Skip to main content
Log in

Humoral Immune Response to Influenza Vaccination in Patients from High Risk Groups

  • Review Article
  • Published:
Drugs Aims and scope Submit manuscript

Abstract

Influenza is one of the most common respiratory diseases. Infections caused by this virus may be very serious and can lead to severe complications. So far, the most effective method of protection against influenza is annual vaccination. The Advisory Committee on Immunisation Practices recommends vaccination against influenza for some groups of people. Unfortunately, in spite of these clear indications, a large number of patients are not vaccinated.

This article reviews the current scientific literature on immunological response to influenza vaccination in patients who are at especially high risk for serious post-influenza complications and for whom immunisation against this virus is strongly recommended. Results of studies carried out in Poland and other countries in elderly people, in patients with pulmonary diseases, renal diseases, diabetes mellitus, cancer and haemophilia, and in those with HIV infection are presented. In this review, we focus on the immune response to haemagglutinin. There are some discrepancies between the results of studies carried out by different authors in high risk groups of patients. Some investigations indicated poorer humoral response to influenza vaccine in these groups, while others showed responses comparable to those in healthy individuals. These differences may be explained by differences in types and stages of the chronic diseases, in the treat-ment and composition of influenza vaccines, and also patients’ ages, vaccination history and prevaccination antibody titres. Influenza vaccines are well tolerated in high risk patients, and all adverse reactions are generally mild and similar to those observed in healthy people. Although, in some cases, immunological responses to influenza vaccination measured in the whole study group were poor, there were some individual patients who, after vaccination, developed antihaema-glutinin antibody titres which are considered to give protection against the infection or contribute to a milder course of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Table I
Table II

Similar content being viewed by others

References

  1. Brydak LB. Influenza and its prophylaxis. Springer PWN: Warsaw, 1998

    Google Scholar 

  2. Van Hoecke Ch, Prikazsky V, Ütö I. Immunogenicity of an inactivated split influenza vaccine in institutionalized elderly patients. Gerontology 1996; 42: 190–8

    Article  PubMed  Google Scholar 

  3. Nichol KL, Lind A, Margolis KL, et al. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med 1995; 333: 889–93

    Article  PubMed  CAS  Google Scholar 

  4. Brydak LB, Bialek J, Rudnicka H, et al. Seroconversion assessment in a billeted military medical university student group after antiinfluenza vaccinations in 1993/1994 in Poland. Anti-infect Drugs Chemother 1997; 15(1): 13–6

    Google Scholar 

  5. Nicholson KG. Socioeconomics of influenza and influenza vaccination in Europe. PharmacoEconomics 1996; 9(3): 75–8

    Article  PubMed  Google Scholar 

  6. Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999; 48: RR–4

    Google Scholar 

  7. Hall CB. Influenza: a shot or not? Pediatrics 1987; 79: 564–6

    PubMed  CAS  Google Scholar 

  8. Groothius JR, Levin MJ, Rabalais GP, et al. Immunization of high-risk infants younger than 18 months of age with split-product influenza vaccine. Pediatrics 1991; 87(6): 823–8

    Google Scholar 

  9. Serwint J. Pediatrician-dependent barriers in influenza vaccine administration. Pediatric Infect Dis J 1993; 12(11): 956–8

    Article  CAS  Google Scholar 

  10. Committee on Infectious Diseases, American Academy of Pediatrics. Immunization in special clinical circumstances. In: Report of the Committee on Infectious Diseases. Elk Grove Village (IL): American Academy of Pediatrics, 1991; 22: 46–66

    Google Scholar 

  11. Glathe H, Bigl S, Grosche A. Comparison of humoral immune responses to trivalent influenza split vaccine in young, middle-aged and elderly people. Vaccine 1993; 11(7): 702–5

    Article  PubMed  CAS  Google Scholar 

  12. Ghendon Y. The immune response to influenza vaccines. Acta Virol 1990, 34: 295–304

    PubMed  CAS  Google Scholar 

  13. Center for Disease Control. Concepts and procedures for laboratory-based influenza surveillance. Atlanta (GA): Center for Disease Control, 1982

    Google Scholar 

  14. Manuguerra JC, Hannoun C. Influenza and other viral respiratory diseases. Surveillance and laboratory diagnosis. Paris: Institute Pasteur, 1999: 188–90

    Google Scholar 

  15. Ada GL, Jones PD. The immune response to influenza infection. Curr Topics Microbiol Immunol 1986; 128: 1–54

    Article  CAS  Google Scholar 

  16. Committee for Proprietary Medicinal Products (CPMP). Note for guidance on harmonisation of requirements for influenza vaccines (revision). 1997 Mar 12: CPMP/BWP/214/96

  17. Commission of the European Communities. The rules governing medicinal products in the european community. Brussels: Commission of the European Communities, 1992; 3, 2: 93–8

    Google Scholar 

  18. Nichol KL, Margolis KL, Wouremna J, et al. Effectiveness of influenza vaccine in the elderly. Gerontology 1996; 42: 274–9

    Article  PubMed  CAS  Google Scholar 

  19. Influenza vaccination coverage levels in selected sites: United States, 1989. MMWRMorb Mortal Wkly Rep 1990; 39: 159–67

  20. Lennox IM, Macphee GJ, McAlpine CH, et al. Use of influenza vaccine in long-stay geriatric units. Age Ageing 1990; 19: 169–72

    Article  PubMed  CAS  Google Scholar 

  21. Morgan R, King D, Turnbull CJ. Influenza vaccination: do the aged reap the benefit? Postgrad Med J 1995; 71: 22–3

    Article  PubMed  CAS  Google Scholar 

  22. Ikematsu H, Kashiwagi S. Efficacy and adverse reactions of influenza vaccine in the elderly. Nippon Rinsho 1997 Oct; 55(10): 2751–7

    PubMed  CAS  Google Scholar 

  23. Zei T, Neri M, Iorio AM. Immunogenicity of trivalent subunit and split influenza vaccines (1989–90 winter season) in volunteers of different groups of age. Vaccine 1991 Sep; 9: 613–7

    Article  PubMed  CAS  Google Scholar 

  24. Gross PA, Russo C, Teplitzky M, et al. Time to peak serum antibody response to influenza vaccine in the elderly. Clin Diagn Lab Immunol 1996 May; 3(3): 361–2

    PubMed  CAS  Google Scholar 

  25. Govaert ThME, Sprenger MJW, Dinant GJ, et al. Immune response to influenza vaccination of elderly people. A randomized double-blind placebo-controlled trial. Vaccine 1994; 12(13): 1185–9

    CAS  Google Scholar 

  26. Brydak LB, Ordyñska E, Wasilewski B, et al. Immunogenicity of trivalent subunit influenza vaccine in elderly people with chronic medical conditions vaccinated in 1993 in Poland. Antiinfect Drugs Chemother 1997; 15(1): 9–12

    Google Scholar 

  27. Govaert ThME, Dinant GJ, Aretz K, et al. Adverse reactions to influenza vaccine in elderly people: randomised double blind placebo controlled trial. BMJ 1993; 307: 988–90

    Article  PubMed  CAS  Google Scholar 

  28. McElhaney JE, Meneilly GS, Beattie BL, et al. The effect of influenza vaccination on 112 production in healthy elderly: implications for current vaccination practices. J Gerontol 1992; 47: M3–M8

    Article  PubMed  CAS  Google Scholar 

  29. McElhaney JE, Meneilly GS, Lechelt KE, et al. Antibody response to whole-virus and split-virus influenza vaccines in successful ageing. Vaccine 1993; 11(10): 1055–60

    Article  PubMed  CAS  Google Scholar 

  30. Cunningham CK, McMillan JA, Gross SJ. Rehospitalization for respiratory illness in infants of less than 32 weeks gestation. Pediatrics 1991; 88: 527–32

    PubMed  CAS  Google Scholar 

  31. Abman SH, Groothius JR. Pathophysiology and treatment of bronchopulmonary dysplasia. Pediatric Clin North Am 1994; 41(2): 277–310

    CAS  Google Scholar 

  32. Daubeney P, Taylor CJ, McGaw J, et al. Immunogenicity and tolerability of a trivalent influenza subunit vaccine (Influvac) in high-risk children aged 6 months to 4 years. BJCP 1997; 51(2): 87–90

    CAS  Google Scholar 

  33. Li M, Groothuis JR, Lehr MV, et al. Maturation of antibody response to influenza vaccine in premature infants. Immunol Infect Dis 1995; 5: 211–7

    CAS  Google Scholar 

  34. Levandovski RA, Regnery HL, Staton E, et al. Antibody responses to influenza B viruses in immunologically unprimed children. Pediatrics 1991; 88; 5: 1031–6

    Google Scholar 

  35. Groothuis JR, Lehr MV, Levin MJ. Safety and immunogenicity of a purified haemagglutinin antigen in very young high-risk children. Vaccine 1994; 12(2): 139–41

    Article  PubMed  CAS  Google Scholar 

  36. Künzel W, Glathe H, Engelmann H, et al. Kinetics of humoral antibody response to trivalent inactivated split influenza vaccine in subjects previously vaccinated or vaccinated for the first time. Vaccine 1996; 14, 12: 1108–10

    Article  Google Scholar 

  37. Pyhälä R, Kumpulainen V, Alanko S, et al. HI antibody kinetics in adult volunteers immunized repeatedly with inactivated trivalent influenza vaccine in 1990–1992. Vaccine 1994; 12(10): 947–52

    Article  PubMed  Google Scholar 

  38. Beyer WEP, Palache AM, Sprenger MJW, et al. Effects of repeated annual influenza vaccination on vaccine sero-response in young and elderly adults. Vaccine 1996; 14(14): 1331–9

    Article  PubMed  CAS  Google Scholar 

  39. Groothius JR, Levin MJ, Lehr MV, et al. Immune response to split-product influenza vaccine in preterm and full-term young children. Vaccine 1992; 10(4): 221–5

    Article  Google Scholar 

  40. Englund JA, Mbawuike I, Hammill H, et al. Maternal immunization with influenza or tetanus toxoid vaccine for passive protection in young infants. J Infect Dis 1993; 168: 647–56

    Article  PubMed  CAS  Google Scholar 

  41. Little JW, Hall WJ, Douglas RG, et al. Airway hyperreactivity and peripheral airway dysfunction in influenza A infection. A Rev Respir Dis 1978; 118: 295–303

    CAS  Google Scholar 

  42. Quarles van Ufford WJ, Savelberg PJ. Asiatic influenza in allergic patients with bronchial asthma. Int Arch Allergy Appl Immunol 1959; 15: 189–92

    Article  Google Scholar 

  43. Hassan WU, Henderson AF, Keaney NP. Influenza vaccination in asthma. Lancet 1992; 339: 194

    Article  PubMed  CAS  Google Scholar 

  44. Committee of Infectious Diseases. Influenza. In: 1994 Red Book. Elk Grove Village (IL): American Academy of Pediatrics, 1994: 275–83

    Google Scholar 

  45. Banks J, Bevan C, Fennerty A, et al. Association between rise in antibodies and increase in airway sensitivity after intramuscular injection of killed influenza virus in asthmatic patients. Eur J Respir Dis 1985; 66: 268–72

    PubMed  CAS  Google Scholar 

  46. Oullette JJ, Reed CE. Increased response of asthmatic subjects to methacholine after influenza vaccine. J Allergy 1965; 36: 558–63

    Article  Google Scholar 

  47. Nicholson KG, Nguyen-Van-Tam JS, Ahmed AH, et al. Randomised placebo-controlled crossover trial on effect of inactivated influenza vaccine on pulmonary function in asthma. Lancet 1998 Jan 31; 351: 326–31

    Article  PubMed  CAS  Google Scholar 

  48. Reid DW, Bromly CL, Stenton SC, et al. A double-blind placebo-controlled study of the effect of influenza vaccination on airway responsiveness in asthma. Respir Med 1998; 92: 1010–1

    Article  PubMed  CAS  Google Scholar 

  49. Ghirga G, Ghirga P, Rodino P, et al. Safety of the subunit influenza vaccine in asthmatic children. Vaccine 1991; 9(12): 913–4

    Article  PubMed  CAS  Google Scholar 

  50. Bell TD, Chai H, Berlow B, et al. Immunization with killed influenza virus in children with chronic asthma. Chest 1978; 73(2): 140–5

    Article  PubMed  CAS  Google Scholar 

  51. Park CL, Frank AL, Sullivan M, et al. Influenza vaccination of children during acute asthma exacerbation and concurrent prednisone therapy. Pediatrics 1996; 98(2): 196–200

    PubMed  CAS  Google Scholar 

  52. Mclntosh K, Foy HM, Modlin JF, et al. Multicenter two-dose trials of bivalent influenza a vaccines in asthmatic children aged six to 18 years. J Infect Dis 1977; 136 Suppl.: S645–S7

    Article  Google Scholar 

  53. El-Madhun AS, Cox RJ, Scime A, et al. Systemic and local immune responses after parenteral influenza vaccination in juvenile diabetic patients and healthy controls: results from a pilot study. Vaccine 1998; 16(2/3): 156–60

    Article  PubMed  CAS  Google Scholar 

  54. Eickhoff TC, Sherman JL, Serfling RE. Observations on excess mortality associated with epidemic influenza. JAMA 1961; 176: 776–82

    Article  PubMed  CAS  Google Scholar 

  55. Erkelens DW. Vaccinate against flu. Diabetes Rev Int 1994; 3(4): 1

    Google Scholar 

  56. Haaheim LR. Diabetics and influenza immunization: missed opportunities. ESWI Influenza Bull 1995; 2: 5

    Google Scholar 

  57. Diepersloot RJA, Bouter KP, Beyer WEP, et al. Humoral immune resopnse and delayed hypersensitivity to influenza vaccine in patients with diabetes mellitus. Diabetologia 1987; 30: 397–401

    Article  PubMed  CAS  Google Scholar 

  58. Steele RW. Current status of vaccines and immune globulins for children with renal disease. Pediatr Nephrol 1994; 8: 7–10

    Article  PubMed  CAS  Google Scholar 

  59. Descamps-Latscha B, Chatenoud L. T cells and B cells in chronic renal failure. Semin Nephrol 1996; 16: 183–91

    PubMed  CAS  Google Scholar 

  60. Köhler H, Girndt M, Dumann H, et al. Immunodefekt bei Niereninsuffizienz. Teil II. Mechanismen des uremischen Immunodefekts. Dtsch Med Wochenschr 1993b; 118: 790–5

    Google Scholar 

  61. Grzesiowski P. Vaccinations in children with renal diseases [in Polish]. Terapia i Leki 1996; XXIV, XLVI, 7-8: 241–7

    Google Scholar 

  62. Brydak LB, Rajkowski T, Machala M, et al. Humoral antibody response following influenza vaccination in patients with nephrotic syndrome. Antiinfect Drugs Chemother 1998; 16(2): 151–5

    CAS  Google Scholar 

  63. Suga T, Niki H, Niikura M, et al. Influenza antibody titers after vaccination of chronic renal failure patients, before and during hemodialysis, or on chronic ambulatory peritoneal dialysis. Tokai I Exp Clin Med 1990; 15: 245–51

    CAS  Google Scholar 

  64. Versluis DJ, Beyer WEP, Masurel N, et al. Intact humoral immune response in patients on continuous ambulatory peritoneal dialysis. Nephron 1988; 49: 16–9

    Article  PubMed  CAS  Google Scholar 

  65. Cappel R, Van Beers D, Liensnard C. Impaired humoral and cell-mediated immune response in dialysed patients after influenza vaccination. Nephron 1983; 33: 21–5

    Article  PubMed  CAS  Google Scholar 

  66. Versluis DJ, Beyer WEP, Masurel N. Value of booster immunization with influenza vaccine in patients undergoing haemodialysis. BMJ 1987; 294: 348–50

    Article  PubMed  CAS  Google Scholar 

  67. Grekas D, Alivanis P, Kotzadamis N, et al. Influenza vaccination in chronic hemodialysis patients. The effect of zinc supplementation. Ren Fail 1992; 14(4): 575–8

    CAS  Google Scholar 

  68. Nikoskelainen J, Vaananen P, Forsstrom J, et al. Influenza vaccination in patients with chronic renal failure. Scand J Infect Dis 1982; 14(4): 245–51

    PubMed  CAS  Google Scholar 

  69. Furth SL, Neu AM, McColley SA, et al. Immune response to influenza vaccination in children with renal disease. Pediatr Nephrol 1995; 9: 566–8

    Article  PubMed  CAS  Google Scholar 

  70. Grekas D, Alivanis P, Kiriazopoulou V, et al. Influenza vaccination on renal transplant patients is safe and seerologically effective. Int J Clin Pharmacol Ther Toxicol 1993; 31(11): 553–6

    PubMed  CAS  Google Scholar 

  71. Brydak LB, Roszkowska-Blaim M, Leszczyñska B, et al. HI antibody kinetics in children with renal failure immunized with inactivated trivalent influenza vaccine. Central European Conference on Modern Vaccinology ‘Vaccines and Immunization’. Poland: Pulawy 1997 May 6–9

  72. Schnaper HW. The immune system in minimal change nephrotic syndrome. Pediatr Nephrol 1989; 3: 101–10

    Article  PubMed  CAS  Google Scholar 

  73. Giacchino F, Quarello F, Pellerey M, et al. Continuous ambulatory peritoneal dialysis improves immunodeficiency in uremic patients. Nephron 1983; 35: 209–10

    Article  PubMed  CAS  Google Scholar 

  74. Koziol-Montewka M, Ksiazek A, Majdan M, et al. Influence of some immune factors on the IL-6 and soluble IL-2 receptor in haemodialized patients. Int Urol Nephrol 1997; 29,3: 369–75

    Article  Google Scholar 

  75. Ridgway D, Wolff LJ. Active immunization of children with leukemia and other malignancies. Leuk Lymphoma 1993; 9: 177–92

    Article  PubMed  CAS  Google Scholar 

  76. Kempe A, Hall CB, MacDonald NE, et al. Influenza in children with cancer. J Pediatr 1989; 115(1): 33–9

    Article  PubMed  CAS  Google Scholar 

  77. Steinhertz PG, Brown AE, Gross PA, et al. Influenza immunization of children with neoplastic diseases. Cancer 1980; 45: 750–6

    Article  Google Scholar 

  78. Brown AE, Steinhertz PG, Miller DR, et al. Immunization against influenza in children with cancer: results of a three-dose trial. J Infect Dis 1982; 145(1): 126

    Article  PubMed  CAS  Google Scholar 

  79. Brydak LB, Rokicka-Milewska R, Jackowska T, et al. Kinetics of humoral response in children with acute lymphoblastic leukemia immunized with influenza vaccine in 1993 in Poland. Leuk Lymphoma 1997; 26: 163–9

    PubMed  CAS  Google Scholar 

  80. Brydak LB, Rokicka-Milewska R, Machala M, et al. Immunogenicity of subunit trivalent influenza vaccine in children with acute lymphoblastic leukemia. Pediatr Infect Dis J 1998; 17: 125–9

    Article  PubMed  CAS  Google Scholar 

  81. Brydak LB, Rokicka-Milewska R, Machala M, et al. Studies on the humoral immune response to hemagglutinin of influenza vaccine in children with acute lymphoblastic leukemia after chemotherapy treatment. Int J Pediatr Hematol Oncol. In press

  82. Bucalossi A, Marotta G, Galieni P, et al. Immunological response to influenza virus vaccine in B-cell chronic lymphocytic leukaemia patients. Acta Haematol 1995; 93: 56

    Article  PubMed  CAS  Google Scholar 

  83. Kilbourne ED, Chanock RM, Choppin PW, et al. Influenza vaccines: summary of influenza workshop. V J Infect Dis 1974; 129: 750

    Article  Google Scholar 

  84. Schafer AI, Chirchill WH, Ames P, et al. The influence of chemotherapy on response of patients with haematologic malignancies to influenza vaccine. Cancer 1979; 43: 25–30

    Article  PubMed  CAS  Google Scholar 

  85. Smithson WA, Siem RA, Ritts RA, et al. Response to influenza virus vaccine in children receiving chemotherapy for malignancy. J Pediatr 1978: 632–3

    Google Scholar 

  86. Borella L, Webster RG. The immunosuppressive effects of long-term combination chemotherapy in children with acute leukemia in remission. Cancer Res 1971; 31: 420–6

    PubMed  CAS  Google Scholar 

  87. Sumaya CV, Williams TE. Persistance of antibody after the administration of influenza vaccine to children with cancer. Pediatrics 1982; 69(2): 226–9

    PubMed  CAS  Google Scholar 

  88. Sumaya CV, Williams TE, Brunell PA. Bivalent influenza vaccine in children with cancer. J Infect Dis 1977; 136: S656–60

    Article  PubMed  Google Scholar 

  89. Lange B, Shapiro SA, Waldman MTG, et al. Antibody response to influenza immunization of children with acute lymphoblastic leukemia. J Infect Dis 1979; 140(3): 402–6

    Article  PubMed  CAS  Google Scholar 

  90. Brydak LB, Calbecka M. Immunogenicity against influenza in patients with blood cancer disease. Leuk Lymphoma 1999; 32(3-4): 369–74

    PubMed  CAS  Google Scholar 

  91. Brunell PA. Immunologic response of immunosuppressed children to influenza vaccine. MMWR 1977 Feb 18: 54

    Google Scholar 

  92. Hirota Y, Kaji M, Ide S, et al. The hemagglutination inhibition antibody responses to an inactivated influenza vaccine among healthy adults: with special reference to the prevaccination antibody and its interaction with age. Vaccine 1996; 14(17/18): 1597–602

    Article  PubMed  CAS  Google Scholar 

  93. Cohen JP, Macauley. Susceptibility to influenza A in HIV-positive patients. JAMA 1989; 261: 245

    Article  PubMed  CAS  Google Scholar 

  94. Cohn D. Bacterial pneumonia in the HIV-infected patients. Infect Dis Clin North Am 1991; 5: 485–507

    PubMed  CAS  Google Scholar 

  95. Thurn JR, Henry K. Influenza A pneumonitis in a patient infected with the human immunodeficiency virus (HIV). Chest 1989; 95: 807–10

    Article  PubMed  CAS  Google Scholar 

  96. Nelson KE, Clements ML, Miotti P, et al. The influence human immunodeficiency virus (HIV) infection on antibody responses to influenza vaccines. Ann Intern Med 1988; 109: 383–8

    PubMed  CAS  Google Scholar 

  97. Kroon FP, Van Dissel JT, De Jong JC, et al. Antibody response to influenza, tetanus and pneumococcal vaccines in HIV-seropositive individuals in relation to the number of CD+ lymphocytes. AIDS 1994; 8: 469–76

    Article  PubMed  CAS  Google Scholar 

  98. Tasker SA, O’Brien WA, Treanor JJ, et al. Effects of influenza vaccination in HIV-infected adults: a double-blind, placebo-controlled trial. Vaccine 1998; 16(9/10): 1039–42

    Article  PubMed  CAS  Google Scholar 

  99. Glesby MJ, Hoover DR, Farzadegan H, et al. The effect of influenza vaccination on human immunofdeficiency virus type 1 load: a randomized, double-blind, placebo-controlled study. J Infect Dis 1996; 174: 1332–6

    Article  PubMed  CAS  Google Scholar 

  100. Schneider MME, Sprenger MJW, Hoepelman IM, et al. Antibody response to tetravalent influenza subunit vaccine in patients infected with human immunodeficiency virus type 1. Int J Antimicrob Agents 1996; 6(4): 195–200

    Article  PubMed  CAS  Google Scholar 

  101. Brydak LB, Hryniewicz HJ, Machala M, et al. Humoral response to influenza vaccination in HIV-infected patients. Clin Drug Invest 1999; 17(6): 435–43

    Article  Google Scholar 

  102. Huengsberg M, Chakraverty MP, Cooper G, et al. Response to influenza immunization in asymptomatic HIV infected men. Genitourin Med 1995; 71: 355–7

    PubMed  CAS  Google Scholar 

  103. Boguslawska-Jaworska J, Dobaczewski G. Immunological disorders in children with hemophilia. In: Rokicka-Milewska R. Pediatria [in Polish]. Warszawa: PWN, 1992

    Google Scholar 

  104. Gazengel C, Rothschild C. Immunologic abnormalities in French non-HIV infected hemophiliac children [abstract book no. 430]. International Congress of the WFH: Oct 12–17; Athens, 1992

  105. Madhok R, Gracie A, Lowe GDO, et al. Impaired cell mediated immunity in hemophilia in the absence of infection with human immunodeficiency virus. BMJ 1986; 293: 978–81

    Article  PubMed  CAS  Google Scholar 

  106. Cuthbert RJG, Ludlam CA, Steel CM, et al. Immunologic studies in HIV seronegative haemophiliacs: relationship to blood product therapy. Br J Haematol 1992; 80: 364–9

    Article  PubMed  CAS  Google Scholar 

  107. Brydak LB, Rokicka-Milewska R, Klukowska A, et al. Antibody kinetics in children with hemophilia immunized with influenza vaccine in 1993 in Poland. Int J Pediatrie Hematol Oncol 1998; 5(1): 13–9

    Google Scholar 

  108. Klukowska A, Brydak L, Rokicka-Milewska R, et al. Influenza vaccinations of haemophilic children [in Polish]. Acta Haematol Polonica 1995; 26(3): 305–10

    CAS  Google Scholar 

  109. Brydak LB, Rokicka-Milewska R, Machala M, et al. Efficacy of subunit influenza vaccine in previously vaccinated children suffering from hemophilia. Clin Microbiol Infect 1998; 4(10): 589–93

    Article  PubMed  Google Scholar 

  110. Rokicka-Milewska R, Brydak L, Machala M, et al. Antibody response to influenza vaccine in children with severe and mild hemophilia. Int J Pediatr Hematol Oncol. In press

  111. McMichael AF, Gotch FM, Noble GR, et al. Cytotoxic T-cell immunity to influenza. N Engl J Med 1983; 309: 13–7

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lidia B. Brydak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brydak, L.B., Machala, M. Humoral Immune Response to Influenza Vaccination in Patients from High Risk Groups. Drugs 60, 35–53 (2000). https://doi.org/10.2165/00003495-200060010-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-200060010-00004

Keywords

Navigation