Journal Article

Clinical and Immunological Characteristics of Patients with 2009 Pandemic Influenza A (H1N1) Virus Infection after Vaccination

Wei Liu, Sake J. de Vlas, Fang Tang, Mai-Juan Ma, Mao-Ti Wei, Li-Juan Liu, Zeng-De Li, Lei Zhang, Zhong-Tao Xin, Yi-Gang Tong, Tao Jiang, Xiao-Ai Zhang, Cui He, Chris Li, Xiao-Ning Xu, Hong Yang, Jan Hendrik Richardus and Wu-Chun Cao

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 51, issue 9, pages 1028-1032
Published in print November 2010 | ISSN: 1058-4838
Published online November 2010 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/656588
Clinical and Immunological Characteristics of Patients with 2009 Pandemic Influenza A (H1N1) Virus Infection after Vaccination

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  • Immunology
  • Public Health and Epidemiology
  • Microbiology

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Background. We followed a cohort of 773 individuals who received a monovalent vaccine against 2009 pandemic influenza A (H1N1). Approximately 6 weeks after vaccination, 12 persons developed the disease.

Methods. Three groups of subjects were studied (12 patients who had or had not received previous monovalent vaccine and 1 group of 49 control subjects who had previously been immunized with the same vaccine). For all patients, clinical features were characterized and the causative viruses sequenced for possible mutations. Nasopharyngeal swabs, serum specimens, and peripheral blood monocyte cells (PBMCs) were collected at different time points up to 11 weeks after symptom onset to measure the virus load and humoral and cellular immune responses. Serum samples and PBMCs were also collected from 49 and 16 vaccinated control subjects, respectively.

Results. Both patient groups had similar clinical manifestations. No substantial viral mutations were detected. Compared with unvaccinated patients, viral loads in vaccinated patients were initially higher, but the levels decreased faster to undetectable levels. However, the virus became detectable again for 6 of them. Two weeks after infection, vaccinated and unvaccinated patients had similar neutralizing antibody levels as the vaccinated control subjects. Thereafter, the neutralizing antibody levels decreased markedly in vaccinated patients. During the acute phase, memory T cell counts and tumor necrosis factor-a levels were significantly higher in vaccinated than in unvaccinated patients.

Conclusions. Although the clinical consequences of infection are comparable between vaccinated and unvaccinated patients, humoral and cellular immune responses in vaccinated patients are boosted for some weeks, indicating an additional benefit of vaccination against 2009 pandemic influenza A (H1N1) virus.

Journal Article.  2972 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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