title: Changes of immunogenic profiles between a single dose and one booster influenza vaccination in hemodialysis patients - an 18-week, open-label trial.
abstract: Annual influenza vaccination is recommended, but its efficacy in dialysis population is still controversial. Here we aimed to compare the dynamic changes of immune response between various influenza vaccination protocols in hemodialysis patients. A 18-week open label, non-randomized, controlled trial was conducted during 2011-2012. The efficacy between unvaccinated, one- and two-dose regimens were evaluated in 175 hemodialysis patients. Immunogenic profiles were assessed by hemagglutination-inhibition assays. At 3-9 weeks post-vaccination, antibody responses were similar between the one- and two-dose regimens, while the seroprotection rates (antibody titer ≥1:40) for influenza A were 55.6-82.5% in the adult (18-60 years) and 33.3-66.7% in the elderly (>60 years). Meanwhile, the seroprotection rates for influenza B were low (4.0-25.0%). By 18 weeks post-vaccination, the seroprotection rates for influenza A and B declined (0.0-33.3%) in both the adult and elderly receiving one- or two-dose regimens. Of dialysis patients, at most 2.4% developed moderate to severe adverse effects(myalgia and headache) after vaccination. In conclusion, the two-dose regimen could not improve immune responses than the one-dose regimen in hemodialysis patients; meanwhile the induced protective antibodies of both regimens could not be maintained for more than 4 months. Modification of current influenza vaccination strategy in dialysis population should be re-considered.
authors: Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors: Yu-Tzu
authors: YT
authors: Chang
authors: Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan.
authors: Jen-Ren
authors: JR
authors: Wang
authors: Department of Internal Medicine, Kuo General Hospital, Tainan, Taiwan.
authors: Meng-Te
authors: MT
authors: Lin
authors: Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan, Taiwan.
authors: Chi-Jung
authors: CJ
authors: Wu
authors: Department of Internal Medicine, Kuo General Hospital, Tainan, Taiwan.
authors: Ming-Song
authors: MS
authors: Tsai
authors: Department of Internal Medicine, Kuo General Hospital, Tainan, Taiwan.
authors: Chiang Lin
authors: CL
authors: Wen-Chi
authors: Department of Internal Medicine, Kuo General Hospital, Tainan, Taiwan.
authors: Te-En
authors: TE
authors: Shih
authors: Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors: Te-Hui
authors: TH
authors: Kuo
authors: Department of Bioscience Technology, Chang Jung Christian University, Tainan, Taiwan.
authors: Eing-Ju
authors: EJ
authors: Song
authors: Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.|Department of Internal Medicine, Kuo General Hospital, Tainan, Taiwan.
authors: Junne-Ming
authors: JM
authors: Sung
mesh_terms: D000328:Adult; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007117:Immunization, Secondary; D007251:Influenza, Human / Q000276:immunology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D006435:Renal Dialysis; D016896:Treatment Outcome; D014611:Vaccination / Q000009:adverse effects