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High prevalence of IgE sensitization to inactivated influenza vaccines, yet robust IgG4 responses, in a healthy pediatric population
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  • Prince Baffour Tonto,
  • Mizuho Nagao,
  • Shigeru Suga,
  • Kiyosu Taniguchi,
  • Masahiro Hirayama,
  • Tetsuo Nakayama,
  • Takuji Kumagai,
  • Takao Fujisawa
Prince Baffour Tonto
Kokuritsu Byoin Kiko Mie Byoin

Corresponding Author:princebaffourtonto@gmail.com

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Mizuho Nagao
Kokuritsu Byoin Kiko Mie Byoin
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Shigeru Suga
Kokuritsu Byoin Kiko Mie Byoin
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Kiyosu Taniguchi
National Mie Hospital
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Masahiro Hirayama
Mie Daigaku
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Tetsuo Nakayama
Kitasato Institute for Life Sciences
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Takuji Kumagai
Kumagai Naika Shonika Iin
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Takao Fujisawa
National Mie Hospital
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Abstract

Background: Anaphylaxis following influenza vaccination is a rare but serious problem. The underlying immune responses are not well understood. This study elucidated the IgE and IgG antibody responses in healthy children and adolescents following inactivated influenza vaccines (IIVs). Methods: The efficacy and safety of quadrivalent IIV (QIV) and trivalent IIV (TIV) were compared in healthy subjects aged 0-18 years. Serum IIV-specific IgE, IgG and IgG4 levels (sIgE, sIgG, sIgG4) were measured with ImmunoCAP. Hemagglutinin inhibition (HI) assay was performed for each influenza virus subtype. Sera from earlier patients who developed anaphylaxis to different IIVs were similarly tested. Results: A total of 393 subjects were enrolled: 96 were 6 months -2 years old, 100 were 3-5 years old, 100 were 6-12 years old, and 97 were 13-18 years old. No anaphylaxis was observed. Generally, QIV and TIV induced similar antibody responses. IIV-sIgE levels rose significantly after vaccination in the 6m-2y and 3-5y groups, did not change in the 6-12y group, and decreased in the 13-18y group. In contrast, the IIV-sIgG4/sIgE ratio increased significantly after vaccination in all age groups. Sensitized subjects had significantly higher HI titers and IIV-sIgG levels in the youngest age group and higher IIV-sIgG4 levels in all age groups compared with the non-sensitized. The IIV-sIgG4/sIgE ratio in 5 patients with anaphylaxis was significantly lower than in age-matched healthy subjects. Conclusion: IIVs induce IgE sensitization in healthy children, but also robust IgG4 responses that may protect them from anaphylaxis.
24 May 2022Submitted to Influenza and other respiratory viruses
24 May 2022Submission Checks Completed
24 May 2022Assigned to Editor
27 Jun 2022Reviewer(s) Assigned
04 Aug 2022Review(s) Completed, Editorial Evaluation Pending
04 Aug 2022Editorial Decision: Revise Minor
06 Aug 20221st Revision Received
08 Aug 2022Submission Checks Completed
08 Aug 2022Assigned to Editor
25 Aug 2022Editorial Decision: Accept