A clinical trial of intradermal and intramuscular seasonal influenza vaccination in patients with atopic dermatitis

Donald Y M Leung, Brett Jepson, Lisa A. Beck, Jon Hanifin, Lynda C. Schneider, Amy S. Paller, Katherine Monti, Gloria David, Jennifer Canniff, Margarita Gomez Lorenzo, Adriana Weinberg

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Antibody responses to the inactivated seasonal influenza vaccine in patients with atopic dermatitis (AD) have not been carefully characterized. Objective: The primary objective of this study was to compare antibody responses to intradermal vaccination in participants with moderate/severe AD with those in nonatopic participants. Secondary objectives were to evaluate the effect of route of administration, Staphylococcus aureus skin colonization, and disease severity on vaccine response. Methods: This was an open-label study conducted in the 2012-2013 influenza season at 5 US clinical sites. A total of 360 participants with moderate/severe AD or nonatopic subjects were assessed for eligibility, 347 of whom received intradermal or intramuscular vaccination per label and were followed for 28 days after vaccination. The primary outcome was the difference in the proportion of participants achieving seroprotection (hemagglutination-inhibition antibody titer ≥1:40 on day 28 after vaccination). Results: Seroprotection rates for influenza B, H1N1, and H3N2 were not different (1) between participants with AD and nonatopic participants receiving intradermal vaccination and (2) between AD participants receiving intradermal and intramuscular vaccination. After intradermal, but not intramuscular, vaccination, participants with AD with S aureus colonization experienced (1) lower seroprotection and seroconversion rates and lower hemagglutination-inhibition antibody titer geometric mean fold increase against influenza B and (2) lower seroconversion rates against influenza H1N1 than noncolonized participants with AD. Conclusion: Participants with AD colonized with S aureus exhibited a reduced immune response to influenza vaccination compared with noncolonized participants after intradermal but not intramuscular vaccination. Because most patients with AD are colonized with S aureus, intramuscular influenza vaccination should be given preference in these patients.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology
DOIs
StateAccepted/In press - May 27 2016

Fingerprint

Atopic Dermatitis
Human Influenza
Vaccination
Clinical Trials
Hemagglutination
Antibody Formation
Patient Preference
Antibodies
Influenza Vaccines
Skin Diseases
Staphylococcus aureus
Vaccines

Keywords

  • Antibody
  • Atopic dermatitis
  • Eczema
  • Influenza
  • Skin
  • Staphylococcus aureus
  • Vaccination

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

A clinical trial of intradermal and intramuscular seasonal influenza vaccination in patients with atopic dermatitis. / Leung, Donald Y M; Jepson, Brett; Beck, Lisa A.; Hanifin, Jon; Schneider, Lynda C.; Paller, Amy S.; Monti, Katherine; David, Gloria; Canniff, Jennifer; Lorenzo, Margarita Gomez; Weinberg, Adriana.

In: Journal of Allergy and Clinical Immunology, 27.05.2016.

Research output: Contribution to journalArticle

Leung, Donald Y M ; Jepson, Brett ; Beck, Lisa A. ; Hanifin, Jon ; Schneider, Lynda C. ; Paller, Amy S. ; Monti, Katherine ; David, Gloria ; Canniff, Jennifer ; Lorenzo, Margarita Gomez ; Weinberg, Adriana. / A clinical trial of intradermal and intramuscular seasonal influenza vaccination in patients with atopic dermatitis. In: Journal of Allergy and Clinical Immunology. 2016.
@article{ffab5a1c23034c35935b4dd324fe7257,
title = "A clinical trial of intradermal and intramuscular seasonal influenza vaccination in patients with atopic dermatitis",
abstract = "Background: Antibody responses to the inactivated seasonal influenza vaccine in patients with atopic dermatitis (AD) have not been carefully characterized. Objective: The primary objective of this study was to compare antibody responses to intradermal vaccination in participants with moderate/severe AD with those in nonatopic participants. Secondary objectives were to evaluate the effect of route of administration, Staphylococcus aureus skin colonization, and disease severity on vaccine response. Methods: This was an open-label study conducted in the 2012-2013 influenza season at 5 US clinical sites. A total of 360 participants with moderate/severe AD or nonatopic subjects were assessed for eligibility, 347 of whom received intradermal or intramuscular vaccination per label and were followed for 28 days after vaccination. The primary outcome was the difference in the proportion of participants achieving seroprotection (hemagglutination-inhibition antibody titer ≥1:40 on day 28 after vaccination). Results: Seroprotection rates for influenza B, H1N1, and H3N2 were not different (1) between participants with AD and nonatopic participants receiving intradermal vaccination and (2) between AD participants receiving intradermal and intramuscular vaccination. After intradermal, but not intramuscular, vaccination, participants with AD with S aureus colonization experienced (1) lower seroprotection and seroconversion rates and lower hemagglutination-inhibition antibody titer geometric mean fold increase against influenza B and (2) lower seroconversion rates against influenza H1N1 than noncolonized participants with AD. Conclusion: Participants with AD colonized with S aureus exhibited a reduced immune response to influenza vaccination compared with noncolonized participants after intradermal but not intramuscular vaccination. Because most patients with AD are colonized with S aureus, intramuscular influenza vaccination should be given preference in these patients.",
keywords = "Antibody, Atopic dermatitis, Eczema, Influenza, Skin, Staphylococcus aureus, Vaccination",
author = "Leung, {Donald Y M} and Brett Jepson and Beck, {Lisa A.} and Jon Hanifin and Schneider, {Lynda C.} and Paller, {Amy S.} and Katherine Monti and Gloria David and Jennifer Canniff and Lorenzo, {Margarita Gomez} and Adriana Weinberg",
year = "2016",
month = "5",
day = "27",
doi = "10.1016/j.jaci.2016.12.952",
language = "English (US)",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - A clinical trial of intradermal and intramuscular seasonal influenza vaccination in patients with atopic dermatitis

AU - Leung, Donald Y M

AU - Jepson, Brett

AU - Beck, Lisa A.

AU - Hanifin, Jon

AU - Schneider, Lynda C.

AU - Paller, Amy S.

AU - Monti, Katherine

AU - David, Gloria

AU - Canniff, Jennifer

AU - Lorenzo, Margarita Gomez

AU - Weinberg, Adriana

PY - 2016/5/27

Y1 - 2016/5/27

N2 - Background: Antibody responses to the inactivated seasonal influenza vaccine in patients with atopic dermatitis (AD) have not been carefully characterized. Objective: The primary objective of this study was to compare antibody responses to intradermal vaccination in participants with moderate/severe AD with those in nonatopic participants. Secondary objectives were to evaluate the effect of route of administration, Staphylococcus aureus skin colonization, and disease severity on vaccine response. Methods: This was an open-label study conducted in the 2012-2013 influenza season at 5 US clinical sites. A total of 360 participants with moderate/severe AD or nonatopic subjects were assessed for eligibility, 347 of whom received intradermal or intramuscular vaccination per label and were followed for 28 days after vaccination. The primary outcome was the difference in the proportion of participants achieving seroprotection (hemagglutination-inhibition antibody titer ≥1:40 on day 28 after vaccination). Results: Seroprotection rates for influenza B, H1N1, and H3N2 were not different (1) between participants with AD and nonatopic participants receiving intradermal vaccination and (2) between AD participants receiving intradermal and intramuscular vaccination. After intradermal, but not intramuscular, vaccination, participants with AD with S aureus colonization experienced (1) lower seroprotection and seroconversion rates and lower hemagglutination-inhibition antibody titer geometric mean fold increase against influenza B and (2) lower seroconversion rates against influenza H1N1 than noncolonized participants with AD. Conclusion: Participants with AD colonized with S aureus exhibited a reduced immune response to influenza vaccination compared with noncolonized participants after intradermal but not intramuscular vaccination. Because most patients with AD are colonized with S aureus, intramuscular influenza vaccination should be given preference in these patients.

AB - Background: Antibody responses to the inactivated seasonal influenza vaccine in patients with atopic dermatitis (AD) have not been carefully characterized. Objective: The primary objective of this study was to compare antibody responses to intradermal vaccination in participants with moderate/severe AD with those in nonatopic participants. Secondary objectives were to evaluate the effect of route of administration, Staphylococcus aureus skin colonization, and disease severity on vaccine response. Methods: This was an open-label study conducted in the 2012-2013 influenza season at 5 US clinical sites. A total of 360 participants with moderate/severe AD or nonatopic subjects were assessed for eligibility, 347 of whom received intradermal or intramuscular vaccination per label and were followed for 28 days after vaccination. The primary outcome was the difference in the proportion of participants achieving seroprotection (hemagglutination-inhibition antibody titer ≥1:40 on day 28 after vaccination). Results: Seroprotection rates for influenza B, H1N1, and H3N2 were not different (1) between participants with AD and nonatopic participants receiving intradermal vaccination and (2) between AD participants receiving intradermal and intramuscular vaccination. After intradermal, but not intramuscular, vaccination, participants with AD with S aureus colonization experienced (1) lower seroprotection and seroconversion rates and lower hemagglutination-inhibition antibody titer geometric mean fold increase against influenza B and (2) lower seroconversion rates against influenza H1N1 than noncolonized participants with AD. Conclusion: Participants with AD colonized with S aureus exhibited a reduced immune response to influenza vaccination compared with noncolonized participants after intradermal but not intramuscular vaccination. Because most patients with AD are colonized with S aureus, intramuscular influenza vaccination should be given preference in these patients.

KW - Antibody

KW - Atopic dermatitis

KW - Eczema

KW - Influenza

KW - Skin

KW - Staphylococcus aureus

KW - Vaccination

UR - http://www.scopus.com/inward/record.url?scp=85012273736&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85012273736&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2016.12.952

DO - 10.1016/j.jaci.2016.12.952

M3 - Article

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

SN - 0091-6749

ER -