Seasonal trivalent inactivated influenza vaccine with topical imiquimod in immunocompromised patients: A randomized controlled trial

Matteo Mombelli; Katja Hoschler; Matthias Cavassini; Manuel Pascual; Oriol Manuel

doi:10.1016/j.jinf.2021.07.010

Seasonal trivalent inactivated influenza vaccine with topical imiquimod in immunocompromised patients: A randomized controlled trial

Matteo Mombelli^*, Katja Hoschler, Matthias Cavassini, Manuel Pascual, Oriol Manuel

^*Corresponding author for this work

Immunisation Hepatitis and Blood Safety

Research output: Contribution to journal › Article › peer-review

7 Citations (Scopus)

Abstract

Background: The effect of the Toll-like receptor 7 agonist imiquimod before intradermal (ID) or intramuscular (IM) influenza vaccine in immunocompromised hosts is unknown.

Methods: In this open-label randomized controlled trial, kidney transplant recipients (KT) and people living with HIV (PLWH) were randomized to receive IM trivalent inactivated influenza vaccine alone (IM), IM vaccine after topical imiquimod (imi+IM) or ID vaccine after topical imiquimod (imi+ID). Immunogenicity was assessed by hemagglutination inhibition assay. The primary outcome was vaccine response, defined as seroconversion to at least one viral strain at day 21.

Results: Seventy patients (35 KT and 35 PLWH) received IM (24), imi+IM (22), or imi+ID (24) vaccine. Vaccine response was 61% (14/23) with IM, 59% (13/22) with imi+IM, and 65% (15/23) with imi+ID vaccine (P = 0.909). Vaccine response was associated with HIV infection compared to kidney transplantation (adjusted-OR 3.74, 95% CI 1.25 – 11.23, P = 0.019), but not with imiquimod application nor ID injection. After vaccination, seroprotection to all viral strains was 79% (19/24) with IM, 68% (15/22) with imi+IM, and 70% (16/23) with imi+ID (P = 0.657). We did not observe any vaccine-related severe adverse event.

Conclusions: In our study, topical imiquimod did not improve the immunogenicity of influenza vaccine in KT and in PLWH.

Original language	English
Pages (from-to)	354-360
Number of pages	7
Journal	Journal of Infection
Volume	83
Issue number	3
Early online date	21 Jul 2021
DOIs	https://doi.org/10.1016/j.jinf.2021.07.010
Publication status	Published - Sept 2021

Bibliographical note

Funding Information: This work was supported by the “Bourse de la relève 2016″ of the Leenaards Foundation awarded to OM.

OM reports grants from Lophius Biosciences, personal fees from MSD, personal fees from Gilead, outside the submitted work. MC reports grants from Gilead, MSD and Viiv, outside the submitted work paid to his institution. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

Open Access: No Open Access licence

Publisher Copyright: © 2021 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Citation: Matteo Mombelli, Katja Hoschler, Matthias Cavassini, Manuel Pascual, Oriol Manuel, Seasonal trivalent inactivated influenza vaccine with topical imiquimod in immunocompromised patients: A randomized controlled trial, Journal of Infection, Volume 83, Issue 3, 2021, Pages 354-360, ISSN 0163-4453.

DOI: https://doi.org/10.1016/j.jinf.2021.07.010.

Keywords

Imiquimod
Influenza
Influenza vaccines

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jinf.2021.07.010

Cite this

@article{2428e2c1207c4be8937771c55d036d28,

title = "Seasonal trivalent inactivated influenza vaccine with topical imiquimod in immunocompromised patients: A randomized controlled trial",

abstract = "Background: The effect of the Toll-like receptor 7 agonist imiquimod before intradermal (ID) or intramuscular (IM) influenza vaccine in immunocompromised hosts is unknown. Methods: In this open-label randomized controlled trial, kidney transplant recipients (KT) and people living with HIV (PLWH) were randomized to receive IM trivalent inactivated influenza vaccine alone (IM), IM vaccine after topical imiquimod (imi+IM) or ID vaccine after topical imiquimod (imi+ID). Immunogenicity was assessed by hemagglutination inhibition assay. The primary outcome was vaccine response, defined as seroconversion to at least one viral strain at day 21. Results: Seventy patients (35 KT and 35 PLWH) received IM (24), imi+IM (22), or imi+ID (24) vaccine. Vaccine response was 61% (14/23) with IM, 59% (13/22) with imi+IM, and 65% (15/23) with imi+ID vaccine (P = 0.909). Vaccine response was associated with HIV infection compared to kidney transplantation (adjusted-OR 3.74, 95% CI 1.25 – 11.23, P = 0.019), but not with imiquimod application nor ID injection. After vaccination, seroprotection to all viral strains was 79% (19/24) with IM, 68% (15/22) with imi+IM, and 70% (16/23) with imi+ID (P = 0.657). We did not observe any vaccine-related severe adverse event. Conclusions: In our study, topical imiquimod did not improve the immunogenicity of influenza vaccine in KT and in PLWH.",

keywords = "Imiquimod, Influenza, Influenza vaccines",

author = "Matteo Mombelli and Katja Hoschler and Matthias Cavassini and Manuel Pascual and Oriol Manuel",

note = "Funding Information: This work was supported by the “Bourse de la rel{\`e}ve 2016″ of the Leenaards Foundation awarded to OM. OM reports grants from Lophius Biosciences, personal fees from MSD, personal fees from Gilead, outside the submitted work. MC reports grants from Gilead, MSD and Viiv, outside the submitted work paid to his institution. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Open Access: No Open Access licence Publisher Copyright: {\textcopyright} 2021 The British Infection Association. Published by Elsevier Ltd. All rights reserved. Citation: Matteo Mombelli, Katja Hoschler, Matthias Cavassini, Manuel Pascual, Oriol Manuel, Seasonal trivalent inactivated influenza vaccine with topical imiquimod in immunocompromised patients: A randomized controlled trial, Journal of Infection, Volume 83, Issue 3, 2021, Pages 354-360, ISSN 0163-4453. DOI: https://doi.org/10.1016/j.jinf.2021.07.010.",

year = "2021",

month = sep,

doi = "10.1016/j.jinf.2021.07.010",

language = "English",

volume = "83",

pages = "354--360",

journal = "Journal of Infection",

issn = "0163-4453",

publisher = "British Infection Society",

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TY - JOUR

T1 - Seasonal trivalent inactivated influenza vaccine with topical imiquimod in immunocompromised patients

T2 - A randomized controlled trial

AU - Mombelli, Matteo

AU - Hoschler, Katja

AU - Cavassini, Matthias

AU - Pascual, Manuel

AU - Manuel, Oriol

N1 - Funding Information: This work was supported by the “Bourse de la relève 2016″ of the Leenaards Foundation awarded to OM. OM reports grants from Lophius Biosciences, personal fees from MSD, personal fees from Gilead, outside the submitted work. MC reports grants from Gilead, MSD and Viiv, outside the submitted work paid to his institution. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Open Access: No Open Access licence Publisher Copyright: © 2021 The British Infection Association. Published by Elsevier Ltd. All rights reserved. Citation: Matteo Mombelli, Katja Hoschler, Matthias Cavassini, Manuel Pascual, Oriol Manuel, Seasonal trivalent inactivated influenza vaccine with topical imiquimod in immunocompromised patients: A randomized controlled trial, Journal of Infection, Volume 83, Issue 3, 2021, Pages 354-360, ISSN 0163-4453. DOI: https://doi.org/10.1016/j.jinf.2021.07.010.

PY - 2021/9

Y1 - 2021/9

N2 - Background: The effect of the Toll-like receptor 7 agonist imiquimod before intradermal (ID) or intramuscular (IM) influenza vaccine in immunocompromised hosts is unknown. Methods: In this open-label randomized controlled trial, kidney transplant recipients (KT) and people living with HIV (PLWH) were randomized to receive IM trivalent inactivated influenza vaccine alone (IM), IM vaccine after topical imiquimod (imi+IM) or ID vaccine after topical imiquimod (imi+ID). Immunogenicity was assessed by hemagglutination inhibition assay. The primary outcome was vaccine response, defined as seroconversion to at least one viral strain at day 21. Results: Seventy patients (35 KT and 35 PLWH) received IM (24), imi+IM (22), or imi+ID (24) vaccine. Vaccine response was 61% (14/23) with IM, 59% (13/22) with imi+IM, and 65% (15/23) with imi+ID vaccine (P = 0.909). Vaccine response was associated with HIV infection compared to kidney transplantation (adjusted-OR 3.74, 95% CI 1.25 – 11.23, P = 0.019), but not with imiquimod application nor ID injection. After vaccination, seroprotection to all viral strains was 79% (19/24) with IM, 68% (15/22) with imi+IM, and 70% (16/23) with imi+ID (P = 0.657). We did not observe any vaccine-related severe adverse event. Conclusions: In our study, topical imiquimod did not improve the immunogenicity of influenza vaccine in KT and in PLWH.

AB - Background: The effect of the Toll-like receptor 7 agonist imiquimod before intradermal (ID) or intramuscular (IM) influenza vaccine in immunocompromised hosts is unknown. Methods: In this open-label randomized controlled trial, kidney transplant recipients (KT) and people living with HIV (PLWH) were randomized to receive IM trivalent inactivated influenza vaccine alone (IM), IM vaccine after topical imiquimod (imi+IM) or ID vaccine after topical imiquimod (imi+ID). Immunogenicity was assessed by hemagglutination inhibition assay. The primary outcome was vaccine response, defined as seroconversion to at least one viral strain at day 21. Results: Seventy patients (35 KT and 35 PLWH) received IM (24), imi+IM (22), or imi+ID (24) vaccine. Vaccine response was 61% (14/23) with IM, 59% (13/22) with imi+IM, and 65% (15/23) with imi+ID vaccine (P = 0.909). Vaccine response was associated with HIV infection compared to kidney transplantation (adjusted-OR 3.74, 95% CI 1.25 – 11.23, P = 0.019), but not with imiquimod application nor ID injection. After vaccination, seroprotection to all viral strains was 79% (19/24) with IM, 68% (15/22) with imi+IM, and 70% (16/23) with imi+ID (P = 0.657). We did not observe any vaccine-related severe adverse event. Conclusions: In our study, topical imiquimod did not improve the immunogenicity of influenza vaccine in KT and in PLWH.

KW - Imiquimod

KW - Influenza

KW - Influenza vaccines

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U2 - 10.1016/j.jinf.2021.07.010

DO - 10.1016/j.jinf.2021.07.010

M3 - Article

AN - SCOPUS:85111870548

SN - 0163-4453

VL - 83

SP - 354

EP - 360

JO - Journal of Infection

JF - Journal of Infection

IS - 3

ER -

Seasonal trivalent inactivated influenza vaccine with topical imiquimod in immunocompromised patients: A randomized controlled trial

Abstract

Bibliographical note

Keywords

UN SDGs

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