Immunogenicity and safety of concomitant bivalent COVID-19 and quadrivalent influenza vaccination: implications of immune imprinting and interference

Min Joo Choi; Young Jun Yu; Jae Won Kim; Hea Jeon Ju; So Youn Shin; Yun Jung Yang; Hee-Jin Cheong; Woo Joo Kim; Chulwoo Kim; Hwa Jung Kim; Sun Kyung Yoon; Se Jin Park; Won Seok Gwak; June Woo Lee; Byoungguk Kim; Joon Young Song

doi:10.1016/j.cmi.2024.01.010

Immunogenicity and safety of concomitant bivalent COVID-19 and quadrivalent influenza vaccination: implications of immune imprinting and interference

Min Joo Choi, Young Jun Yu, Jae Won Kim, Hea Jeon Ju, So Youn Shin, Yun Jung Yang, Hee-Jin Cheong, Woo Joo Kim, Chulwoo Kim, Hwa Jung Kim, Sun Kyung Yoon, Se Jin Park, Won Seok Gwak, June Woo Lee, Byoungguk Kim, Joon Young Song

Department of Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Objectives: Concomitant COVID-19 and influenza vaccination would be an efficient strategy. Although the co-administration of monovalent COVID-19 and influenza vaccinations showed acceptable immunogenicity, it remains unknown whether the bivalent COVID-19 vaccine could intensify immune interference. We aimed to evaluate the immunogenicity and safety of concomitant BA.5-based bivalent COVID-19 and influenza vaccination. Methods: An open-label, nonrandomized clinical trial was conducted for 154 age-matched and sex-matched healthy adults between October 2022 and December 2022. Participants received either a concomitant bivalent COVID-19 mRNA booster and quadrivalent influenza vaccination (group C) or separate vaccinations (group S) at least 4 weeks apart. Solicited and unsolicited adverse events were reported up to 6 months postvaccination. Immunogenicity was evaluated by anti-spike (S) IgG electrochemiluminescence immunoassay, focus reduction neutralization test, and hemagglutination inhibition assay. Results: Group C did not meet the noninferiority criteria for the seroconversion rates of anti-S IgG and neutralizing antibodies against the wild-type SARS-CoV-2 strain compared with group S (44.2% vs. 46.8%, difference of −2.6% [95% CI, −18 to 13.4]; 44.2% vs. 57.1%, difference of −13.0% [95% CI to −28.9 to 2.9]). However, group C showed a stronger postvaccination neutralizing antibody response against Omicron BA.5 (72.7% vs. 64.9%). Postvaccination geometric mean titers for SARS-CoV-2 and influenza strains were similar between groups, except for influenza B/Victoria. Most adverse events were mild and comparable between the study groups. Discussion: Concomitant administration of bivalent COVID-19 mRNA and quadrivalent influenza vaccines showed tolerable safety profiles and sufficient immunogenicity, particularly attenuating immune imprinting induced by previous ancestral vaccine strains.

Original language	English
Pages (from-to)	653-659
Number of pages	7
Journal	Clinical Microbiology and Infection
Volume	30
Issue number	5
DOIs	https://doi.org/10.1016/j.cmi.2024.01.010
Publication status	Published - 2024 May

Bibliographical note

Publisher Copyright:
© 2024 European Society of Clinical Microbiology and Infectious Diseases

Keywords

COVID-19
Concomitant
Immunogenicity
Influenza
Vaccine

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.cmi.2024.01.010

Cite this

Choi, M. J., Yu, Y. J., Kim, J. W., Ju, H. J., Shin, S. Y., Yang, Y. J., Cheong, H.-J., Kim, W. J., Kim, C., Kim, H. J., Yoon, S. K., Park, S. J., Gwak, W. S., Lee, J. W., Kim, B., & Song, J. Y. (2024). Immunogenicity and safety of concomitant bivalent COVID-19 and quadrivalent influenza vaccination: implications of immune imprinting and interference. Clinical Microbiology and Infection, 30(5), 653-659. https://doi.org/10.1016/j.cmi.2024.01.010

Choi, MJ, Yu, YJ, Kim, JW, Ju, HJ, Shin, SY, Yang, YJ, Cheong, H-J, Kim, WJ, Kim, C, Kim, HJ, Yoon, SK, Park, SJ, Gwak, WS, Lee, JW, Kim, B & Song, JY 2024, 'Immunogenicity and safety of concomitant bivalent COVID-19 and quadrivalent influenza vaccination: implications of immune imprinting and interference', Clinical Microbiology and Infection, vol. 30, no. 5, pp. 653-659. https://doi.org/10.1016/j.cmi.2024.01.010

@article{eb567f1231064913b6d7f3ab8b9fd63c,

title = "Immunogenicity and safety of concomitant bivalent COVID-19 and quadrivalent influenza vaccination: implications of immune imprinting and interference",

abstract = "Objectives: Concomitant COVID-19 and influenza vaccination would be an efficient strategy. Although the co-administration of monovalent COVID-19 and influenza vaccinations showed acceptable immunogenicity, it remains unknown whether the bivalent COVID-19 vaccine could intensify immune interference. We aimed to evaluate the immunogenicity and safety of concomitant BA.5-based bivalent COVID-19 and influenza vaccination. Methods: An open-label, nonrandomized clinical trial was conducted for 154 age-matched and sex-matched healthy adults between October 2022 and December 2022. Participants received either a concomitant bivalent COVID-19 mRNA booster and quadrivalent influenza vaccination (group C) or separate vaccinations (group S) at least 4 weeks apart. Solicited and unsolicited adverse events were reported up to 6 months postvaccination. Immunogenicity was evaluated by anti-spike (S) IgG electrochemiluminescence immunoassay, focus reduction neutralization test, and hemagglutination inhibition assay. Results: Group C did not meet the noninferiority criteria for the seroconversion rates of anti-S IgG and neutralizing antibodies against the wild-type SARS-CoV-2 strain compared with group S (44.2% vs. 46.8%, difference of −2.6% [95% CI, −18 to 13.4]; 44.2% vs. 57.1%, difference of −13.0% [95% CI to −28.9 to 2.9]). However, group C showed a stronger postvaccination neutralizing antibody response against Omicron BA.5 (72.7% vs. 64.9%). Postvaccination geometric mean titers for SARS-CoV-2 and influenza strains were similar between groups, except for influenza B/Victoria. Most adverse events were mild and comparable between the study groups. Discussion: Concomitant administration of bivalent COVID-19 mRNA and quadrivalent influenza vaccines showed tolerable safety profiles and sufficient immunogenicity, particularly attenuating immune imprinting induced by previous ancestral vaccine strains.",

keywords = "COVID-19, Concomitant, Immunogenicity, Influenza, Vaccine",

author = "Choi, {Min Joo} and Yu, {Young Jun} and Kim, {Jae Won} and Ju, {Hea Jeon} and Shin, {So Youn} and Yang, {Yun Jung} and Hee-Jin Cheong and Kim, {Woo Joo} and Chulwoo Kim and Kim, {Hwa Jung} and Yoon, {Sun Kyung} and Park, {Se Jin} and Gwak, {Won Seok} and Lee, {June Woo} and Byoungguk Kim and Song, {Joon Young}",

note = "Publisher Copyright: {\textcopyright} 2024 European Society of Clinical Microbiology and Infectious Diseases",

year = "2024",

month = may,

doi = "10.1016/j.cmi.2024.01.010",

language = "English",

volume = "30",

pages = "653--659",

journal = "Clinical Microbiology and Infection",

issn = "1198-743X",

publisher = "Elsevier Limited",

number = "5",

}

TY - JOUR

T1 - Immunogenicity and safety of concomitant bivalent COVID-19 and quadrivalent influenza vaccination

T2 - implications of immune imprinting and interference

AU - Choi, Min Joo

AU - Yu, Young Jun

AU - Kim, Jae Won

AU - Ju, Hea Jeon

AU - Shin, So Youn

AU - Yang, Yun Jung

AU - Cheong, Hee-Jin

AU - Kim, Woo Joo

AU - Kim, Chulwoo

AU - Kim, Hwa Jung

AU - Yoon, Sun Kyung

AU - Park, Se Jin

AU - Gwak, Won Seok

AU - Lee, June Woo

AU - Kim, Byoungguk

AU - Song, Joon Young

PY - 2024/5

Y1 - 2024/5

N2 - Objectives: Concomitant COVID-19 and influenza vaccination would be an efficient strategy. Although the co-administration of monovalent COVID-19 and influenza vaccinations showed acceptable immunogenicity, it remains unknown whether the bivalent COVID-19 vaccine could intensify immune interference. We aimed to evaluate the immunogenicity and safety of concomitant BA.5-based bivalent COVID-19 and influenza vaccination. Methods: An open-label, nonrandomized clinical trial was conducted for 154 age-matched and sex-matched healthy adults between October 2022 and December 2022. Participants received either a concomitant bivalent COVID-19 mRNA booster and quadrivalent influenza vaccination (group C) or separate vaccinations (group S) at least 4 weeks apart. Solicited and unsolicited adverse events were reported up to 6 months postvaccination. Immunogenicity was evaluated by anti-spike (S) IgG electrochemiluminescence immunoassay, focus reduction neutralization test, and hemagglutination inhibition assay. Results: Group C did not meet the noninferiority criteria for the seroconversion rates of anti-S IgG and neutralizing antibodies against the wild-type SARS-CoV-2 strain compared with group S (44.2% vs. 46.8%, difference of −2.6% [95% CI, −18 to 13.4]; 44.2% vs. 57.1%, difference of −13.0% [95% CI to −28.9 to 2.9]). However, group C showed a stronger postvaccination neutralizing antibody response against Omicron BA.5 (72.7% vs. 64.9%). Postvaccination geometric mean titers for SARS-CoV-2 and influenza strains were similar between groups, except for influenza B/Victoria. Most adverse events were mild and comparable between the study groups. Discussion: Concomitant administration of bivalent COVID-19 mRNA and quadrivalent influenza vaccines showed tolerable safety profiles and sufficient immunogenicity, particularly attenuating immune imprinting induced by previous ancestral vaccine strains.

AB - Objectives: Concomitant COVID-19 and influenza vaccination would be an efficient strategy. Although the co-administration of monovalent COVID-19 and influenza vaccinations showed acceptable immunogenicity, it remains unknown whether the bivalent COVID-19 vaccine could intensify immune interference. We aimed to evaluate the immunogenicity and safety of concomitant BA.5-based bivalent COVID-19 and influenza vaccination. Methods: An open-label, nonrandomized clinical trial was conducted for 154 age-matched and sex-matched healthy adults between October 2022 and December 2022. Participants received either a concomitant bivalent COVID-19 mRNA booster and quadrivalent influenza vaccination (group C) or separate vaccinations (group S) at least 4 weeks apart. Solicited and unsolicited adverse events were reported up to 6 months postvaccination. Immunogenicity was evaluated by anti-spike (S) IgG electrochemiluminescence immunoassay, focus reduction neutralization test, and hemagglutination inhibition assay. Results: Group C did not meet the noninferiority criteria for the seroconversion rates of anti-S IgG and neutralizing antibodies against the wild-type SARS-CoV-2 strain compared with group S (44.2% vs. 46.8%, difference of −2.6% [95% CI, −18 to 13.4]; 44.2% vs. 57.1%, difference of −13.0% [95% CI to −28.9 to 2.9]). However, group C showed a stronger postvaccination neutralizing antibody response against Omicron BA.5 (72.7% vs. 64.9%). Postvaccination geometric mean titers for SARS-CoV-2 and influenza strains were similar between groups, except for influenza B/Victoria. Most adverse events were mild and comparable between the study groups. Discussion: Concomitant administration of bivalent COVID-19 mRNA and quadrivalent influenza vaccines showed tolerable safety profiles and sufficient immunogenicity, particularly attenuating immune imprinting induced by previous ancestral vaccine strains.

KW - COVID-19

KW - Concomitant

KW - Immunogenicity

KW - Influenza

KW - Vaccine

UR - http://www.scopus.com/inward/record.url?scp=85187517440&partnerID=8YFLogxK

U2 - 10.1016/j.cmi.2024.01.010

DO - 10.1016/j.cmi.2024.01.010

M3 - Article

C2 - 38253313

AN - SCOPUS:85187517440

SN - 1198-743X

VL - 30

SP - 653

EP - 659

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

IS - 5

ER -

Immunogenicity and safety of concomitant bivalent COVID-19 and quadrivalent influenza vaccination: implications of immune imprinting and interference

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this