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Effect of a second, booster, influenza vaccination on antibody responses in quiescent systemic lupus erythematosus: An open, prospective, controlled study
Rheumatology, 08/24/09

Holvast A et al. – Study reports that additional value of a booster influenza vaccination in systemic lupus erythematosus (SLE) is limited to patients who were not vaccinated in the previous year.

• Aim was to assess whether a booster vaccination could improve antibody responses, as determined by seroprotection rates, in SLE pts
• SLE pts (n=52) with quiescent disease (SLEDAI ≤4) and healthy controls (HCs) (n=28) received subunit influenza vaccine in Oct-Dec 2007
• After 4 wks, only SLE pts received a second dose of vaccination
• Sera were obtained before both vaccinations, and 4 wks after the second vaccination
• At each visit, SLE disease activity was recorded
• The haemagglutination inhibition test was used to measure antibody titres
• Seroprotection was defined as a titre ≥40

• Following the first vaccination, seroprotection rates and geometric mean titres (GMTs) to each vaccine strain increased in both SLE pts and controls to comparable levels
• Seroprotection rates in SLE pts after the first vaccination were:
  • 86.5% to A/H1N1
  • 80.8% to A/H3N2, and
  • 61.5% to the B-strain
  • While GMTs were 92.6, 56.2 and 39.2, respectively
• Overall, the booster vaccination did not lead to a further rise of seroprotection rates and GMTs in SLE pts
• However, in pts not vaccinated in the previous year, GMT and seroconversion rate to A/H1N1 did rise following the booster vaccination
• Both influenza vaccinations did not increase SLEDAI scores

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