Imperial College London
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DrAnikaSinganayagam

Faculty of Medicine, Department of Infectious Disease

Clinical Lecturer
 
 
 
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Contact

 

anika.singanayagam

 
 
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Location

 

Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Lindsey,
author = {Lindsey, BB and Singanayagam, A and Tregoning, JS and De, Silva T and Barclay, W},
journal = {Lancet Respiratory Medicine},
title = {The impact of an updated pandemic H1N1 strain on shedding and immunogenicity to Russian-backbone live attenuated influenza vaccine among children in The Gambia: an open-label, observational, phase 4 study},
url = {http://hdl.handle.net/10044/1/68667},
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Poor efficacy and effectiveness of thepandemic H1N1 (pH1N1) component inlive attenuated  influenza  vaccine  (LAIV)has  been  demonstrated  in  several  studies.The  reasons  for this are unclear, butmay be due toimpairedreplicative fitness of pH1N1 A/California/07/2009-like (Cal09) strains.  The aim of this study was to establish whether an updated pH1N1 strain in the Russian-backbone trivalent LAIV resulted in greater shedding and immunogenicitycompared to Cal09.Methods: In an open-label, prospective,observational,phase 4study, we evaluated the impact of updating the pH1N1 component in the WHO prequalified Russian-backbone trivalent LAIV from Cal09in 2016-17(n=118) to an A/Michigan/45/2015-like strain (A/17/New York/15/5364, NY15) in 2017-18(n=126),on  shedding  and  immunogenicity  in  Gambian  children  aged  2-4  years  old.The  study  was  nested  within  a  randomised  controlled  trial  investigating  LAIV-microbiome interactions (ClinicalTrials.gov NCT02972957). Findings: Cal09  showed  impairednasopharyngeal  shedding(13.6%children  shedding at  day  2 post-LAIV)compared to H3N2(45.8%)and influenza B(80.5%), along with sub-optimal serum antibody(5.1%seroconversion)and T-cell  responses(40.5% CD4+IFN-g+ and/or  CD4+IL-2+responders).  Following  the  switch  to  NY15,  a  significant  increase  in pH1N1 shedding(63.5%)was  seen, along with  improvements  in seroconversion(19.1%)and  influenza-specific  CD4+  T-3cell responses(65.7%). The improvement in pH1N1 seroconversion with NY15 was even greater in  children  seronegative  at  baseline(37.5%  vs.  7.6%). Persistent  shedding today 7was independently  associated  with  both  seroconversionand  CD4+  T  cell responsein  multivariable logistic regression. Interpretation:The  pH1N1  component  switch  may  have  overcome  problems  in  prior LAIV formulations.LAIV effectiveness against pH1N1 shouldtherefore improve in upcoming influenza seasons. Our  dataalso highlightthe  importance  of  evaluat
AU  - Lindsey,BB
AU  - Singanayagam,A
AU  - Tregoning,JS
AU  - De,Silva T
AU  - Barclay,W
SN  - 2213-2600
TI  - The impact of an updated pandemic H1N1 strain on shedding and immunogenicity to Russian-backbone live attenuated influenza vaccine among children in The Gambia: an open-label, observational, phase 4 study
T2  - Lancet Respiratory Medicine
UR  - http://hdl.handle.net/10044/1/68667
ER  -
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