Adverse Reactions of Trivalent Influenza Vaccine in HIV-Infected Individuals
In this study, we assessed the adverse reactions to influenza vaccination in HIV- infected individuals. From November 2006 to January 2007, a total of 203 HIV-infected persons were recruited. Demographic data were collected. Subjects were evaluated 48 h and 15 days after vaccination for symptoms and significant health events as possible side effects. Participants were instructed to measure their temperature in the morning and evening for 2 days post-immunization and to assess injection site and systemic adverse reactions. 80.3% of the subjects were male. The mean age of the subjects was 36.9±7.9 years. Local and systemic reactions were reported by 61 (30%) and 62 (30.5%) persons, respectively. The most common adverse reactions to the influenza vaccine included skin redness (37 cases), induration (32 cases), and pain (55 cases) as local reac-tions, and fever (22 cases), myalgia (46 cases), headache (12 cases) and weakness (35 cases) as general reactions. 1.4 % of the subjects had fever over 38.5 ºC. There were significant associations between myalgia and flushing with CD4 counts (P
Kempe A, Hall CB, McDonald NE, Foye HR, Woodin KA, Cohen HJ, Lewis ED, Gullace M, Gala CL, Dulberg CS. Influenza in children with cancer. J Pediatr 1989; 115: 33-39.
Couch RB, Englund JA, Whimbey E . Respiratory viral infections in immunocompetent and immunocompromised persons. Am J Med 1997; 102: 2-9.
Fine AD, Bridges CB, De Guzman AM, Glover L, Zeller B, Wong SJ, Baker I, Regnery H, Fukuda K. Influenza A among patients with human immunodeficiency virus: An outbreak of infection at a residential facility in New York City. Clin Infect Dis 2001; 32:1784-91.
O'Brien WA, Grovit-Ferbas K, Namazi A, Ovcak-Derzic S, Wang HJ, Park J, Yeramian C, Mao SH, Zack JA. Human immunodeficiency virus-type 1 replication can be increased in peripheral blood of seropositive patients after influenza vaccination. Blood 1995; 86:1082-9.
Ho DD. HIV-1 viraemia and influenza. Lancet 1992; 339(8808):1549.
Brichacek B, Swindells S, Janoff EN, Pirruccello S, Stevenson M. Increased plasma human immunodeficiency virus type 1 burden following antigenic challenge with pneumococcal vaccine. J Infect Dis 1996; 174:1191-9.
Rosok B, Voltersvik P, Bjerknes R, Axelsson M, Haaheim LR, Asjo B. Dynamics of HIV-1 replication following influenza vaccination of HIV+ individuals. Clin Exp Immunol 1996; 104:203-7.
Staprans SI, Hamilton BL, Follansbee SE, Elbeik T, Barbosa P, Grant RM, Feinberg MB: Activation of virus replication after vaccination of HIV-1-infected individuals. J Exp Med 1995; 182:1727-37.
Vigano A, Bricalli D, Trabattoni D, Salvaggio A, Ruzzante S, Barbi M, Di Sanzo G, Principi N, Clerici M. Immunization with both T cell-dependent and T cell-independent vaccines augments HIV viral load secondarily to stimulation of tumor necrosis factor alpha. AIDS Res Hum Retroviruses 1998; 14:727-34.
Kroon FP, van Dissel JT, de Jong JC, van Furth R. Antibody response to influenza, tetanus and pneumococcal vaccines in HIV-seropositive individuals in relation to the number of CD4+ lymphocytes. AIDS 1994; 8:469-76.
Miotti PG, Nelson KE, Dallabetta GA, Farzadegan H, Margolick J, Clements ML. The influence of HIV infection on antibody responses to a two-dose regimen of influenza vaccine. JAMA 1989; 262:779-83.
Nelson KE, Clements ML, Miotti P, Cohn S, Polk BF. The influence of human immunodeficiency virus (HIV) infection on antibody responses to influenza vaccines. Intern Med 1988; 109:383-8.
Chadwick EG, Chang G, Decker MD, Yogev R, Dimichele D, Edwards KM. Serologic response to standard inactivated influenza vaccine in human immunodeficiency virusinfected children. Pediatr Infect Dis J 1994; 13:206-11.
Ragni MV, Ruben FL, Winkelstein A, Spero JA, Bontempo FA, Lewis JH. Antibody responses to immunization of patients with hemophilia with and without evidence of human immunodeficiency virus (human T-lymphotropic virus type III) infection. J Lab Clin Med 1987; 109:545-9.
Jackson CR, Vavro CL, Valentine ME, Pennington KN,Lanier ER, Katz SL, Diliberti JH, McKinney RE, Wilfert CM, St Clair MH. Effect of influenza immunization on immunologic and virologic characteristics of pediatric patients infected with human immunodeficiency virus. Pediatr Infect Dis J 1997; 16:200-4.
Bridges CB, Fukuda K, Cox NJ, Singleton JA. Advisory Committee on Immunization Practices. Prevention and controlof influenza. Recommendations of the advisory committee on immunization practices (ACIP). MMWR Recomm Rep 2001; 50(RR-4):1.
Centers for Disease Control and Prevention. Recommended Adult Immunization Schedule-United States, October 2006–September 2007, MMWR Recomm Rep. 2006; 55:Q1–Q4.
Smith NM, Bresee JS, et al. Advisory Committee on Immunization Practices, Prevention and Control of Influenza: recommendations of the Advisory Committee on immunization Practices (ACIP). MMWR Recomm Rep 2006; 55:1-42.
CDC-Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on immunization practices (ACIP). MMWR Morb Mortal Wkly Rep 2002; 51: 1-31.
Tasker SA, Treanor JJ, Paxton WB, Wallace MR. Efficacy of influenza vaccination in HIV infected persons. A randomized, doubleblind, placebo-controlled trial. Ann Intern Med 1999; 131:430-433.
Brydak LB, Machala M. Humoral immune response to influenza vaccination in patients from high risk groups. Drug 2000; 60:35-53.
Centers for Disease Control. Influenza vaccination coverage levels in selected sites-United States. MMWR 1990; 39:111-3.
Mostow SR, Schoenbaum SC, Dowdle WR. Studies with inactivated influenza vaccine purified by zonal centrifugation.
I. Adverse reactions and serological response. Bull World Health Organ 1969; 41:525-30.
Margolis Kb, Nichol Kb, Poland GA, Pluhar RE. Frequency of adverse reactions to influenza vaccine in the elderly. A randomised, placebo controlled trial. JAMA 1990; 264:1139-41.
Margolis Kb, Poland GA, Nichol Kb, MacPherson DS, Meyer JD, Kom JE, et al. Frequency of adverse reactions after influenza vaccination. Am J Med 1990; 88:27-30.
Palache AM. Influenza vaccination. The effect of dose and age of the antibody response (thesis). Rotterdam: Erasmus Universiteit Rotterdam. 1991.
Scheifel DW, Bjomson G, Johnston J. Evaluation of adverse events after influenza vaccination in hospital personnel. Can Med Assoc J 1990; 142:127-30.
Gabutti G, Guido M, Durando P, De Donno A, Quattrocchi M. Safety and immunogenicity of conventional subunit and MF59-adjuvanted influenza vaccines in human immunodeficiency virus-1-seropositive patients. J Int Med Res. 2005; 3: 406-16.
Zuccotti GV, Zenga A, Durando P, Massone L, Bruzzone B, Sala D, Riva E. Immunogenicity and tolerability of a trivalent virosomal influenza vaccine in a cohort of HIVinfected children. J Int Med Res. 2004; 32:492-9.
Prevention and control of influenza. Recommendations of the Advisory Committee on immunization practices. MMWR 2004; 53(RR06):1-40.
Mostow Sr, Eickhof TC, Chelgren GA, Retaillou HF, Castle M. Studies of inactivated influenza virus vaccines in hospital employees. J Infect Dis 1977; 136: S533-8.
Masurel N, Laufer J. A one-year study of trivalent influenza vaccines in primed and unprimed volunteers: immunogenicity, clinical reactions and protection. J Hyg (Lond) 1984; 92:263-76.
Cate TR, Kasel JA, Couch RB, Six HR, Knight V. Clinical trials of bivalent influenza A/New Jersey/76-A/Victoria/75 vaccines in the elderly. J Infect Dis 1977; 136(suppl): 5518- 25.