title: Booster influenza vaccination does not improve immune response in adult inflammatory bowel disease patients treated with immunosuppressives: a randomized controlled trial.
abstract: BACKGROUND
  This research was conducted is to assess the effect of booster doses of the trivalent influenza vaccine in adult inflammatory bowel disease (IBD) patients treated with anti-tumor necrosis factor (TNF)-α agents and/or immunomodulators.
  
  
  METHODS
  Adult IBD patients and healthy individuals were subcutaneously administered the trivalent influenza vaccine. They were randomized into two groups: the single vaccination group and the two vaccination booster group. Blood samples were collected, and the antibody titers against each influenza strain were determined by hemagglutination inhibition at 3 different time points (pre-vaccination, 3 weeks post-vaccination, and after the flu season) in the single vaccination group and at 4 time points (pre-vaccination, 3 weeks post-first vaccination, 3 weeks post-second vaccination, and after the flu season) in the booster vaccination group.
  
  
  RESULTS
  Seventy-eight IBD patients and 11 healthy controls were randomized into the single vaccination group and the booster vaccination group. Twenty-nine patients received immunomodulators; 21 received anti-TNF-α agents; and 28 received a combination of both. No significant differences were observed in the evaluated immune response parameters between 3 weeks post-vaccination in the single vaccination group and 3 weeks post-second vaccination in the booster vaccination group (geometric mean titers: H1N1, p = 0.09; H3N2: p = 0.99; B: p = 0.94). A higher pre-vaccination titer was significantly associated with sufficient seroprotection rate after vaccination for the H1N1 strain (odds ratio 11.93, p = 0.03).
  
  
  CONCLUSIONS
  The second booster of trivalent influenza vaccination did not improve the immune response in adult IBD patients who were treated with immunomodulators and/or anti-TNF-α agents.
authors: Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
authors: Hiroko
authors: H
authors: Matsumoto
authors: Satoko
authors: S
authors: Ohfuji
authors: Kenji
authors: K
authors: Watanabe
authors: Hirokazu
authors: H
authors: Yamagami
authors: Wakaba
authors: W
authors: Fukushima
authors: Kazuhiro
authors: K
authors: Maeda
authors: Noriko
authors: N
authors: Kamata
authors: Mitsue
authors: M
authors: Sogawa
authors: Masatsugu
authors: M
authors: Shiba
authors: Tetsuya
authors: T
authors: Tanigawa
authors: Kazunari
authors: K
authors: Tominaga
authors: Toshio
authors: T
authors: Watanabe
authors: Yasuhiro
authors: Y
authors: Fujiwara
authors: Yoshio
authors: Y
authors: Hirota
authors: Tetsuo
authors: T
authors: Arakawa
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000096:biosynthesis; D005260:Female; D006801:Humans; D007117:Immunization, Secondary / Q000379:methods; D016867:Immunocompromised Host / Q000276:immunology; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D009980:Influenza A virus / Q000276:immunology; D009981:Influenza B virus / Q000276:immunology; D007252:Influenza Vaccines / Q000009:adverse effects / Q000276:immunology*; D007251:Influenza, Human / Q000150:complications / Q000276:immunology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications / Q000276:immunology / Q000517:prevention & control; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014611:Vaccination / Q000379:methods; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007166:Immunosuppressive Agents; D007252:Influenza Vaccines; D014409:Tumor Necrosis Factor-alpha