Efficacy of the Trivalent Influenza Vaccination in Thai Patients with Hemodialysis or Kidney Transplant Compared with Healthy Volunteers
Udom Krairittichai MD*, Malinee Chittaganpitch MSc**
Affiliation : * Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand ** Respiratory virus section, National Institute of Health, Department of Medical Sciences, Bangkok, Thailand
Objective : To evaluate the immune response to trivalent influenza vaccination in Thai patients with hemodialysis (HD) or
kidney transplant (KT) compared with healthy volunteers.
Material and Method: This was a cross-sectional study in Thai healthy volunteers and patients with HD and KT who
received the trivalent influenza vaccine provided by the Ministry of Public Health of Thailand from 1 November 2011 to 31
December 2011. Each subject was injected intramuscularly with one dose (0.5 milliliter) of trivalent influenza vaccine
containing viral strains recommended by the WHO for the 2011 influenza season (southern hemisphere). Blood samples
before and 6 weeks after the vaccination were measured for immune response using a hemagglutination-inhibition antibody
assay.
Results : Subjects consisted of 30 healthy volunteers, 30 patients with HD and 30 patients with KT. Prevalence of pre-
vaccination seroprotective (SP) immunity in each group (healthy volunteers, HD, KT) was as follows: against H1N1 (33.3%:
23.3%: 10.0%), H3N2 (80.0%: 26.7%: 23.3%) and B (60.0%: 20.0%: 3.3%) viral strains, respectively. Those who were
seronegative (SN) before testing positive after one dose of this vaccine were as follows: H1N1 (100.0%: 73.9%: 74.1%),
H3N2 (66.7%: 86.4%: 34.8%) or B (58.3%: 66.7%: 48.3%) viral strains, respectively. The healthy group showed significantly
higher SP immune response for H1N1 than the HD and KT groups (p = 0.023). The HD group had significantly higher SP
immune response for H3N2 than the KT groups (p = 0.001). Immune responses for the B vaccine in all groups were not
different. No major adverse event was found in any group.
Conclusion : Immune response for H1N1 vaccine in the HD and KT groups was slightly less than that of the healthy group.
Immune response for H3N2 vaccine in the KT groups was less than in the healthy and HD groups. Immune responses for
B vaccine in all groups were not different.
Keywords : H1N1 influenza A virus infection, Influenza vaccine
