Evidence map›Paper›PMID 27129425›Full record

Trial reportVaccine2016

Morning vaccination enhances antibody response over afternoon vaccination: A cluster-randomised trial.

Joanna E Long, Mark T Drayson, Angela E Taylor, Kai M Toellner, Janet M Lord, Anna C Phillips

Erratum issuedOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Vaccine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 156 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
156citing papers in PubMed, 5 pooled it
20.0field-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

156 citing papers in PubMed, 5 syntheses or guidelines pooled it, 295 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
  18. Review
  19. Review
  20. Article

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Joanna E LongSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK.
Mark T DraysonInstitute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK.
Angela E TaylorInstitute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK.
Kai M ToellnerInstitute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK.
Janet M LordInstitute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK.
Anna C PhillipsSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK. Electronic address: a.c.phillips@bham.ac.uk.
University of Birmingham · GB

Funding

Medical Research Council G1001390
6 · The paper itself

Abstract

objectivesOlder adults are less able to produce a protective antibody response to vaccinations. One factor that contributes to this is immune ageing. Here we examined whether diurnal variations in immune responses might extend to the antibody response to vaccination.

designWe utilised a cluster-randomised trial design.

setting24 General Practices (GPs) across the West Midlands, UK who were assigned to morning (9-11am; 15 surgeries) or afternoon (3-5pm; 9 surgeries) vaccination times for the annual UK influenza vaccination programme.

participants276 adults (aged 65+ years and without a current infection or immune disorder or taking immunosuppressant medication).

interventionsParticipants were vaccinated in the morning or afternoon between 2011 and 2013.

main outcome measuresThe primary outcome was the change in antibody titres to the three vaccine influenza strains from pre-vaccination to one month post-vaccination. Secondary outcomes of serum cytokines and steroid hormone concentrations were analysed at baseline to identify relationships with antibody responses.

resultsThe increase in antibody levels due to vaccination differed between morning and afternoon administration; mean difference (95% CI) for H1N1 A-strain, 293.3 (30.97-555.66) p=.03, B-strain, 15.89 (3.42-28.36) p=.01, but not H3N2 A-strain, 47.0 (-52.43 to 146.46) p=.35; those vaccinated in the morning had a greater antibody response. Cytokines and steroid hormones were not related to antibody responses. No adverse events were reported.

conclusionsThis simple manipulation in the timing of vaccine administration to favour morning vaccination may be beneficial for the influenza antibody response in older adults, with potential implications for vaccination strategies generally.

trial registrationThis trial is registered with the ISRCTN (ISRCTN70898162).

Indexed as

Antibody FormationTime FactorsAgedAntibodies, ViralFemaleHumansInfluenza, HumanInfluenza VaccinesMaleVaccinationAntibodies, ViralInfluenza VaccinesAgeingAntibodiesCluster-randomisedInfluenza vaccineTime of dayVaccination

Identifiers

PMID27129425
PMCPMC4874947
OpenAlexW2345018973

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.