Research Paper Volume 12, Issue 24 pp 24633—24650
The impact of physical frailty on the response to inactivated influenza vaccine in older adults
- 1 Department of Family Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
- 2 Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA 15213, USA
- 3 Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA 15224, USA
- 4 Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA 15261, USA
- 5 Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA
- 6 Ohio State University College of Nursing, Columbus, OH 43210, USA
- 7 National Center for Immunization and Respiratory Diseases, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
Received: August 14, 2020 Accepted: October 27, 2020 Published: December 9, 2020https://doi.org/10.18632/aging.202207
How to Cite
Copyright: © 2020 Moehling et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Physical frailty’s impact on hemagglutination inhibition antibody titers (HAI) and peripheral blood mononuclear cell (PBMC) transcriptional responses after influenza vaccination is unclear. Physical frailty was assessed using the 5-item Fried frailty phenotype in 168 community- and assisted-living adults ≥55 years of age during an observational study. Blood was drawn before, 3, 7, and 28 days post-vaccination with the 2017-2018 inactivated influenza vaccine. HAI response to the A/H1N1 strain was measured at Days 0 and 28 using seropositivity, seroconversion, log2 HAI titers, and fold-rise in log2 HAI titers. RNA sequencing of PBMCs from Days 0, 3 and 7 was measured in 28 participants and compared using pathway analyses. Frailty was not significantly associated with any HAI outcome in multivariable models. Compared with non-frail participants, frail participants expressed decreased cell proliferation, metabolism, antibody production, and interferon signaling genes. Conversely, frail participants showed elevated gene expression in IL-8 signaling, T-cell exhaustion, and oxidative stress pathways compared with non-frail participants. These results suggest that reduced effectiveness of influenza vaccine among older, frail individuals may be attributed to immunosenescence-related changes in PBMCs that are not reflected in antibody levels.