Immune response to 2009 pandemic H1N1 influenza virus A monovalent vaccine in children with cancer†
Ting-Yu Yen MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Pediatrics, Children's Hospital, China Medical University & Hospitals, Taichung, Taiwan
Search for more papers by this authorShiann-Tarng Jou MD, PhD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorYung-Li Yang MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorHsiu-Hao Chang MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorMeng-Yao Lu MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorDong-Tsamn Lin MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorKai-Hsin Lin MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Li-Min Huang MD, PhD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 8, Chung-Shan South Road, Taipei 10016, Taiwan.===Search for more papers by this authorCorresponding Author
Luan-Yin Chang MD, PhD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 8, Chung-Shan South Road, Taipei 10016, Taiwan.===Search for more papers by this authorTing-Yu Yen MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Pediatrics, Children's Hospital, China Medical University & Hospitals, Taichung, Taiwan
Search for more papers by this authorShiann-Tarng Jou MD, PhD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorYung-Li Yang MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorHsiu-Hao Chang MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorMeng-Yao Lu MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorDong-Tsamn Lin MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorKai-Hsin Lin MD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Search for more papers by this authorCorresponding Author
Li-Min Huang MD, PhD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 8, Chung-Shan South Road, Taipei 10016, Taiwan.===Search for more papers by this authorCorresponding Author
Luan-Yin Chang MD, PhD
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 8, Chung-Shan South Road, Taipei 10016, Taiwan.===Search for more papers by this authorConflict of interest: Nothing to declare.
Abstract
Purpose
This study investigated the immune response to 2009 pandemic H1N1 influenza monovalent vaccine in children with cancer receiving chemotherapy.
Methods
We enrolled 25 pediatric patients. Ten patients younger than 10 years old received two vaccinations and the remaining 15 patients older than 10 years old received one. We checked hemagglutination-inhibition (HAI) antibody titers in sera of patients before and 3–4 weeks after vaccination. Seroprotective titer was defined as HAI antibody titer ≥40 and seroresponse as ≥4-fold increase in HAI antibody titers after vaccination.
Results
The pre- and post-vaccination seroprotective rates were 52% and 72% (P = 0.24). Sixteen (64%) patients were possibly exposed to 2009 pandemic H1N1 influenza previously, and there was significant association between possible exposure and pre-vaccination seroprotective rate (P = 0.03). Post-vaccination seroresponse rate was 32%, and seroresponse was greater in patients without pre-vaccination seroprotective titer than those with pre-vaccination seroprotective titer (50% vs. 15%, P = 0.07). Children with lymphocyte counts above 1,500/µl during vaccination period had better seroresponse than those with lymphocyte counts below 1,500/µl (P = 0.008). Post-vaccination geometric mean titer (GMT) significantly increased in patients younger than 10 years receiving two vaccinations (pre- and post-vaccination GMT were 21.4 and 60.6, respectively; P = 0.025).
Conclusions
Monovalent vaccine for the 2009 pandemic H1N1 influenza A was found to be partially immunogenic in children with cancer, as evidenced by 32% of seroresponse rate. Immune response can be improved with vaccinations administered to patients whose absolute lymphocyte counts returned to a level of 1,500/µl or higher. Pediatr Blood Cancer 2011; 57: 1154–1158. © 2011 Wiley Periodicals, Inc.
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