title: Frailty is associated with impairment of vaccine-induced antibody response and increase in post-vaccination influenza infection in community-dwelling older adults.
abstract: Annual immunization with a trivalent inactivated vaccine (TIV) is considered efficacious for prevention of seasonal influenza in older adults. However, significant controversy exists in the current literature regarding the clinical effectiveness of TIV immunization in this highly heterogeneous population. Frailty is an important geriatric syndrome characterized by decreased physiologic reserve and increased vulnerability to stressors. Using a validated set of frailty criteria, we conducted a prospective observational study to evaluate TIV-induced strain-specific hemagglutination inhibition (HI) antibody titers and post-vaccination rates of influenza-like illness (ILI) and infection in frail and nonfrail older adults. The results indicate that frailty was associated with significant impairment in TIV-induced strain-specific HI titers and increased rates of ILI and laboratory-confirmed influenza infection. These findings suggest that assessing frailty status in the elderly may identify those who are less likely to respond to TIV immunization and be at higher risk for seasonal influenza and its complications.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
authors.forename: Xu
authors.initials: X
authors.lastname: Yao
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hamilton
authors.forename: Nan-ping
authors.initials: NP
authors.lastname: Weng
authors.forename: Qian-Li
authors.initials: QL
authors.lastname: Xue
authors.forename: Jay H
authors.initials: JH
authors.lastname: Bream
authors.forename: Huifen
authors.initials: H
authors.lastname: Li
authors.forename: Jing
authors.initials: J
authors.lastname: Tian
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Yeh
authors.forename: Barbara
authors.initials: B
authors.lastname: Resnick
authors.forename: Xiyan
authors.initials: X
authors.lastname: Xu
authors.forename: Jeremy
authors.initials: J
authors.lastname: Walston
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
authors.forename: Sean X
authors.initials: SX
authors.lastname: Leng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D016330:Frail Elderly; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D015994:Incidence; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000276:immunology*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D007252:Influenza Vaccines; D015164:Vaccines, Inactivated