Variable efficacy of repeated annual influenza vaccination

Derek J. Smith, Stephanie Forrest, David H. Ackley, Alan S. Perelson

Research output: Contribution to journalArticle

220 Citations (Scopus)

Abstract

Conclusions have differed in studies that have compared vaccine efficacy in groups receiving influenza vaccine for the first time to efficacy in groups vaccinated more than once. For example, the Hoskins study [Hoskins, T. W., Davis, J. R., Smith, A. J., Miller, C. L. and Aiichin, A. (1979) Lancet i, 33-35] concluded that repeat vaccination was not protective in the long term, whereas the Keitel study [Keitel, W. A., Cate, T. R., Couch, R. B., Huggins, L. L. and Hess, K. R. (1997) Vaccine 15, 1114-1122] concluded that repeat vaccination provided continual protection. We propose an explanation, the antigenic distance hypothesis, and test it by analyzing seven influenza outbreaks that occurred during the Hoskins and Keitel studies. The hypothesis is that variation in repeat vaccine efficacy is due to differences in antigenic distances among vaccine strains and between the vaccine strains and the epidemic strain in each outbreak. To test the hypothesis, antigenic distances were calculated from historical hemagglutination inhibition assay tables, and a computer model of the immune response was used to predict the vaccine efficacy of individuals given different vaccinations. The model accurately predicted the observed vaccine efficacies in repeat vaccinees relative to the efficacy in first-time vaccinees (correlation 0.87). Thus, the antigenic distance hypotheSiS offers a parsimonious explanation of the differences between and within the Hoskins and Keitel studies. These results have implications for the selection of influenza vaccine strains, and also for vaccination strategies for other antigenically variable pathogens that might require repeated vaccination.

Original languageEnglish (US)
Pages (from-to)14001-14006
Number of pages6
JournalProceedings of the National Academy of Sciences of the United States of America
Volume96
Issue number24
DOIs
StatePublished - Nov 23 1999
Externally publishedYes

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Human Influenza
Vaccination
Vaccines
Influenza Vaccines
Disease Outbreaks
Hemagglutination
Computer Simulation

Keywords

  • Antigenic distance
  • Original antigenic sin
  • Repeated vaccination
  • Vaccine efficacy

ASJC Scopus subject areas

  • General

Cite this

Variable efficacy of repeated annual influenza vaccination. / Smith, Derek J.; Forrest, Stephanie; Ackley, David H.; Perelson, Alan S.

In: Proceedings of the National Academy of Sciences of the United States of America, Vol. 96, No. 24, 23.11.1999, p. 14001-14006.

Research output: Contribution to journalArticle

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