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Updated: Aug 7, 2026

An Optimized Hemagglutination Inhibition (HI) Assay to Quantify Influenza-specific Antibody Titers
Published on: December 1, 2017
Annual influenza vaccination: immune response in patients over 10 years
P A Gross1, C R Denning, P F Gaerlan
1Department of Internal Medicine, Hackensack University Medical Center, NJ, USA.
Insights
Annual influenza immunization in cystic fibrosis (CF) patients consistently generates protective antibody levels. This 10-year study found no significant change in antibody titers or Shwachman scores, indicating sustained vaccine effectiveness.
Area of Science:
- Immunology
- Pediatrics
- Pulmonology
Background:
- Cystic Fibrosis (CF) patients face increased risk from influenza.
- Annual influenza vaccination is recommended for individuals with CF.
- The long-term impact of repeated influenza immunization on antibody response in CF patients is not well-defined.
Purpose of the Study:
- To evaluate the effect of repeated annual influenza immunization on serum antibody levels in children and young adults with CF.
- To assess the durability of the immune response to influenza vaccination over a 10-year period in this population.
Main Methods:
- A 10-year observational cohort study was conducted.
- Thirty-eight children and young adults with CF were included.
- Serum hemagglutination inhibition (HI) antibody titers were measured annually pre- and post-vaccination.
Main Results:
- No significant upward or downward trend in geometric mean serum HI antibody titers was observed over 10 years.
- The majority of participants achieved presumably protective antibody titers (≥1:40) annually for all tested influenza strains (A/H3N2, A/H1N1, B).
- Mean Shwachman scores remained stable, with no significant difference between the initial and final scores (77 vs. 76).
Conclusions:
- Repeated annual influenza vaccination effectively induces protective serum antibody levels in most children and young adults with CF.
- The study suggests sustained immunogenicity and clinical stability associated with annual influenza immunization in this cohort over a decade.
Objective:
To determine the effect of repeated annual influenza immunization on the host's serum antibody.
Design:
Ten year observational study with cohort design.
Setting:
Cystic Fibrosis Center at St. Vincent's Hospital and Medical Center, New York City, NY.
Patients:
Thirty-eight children and young adults with cystic fibrosis (CF).
Measurements:
Serum hemagglutination inhibition (HI) antibody titers were determined at the time of vaccination and 4 weeks later each year in the fall before the influenza epidemic. Shwachman scores were determined each year.
Results:
While the pre-vaccination and post-vaccination geometric mean serum HI antibody titers varied from year to year, no upward or downward trend was evident over the 10 year period. The reciprocal of the post-vaccination geometric mean HI titers ranged annually from 32 to 74 for the influenza A (H3N2) vaccine strains, from 53 to 133 for the influenza A (H1N1) strains, and from 18 to 174 for influenza B strains. In addition, the majority of vaccinees had a presumably protective post-vaccination serum HI titer > or = 1:40 each year for all three vaccine strains. The initial mean Shwachman score of the group was 77. The final score of 76 after 10 years was not significantly different.
Conclusions:
Annual influenza vaccination appears to regularly induce presumably protective serum antibody levels in most CF children and young adults studied over a 10 year period.
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