoSmithKline: Consultant, Grant/Research Support
Meissa Vaccines: Consultant
Merck: Grant/Research Support
Novavax: Grant/Research Support
Sanofi Pasteur: Consultant
Paul A. Carpenter, MB. BS., BSc. (Med)
Full Member
Fred Hutchinson Cancer Research Center; University of Washington
Seattle, Washington
Disclosure: Nothing to disclose
Monica I. Ardura, DO, MSCS
Associate Professor of Pediatrics
Nationwide Children's Hospital
Columbus, Ohio
Disclosure: Shire: Grant/Research Support
Rachel Wattier, MD, MHS
Assistant Professor
University of California, San Francisco
San Francisco, CA
Disclosure: Nothing to disclose
Kenny Truong, BSN
Research Nurse
University of California, San Francisco
San Francisco, CA
Disclosure: Nothing to disclose
Gabriela Maron, MD
Assistant Member
St. Jude Children's Research Hospital
Memphis, Tennessee
Disclosure: Nothing to disclose
Kim J. Allison, RN
Manager Clinical Research Operations
St. Jude Children's Research Hospital
Memphis, TN
Disclosure: Nothing to disclose
Natasha B. Halasa, MD, MPH
Associate Professor
Vanderbilt University Medical Center
Nashville, Tennessee
Disclosure: Moderna: Consultant
Sanofi Pasteur: Grant/Research Support, vaccine and HAI testing
Background : Pediatric hematopoietic cell transplant (HCT) recipients often fail to have robust responses to influenza (flu) vaccine. We conducted a blinded phase II trial comparing high-dose (HD) trivalent inactivated vaccine (TIV) vs standard dose (SD) quadrivalent inactivated vaccine (QIV).
Methods :
Children 3-17 years old and 3-35 months post-allogeneic HCT were enrolled at 9 centers and randomized to either 2 doses of HD-TIV or SD-QIV during the 2016-17 flu season. We compared immune responses by hemagglutination inhibition (HAI) from children 3-11 (early) vs 12-35 (late) months (m) post-HCT to 3 common flu vaccine antigens, irrespective of vaccine type. HAI responses were evaluated at baseline (visit 1), 1 m post dose 1 (visit 2) and dose 2 (visit 3), and 7 m post dose 2 (visit 4). Geometric mean titers (GMT) were adjusted for baseline log-titer values.
Results :
Thirty-one children, median age 11 (7-15) years, were enrolled; 17 (55%) were immunized early and 14 (45%) late. Over 50% of patients had a potentially seroprotective (≥1:40) HAI titer at baseline, with no significant difference post-vaccination between early and late subjects. Table 1 compares early vs late subjects with HAI seroconversion (4-fold HAI titer rise). Post dose 1, late subjects, compared with early, had higher rates of seroconversion to all influenza strains. Post dose 2, early subjects, compared with late, had increased seroconversion. Late subjects had higher GMTs for H1N1 post dose 1 & 2, H3N2 after dose 1, and strain B/VIC post dose 1 & 2 (Figure 1). Although immunogenicity waned throughout flu season, higher seroconversion rates and GMT to H3N2 and strain B/VIC were retained in late subjects.
Conclusion : Compared to subjects in early post-HCT group, late post-HCT subjects had better flu vaccine immune responses as noted by higher GMT and HAI seroconversion. However, 2 doses seemed more beneficial in the early post-HCT group. Future analyses are underway, including comparing immunogenicity of HD vs SD flu vaccine.
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