title: Immunotherapies influence the influenza vaccination response in multiple sclerosis patients: an explorative study.
abstract: The immunogenicity of influenza vaccines in MS patients undergoing immunomodulatory treatment is not well studied.
  
  
  
  This explorative study investigated the influence of immunomodulatory treatment on MS patients receiving pandemic H1N1 (swine flu) vaccination in 2009 and seasonal influenza vaccination in 2010.
  
  
  
  We investigated the immune response to pandemic H1N1 vaccination among 113 MS patients and 216 controls during the pandemic of 2009. We also investigated the serological response to seasonal influenza vaccination (2010 - 2011 season) among 49 vaccinated and 62 non-vaccinated MS patients, versus 73 controls. We evaluated these vaccine responses by haemagglutination inhibition assay.
  
  
  
  MS patients receiving immunomodulatory treatment had reduced protection (27.4%), compared to controls (43.5%) (p = 0.006), after pandemic H1N1 vaccination (2009). The rates of protection were not influenced by interferon beta treatment (44.4% protected), but were reduced among patients receiving glatiramer acetate (21.6%), natalizumab (23.5%), and mitoxantrone (0.0%). A similar pattern emerged after MS patients received a seasonal influenza vaccination in 2010.
  
  
  
  These findings suggest that MS patients receiving immunomodulatory therapies other than interferon beta should be considered for a vaccine response analysis and perhaps be offered a second dose of the vaccine, in cases of insufficient protection.
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway henning.kristian.olberg@helse-bergen.no.
authors.forename: Henning K
authors.initials: HK
authors.lastname: Olberg
authors.affiliation: Department of Research and Development, Haukeland University Hospital, Bergen, Norway Influenza Centre, Department of Clinical Science, University of Bergen, Norway KG Jebsen Centre for Influenza Vaccine Research, Department of Clinical Science, University of Bergen, Norway.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Cox
authors.affiliation: Department of Research and Development, Haukeland University Hospital, Bergen, Norway Influenza Centre, Department of Clinical Science, University of Bergen, Norway.
authors.forename: Jane K
authors.initials: JK
authors.lastname: Nostbakken
authors.affiliation: Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Norway.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Aarseth
authors.affiliation: Department of Neurology, Haukeland University Hospital, Bergen, Norway KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Norway Department of Clinical Medicine, University of Bergen, Norway.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Vedeler
authors.affiliation: Norwegian Multiple Sclerosis Registry and Biobank, Department of Neurology, Haukeland University Hospital, Bergen, Norway KG Jebsen Centre for MS-Research, Department of Clinical Medicine, University of Bergen, Norway Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Kjell-Morten
authors.initials: KM
authors.lastname: Myhr
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007115:Immunization Schedule; D016867:Immunocompromised Host; D007155:Immunologic Factors / Q000009:adverse effects*; D007167:Immunotherapy / Q000009:adverse effects* / Q000379:methods; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology*; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000276:immunology*; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D012307:Risk Factors; D012621:Seasons; D013997:Time Factors; D016896:Treatment Outcome; D014611:Vaccination; D064166:Vaccine Potency
chemical_list: D007155:Immunologic Factors; D007252:Influenza Vaccines
keywords: Immunity; immunomodulation; immunotherapy; influenza; multiple sclerosis; pandemic influenza; protection; risk; vaccination