Immunogenicity of influenza vaccination in children with Inflammatory Bowel Disease
Bibliographic record
Abstract
Children with inflammatory bowel disease (IBD) are frequently treated with immunosuppressive therapies. Protection against vaccine-preventable diseases is important because of the risk of increased susceptibility and severity of infection with immunosuppressive therapy. However, immunosuppressive therapy may affect response to vaccine. The objective of this study was to evaluate the immunogenic response and the serologic protection to influenza vaccine in children with IBD compared to healthy sibling controls. In this prospective, open-label, controlled study, children with IBD and healthy sibling controls underwent serum collection for pre-immunization hemagglutination inhibition titer. Then the trivalent (A/Brisbane/10/2007 [H3N2], A/Brisbane/59/2007 [H1N1], B/Florida/4/2006 [B]) inactivated influenza vaccine was administered. Three to 5 weeks later, all participants underwent serum collection for post-immunization hemagglutination inhibition titers. An immunogenic response against each influenza strain was defined as a four-fold or greater increase in hemagglutination inhibition titer from pre-immunization to post-immunization. Seroprotection against each influenza strain was defined as a post-immunization hemagglutination inhibition titer of 40 or greater. Children with IBD were classified according to therapy as immunosuppressed (on corticosteroids, azathioprine, 6-mercaptopurine, methotrexate, or tumor necrosis factor-α inhibitor) or nonimmunosuppressed (on aminosalicylates only, antibiotics only, or no therapy). Sixty children with IBD (26 Crohn's disease, 24 ulcerative colitis, 10 indeterminate colitis) and 53 healthy sibling controls completed the study. Overall, the proportion of children with IBD who developed an immunogenic response to H3N2, H1N1, and B strains were 70.0%, 71.7%, and 53.3%, respectively, and serologic protection to H3N2, H1N1, and B strains were 95.0%, 98.3%, and 85.0%, respectively. A lower proportion of children with IBD developed an immunogenic response to B strain compared to sibling controls (53.3% vs 81.1%, p=0.0009). There was no difference between the proportion of children with IBD compared to sibling controls that developed an immunogenic response to H3N2 and H1N1 strains or serologic protection to all 3 strains. A lower proportion of immunosuppressed children with IBD developed serologic protection to B strain compared to nonimmunosuppressed children with IBD (78.6% vs 100%, p=0.02). No serious vaccine-associated adverse events occurred. Overall, children with IBD develop a high prevalence of serologic protection to influenza vaccination. The difference in the higher proportion of children with IBD who developed serologic protection compared to an immunogenic response may be explained by previous influenza vaccination or infection providing serologic protection. Children with IBD, especially those on immunosuppressive therapy, may have less serologic protection against B strains of influenza vaccination. Future studies are required to evaluate the benefit of a booster vaccination in this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".