ArticleOpen forum infectious diseases2020
Frailty Is Associated With Increased Hemagglutination-Inhibition Titers in a 4-Year Randomized Trial Comparing Standard- and High-Dose Influenza Vaccination.
Article in Open forum infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Influenza vaccine effectiveness according to frailty status in adults aged ≥ 50 years: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Trivalent and quadrivalent seasonal influenza vaccine in adults aged 60 and older: a systematic review and network meta-analysis.BMJ evidence-based medicine · 2024Pooled it
- Relative Effectiveness of High-Dose Versus Standard-Dose Influenza Vaccination Against Hospitalizations and Deaths According to Frailty Score: A Post Hoc Analysis of the DANFLU-1 Randomized Trial.The Journal of infectious diseases · 2026Trial
- Medication count, including statin or metformin use, is not associated with influenza vaccine responses in older adults.Vaccine · 2025Trial
- The Decline in Influenza Antibody Titers and Modifiers of Vaccine Immunity from over Ten Years of Serological Data.medRxiv : the preprint server for health sciences · 2026Article
- CMV-specific clonal expansion of Th1, GZMKbioRxiv : the preprint server for biology · 2025Article
- The impact of frailty syndrome on humoral response to SARS-CoV-2 mRNA vaccines in older kidney transplant recipients.International urology and nephrology · 2023Article
- Antibody-mediated NK cell activation as a correlate of immunity against influenza infection.Nature communications · 2023Article
- Article
- Factors associated with humoral immune response in older adults who received egg-free influenza vaccine.Vaccine · 2023Observational
- Sex-Differential and Non-specific Effects of Vaccines Over the Life Course.Current topics in microbiology and immunology · 2023Review
- Advanced biological age is associated with improved antibody responses in older high-dose influenza vaccine recipients over four consecutive seasons.Immunity & ageing : I & A · 2022Article
- Natural immunity helps overcome the age-related decline of SARS-CoV-2 vaccine immunogenicity.The lancet. Healthy longevity · 2022Article
- Markers of systemic inflammation are positively associated with influenza vaccine antibody responses with a possible role for ILT2(+)CD57(+) NK-cells.Immunity & ageing : I & A · 2022Article
- Roadmap for Sex-Responsive Influenza and COVID-19 Vaccine Research in Older Adults.Frontiers in aging · 2022Review
- NK- and T-cell granzyme B and K expression correlates with age, CMV infection and influenza vaccine-induced antibody titres in older adults.Frontiers in aging · 2022Article
- Sex-specific effects of aging on humoral immune responses to repeated influenza vaccination in older adults.NPJ vaccines · 2021Article
- Antibody Responsiveness to Influenza: What Drives It?Viruses · 2021Review
- Key Determinants of Cell-Mediated Immune Responses: A Randomized Trial of High Dose Vs. Standard Dose Split-Virus Influenza Vaccine in Older Adults.Frontiers in aging · 2021Article
- Unanticipated efficacy of SARS-CoV-2 vaccination in older adults.Immunity & ageing : I & A · 2021Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough high-dose (HD) vaccines have been reported to stimulate higher antibody responses compared with standard-dose (SD) influenza vaccines, there have been limited studies on the impact of frailty on such responses.
methodsWe conducted a randomized, double-blind trial (2014/2015 to 2017/2018) of SD versus HD trivalent split-virus vaccine (Fluzone) in 612 study participants aged 65+ over 4 influenza seasons. Hemagglutination inhibition antibody titers for influenza H1N1, H3N2, and B vaccine subtypes were measured at baseline and at 4, 10, and 20 weeks postvaccination and frailty was measured using a validated frailty index.
resultsGeometric mean antibody titers were significantly higher in HD compared with SD vaccine recipients for all influenza subtypes at all time points postvaccination. However, frailty was positively correlated with 4-week titers and was associated with increased odds of being a vaccine responder. For influenza A subtypes, this was mostly limited to HD recipients.
conclusionsFrailty was associated with higher titers and increased antibody responses at 4 weeks after influenza vaccination, which was partially dependent on vaccine dosage. Chronic inflammation or dysregulated immunity, both of which are commonly observed with frailty, may be responsible, but it requires further investigation.
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