Evidence map›Paper›PMID 26667611›Full record

ArticleVaccine2016

The confounded effects of age and exposure history in response to influenza vaccination.

Ana Mosterín Höpping, Janet McElhaney, Judith M Fonville, Douglas C Powers, Walter E P Beyer, Derek J Smith

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Vaccine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing papers in PubMed, 4 pooled it
9.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

66 citing papers in PubMed, 4 syntheses or guidelines pooled it, 114 citations in OpenAlex.

  1. Pooled it
  2. [High-dose trivalent influenza vaccine: safety and immunogenicity].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Enhanced Influenza Vaccines Extend A(H3N2) Antibody Reactivity in Older Adults but Prior Vaccination Effects Persist.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025
    Trial
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Immunogenicity and safety of Southern Hemisphere inactivated quadrivalent influenza vaccine: a Phase III, open-label study of adults in Brazil.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
    Trial
  11. Influenza vaccine-specific CD4NPJ vaccines · 2026
    Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Review
  17. Influenza Vaccine Effectiveness in Australia During 2017-2019.Influenza and other respiratory viruses · 2025
    Article
  18. Article
  19. Article
  20. Review

6 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Ana Mosterín HöppingCentre for Pathogen Evolution, University of Cambridge, Department of Zoology, Downing Street, Cambridge CB2 3EJ, UK; World Health Organization Collaborating Center for Modeling, Evolution, and Control of Emerging Infectious Diseases, Cambridge CB2 3EJ, UK.
Janet McElhaneyAdvanced Medical Research Institute of Canada, Sudbury, ON, Canada P3E 5J1.
Judith M FonvilleCentre for Pathogen Evolution, University of Cambridge, Department of Zoology, Downing Street, Cambridge CB2 3EJ, UK; World Health Organization Collaborating Center for Modeling, Evolution, and Control of Emerging Infectious Diseases, Cambridge CB2 3EJ, UK.
Douglas C PowersCentre for Pathogen Evolution, University of Cambridge, Department of Zoology, Downing Street, Cambridge CB2 3EJ, UK; World Health Organization Collaborating Center for Modeling, Evolution, and Control of Emerging Infectious Diseases, Cambridge CB2 3EJ, UK; Erasmus MC, Department of Viroscience, P.O. Box 2040, Ee1726, 3000 CA Rotterdam, The Netherlands; Advanced Medical Research Institute of Canada, Sudbury, ON, Canada P3E 5J1.
Walter E P BeyerErasmus MC, Department of Viroscience, P.O. Box 2040, Ee1726, 3000 CA Rotterdam, The Netherlands.
Derek J SmithCentre for Pathogen Evolution, University of Cambridge, Department of Zoology, Downing Street, Cambridge CB2 3EJ, UK; World Health Organization Collaborating Center for Modeling, Evolution, and Control of Emerging Infectious Diseases, Cambridge CB2 3EJ, UK; Erasmus MC, Department of Viroscience, P.O. Box 2040, Ee1726, 3000 CA Rotterdam, The Netherlands. Electronic address: derek.smith@antigenic-cartography.org.
University of Cambridge · GBErasmus MC · NLErasmus University Rotterdam · NL

Funding

NIH Director's Pioneer Award:Antigenic Cartography (RMI)DP1OD000490 · OD · UNIVERSITY OF CAMBRIDGE · PI SMITH, DEREK JAMES · 2005 to 2009
$2.6M
AGE AND VACCINE MODULATION OF INFLUENZA IMMUNITYR29AG011876 · NIA · SAINT LOUIS UNIVERSITY · PI POWERS, DOUGLAS C · 1995 to 1998
–
NIAID NIH HHS HHSN266200700010CNIAID NIH HHS HHSN272201400008CNIA NIH HHS R29AG11876NIH HHS DP1 OD000490PHS HHS HHSN266200700010CPHS HHS HHSN272201400008CWellcome Trust 100891
6 · The paper itself

Abstract

Numerous studies have explored whether the antibody response to influenza vaccination in elderly adults is as strong as it is in young adults. Results vary, but tend to indicate lower post-vaccination titers (antibody levels) in the elderly, supporting the concept of immunosenescence-the weakening of the immunological response related to age. Because the elderly in such studies typically have been vaccinated against influenza before enrollment, a confounding of effects occurs between age, and previous exposures, as a potential extrinsic reason for immunosenescence. We conducted a four-year study of serial annual immunizations with inactivated trivalent influenza vaccines in 136 young adults (16 to 39 years) and 122 elderly adults (62 to 92 years). Compared to data sets of previously published studies, which were designed to investigate the effect of age, this detailed longitudinal study with multiple vaccinations allowed us to also study the effect of prior vaccination history on the response to a vaccine. In response to the first vaccination, young adults produced higher post-vaccination titers, accounting for pre-vaccination titers, than elderly adults. However, upon subsequent vaccinations the difference in response to vaccination between the young and elderly age groups declined rapidly. Although age is an important factor when modeling the outcome of the first vaccination, this term lost its relevance with successive vaccinations. In fact, when we examined the data with the assumption that the elderly group had received (on average) as few as two vaccinations prior to our study, the difference due to age disappeared. Our analyses therefore show that the initial difference between the two age groups in their response to vaccination may not be uniquely explained by immunosenescence due to ageing of the immune system, but could equally be the result of the different pre-study vaccination and infection histories in the elderly.

Indexed as

Age FactorsImmunity, HumoralAdolescentAdultAgedAged, 80 and overAntibodies, ViralConfounding Factors, EpidemiologicHumansInfluenza, HumanInfluenza VaccinesLinear ModelsLongitudinal StudiesMiddle AgedVaccines, InactivatedYoung AdultAntibodies, ViralInfluenza VaccinesVaccines, InactivatedElderlyImmunosenescenceInfluenza vaccineRepeated vaccinationVaccine efficacy

Identifiers

PMID26667611
PMCPMC4724805
OpenAlexW2187695758

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.