Age Differences in Influenza and Herpes Zoster Vaccine Responses (INFLUENZA-SHINGRIX)

Radboud University Medical Center148 enrolled

Overview

Vaccines are used to prevent infectious diseases worldwide. Unfortunately, many vaccines, like the flu vaccine, are less effective in older adults. This single-centre open label partially randomised, partially placebo-controlled trial evaluates the differences in immune response between young and older adults after vaccination with a quadrivalent inactivated influenza vaccine and an adjuvanted herpes zoster vaccination. Exploring the underlying mechanisms between the differences in immunogenicity can provide important information for future vaccine development.

Rationale: Vaccination of the older adults is often advised as they are a high-risk population; however, vaccine efficacy generally decreases with age. This is mainly due to a decrease in adaptive immune responses known as immunosenescence, which is a factor influencing the response to influenza vaccination. On the other hand, there are vaccines that show high efficacy (more than 95%) in older adults, one of the most effective being the AS01 adjuvanted herpes zoster vaccine, Shingrix. The differential immune pathways associated with vaccine responsiveness as well as the immune mechanisms by which adjuvants overcome immunosenescence remain poorly understood. Targeting key immune pathways could be a way to improve vaccine efficacy in older adults. Objective: To explore immunological features between young and older adults after administration of an adjuvanted herpes zoster (Shingrix) or influenza unadjuvanted (Fluarix) vaccine that could explain differences in vaccine immunogenicity. Study design: A single centre open label, randomised, and partially placebo-controlled trial Study population: Approximately 140 healthy adults, 80 of which are between 18-35 years old, the other 60 are 60+ years old. Intervention: Two groups of young and elderly volunteers receive recombinant zoster vaccine (Shingrix), while two other groups will receive a quadrivalent influenza vaccine (Fluarix). Two groups of young volunteers will receive a placebo. Main study parameter: To identify immune senescence-related differences contributing to vaccine immunogenicity

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Interventions

Herpes zoster vaccination (Shingrix, GSK)BIOLOGICAL

Shingrix is an ASO1-adjuvanted herpes zoster vaccination used to prevent shingles and its associated complications in at-risk populations

Influenza Vaccine (Fluarix Tetra Northern Hemisphere 2021 or 2022, GSK)BIOLOGICAL

Fluarix Tetra is a quadrivalent inactivated influenza vaccine

PlaceboBIOLOGICAL

0.9% NaCl

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 18-35 years old OR age ≥60 years old * Written informed consent Exclusion Criteria: * Known allergy to (components of) the influenza or herpes zoster vaccine * Immunocompromised subjects and subjects with active malignancy within the last two years * Previous herpes zoster vaccination in the last year * Receipt of any vaccination 4 weeks prior to the start of the study or plans to receive any other vaccination in the first 2 months after inclusion * Use of systemic immunomodulatory drugs:steroids, anti-inflammatory biological treatments (e.g. anti-cytokine monoclonal antibodies) * Acute or active illness within two weeks prior to the start of the study * Pregnant, breastfeeding or planning to become pregnant during the study period

Locations (1)

Radboud University

Nijmegen, Gelderland, Netherlands

Outcomes

Primary Outcomes

Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

Time frame: 2 months after influenza vaccination

Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

Time frame: 6 months after influenza vaccination

Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

Time frame: 2 months after the first dose of herpes zoster vaccination

Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

Time frame: 2 months after the second dose of herpes zoster vaccination

Changes in cytokine productions of PBMCs upon incubation with viral, bacterial, and fungal antigens

IL-6, TNF, IL-1b, IFNg cytokine concentrations will be measured.

Time frame: 6 months after the second dose of herpes zoster vaccination

Change in transcriptional profile of individual cells from PBMC population

Gene expression profile of PBMCs will be measured by single cell-RNA sequencing.

Time frame: 2 months after influenza vaccination

Change in transcriptional profile of individual cells from PBMC population

Gene expression profile of PBMCs will be measured by single cell-RNA sequencing.

Time frame: 6 months after influenza vaccination

Transcriptional profile of individual cells from PBMC population