Summary of clinical trials of influenza virus vaccines in adults

Trials in approximately 3,900 adults were conducted with influenza A/New Jersey/76, A/Victoria/75, and B/Hong Kong/72 virus vaccines. Subjects were observed following a standard protocol, and serologic testing was performed in a single laboratory. The data indicate that prior experience of the population with earlier influenza viruses ("priming") is a determinant in response to vaccination. Thus, participants older than 25 years showed good serologic response following a single inoculation of A/New Jersey/76 virus, while younger persons responded poorly. Serological responses to A/Victoria/75 and B/Hong Kong/72 viruses were, in contrast, equally good in the younger and older adults. Whole-virus vaccines were measurably more reactive than split-virus vaccines, a finding more easily discernined in unprimed populations. In the unprimed persons, a single dose of split-virus vaccine was less immunogenic than a single dose of whole-virus vaccine. The presence of preexisting antibodies appeared to reduce systemic reactivity. For adequate immunization of a totally unprimed population, a single relatively large and reactive dose of whole-virus vaccine or two, properly spaced, smaller nonreactive doses of either whole-virus vaccine or split-virus vaccine would be required.