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Type: Journal article
Title: Heterologous prime-boost vaccination using an ASO3B-adjuvanted influenza A(H5N1) vaccine in infants and children <3 years of age
Author: Nolan, T.
Izurieta, P.
Lee, B.
Chan, P.
Marshall, H.
Booy, R.
Drame, M.
Vaughn, D.
Citation: Journal of Infectious Diseases, 2014; 210(11):1800-1810
Publisher: Oxford University Press
Issue Date: 2014
ISSN: 0022-1899
Statement of
Terry Nolan, Patricia Izurieta, Bee-Wah Lee, Poh Chong Chan, Helen Marshall, Robert Booy, Mamadou Drame, and David W. Vaughn
Abstract: BACKGROUND: Protecting young children from pandemic influenza should also reduce transmission to susceptible adults, including pregnant women. METHODS: An open study assessed immunogenicity and reactogenicity of a heterologous booster dose of A/turkey/Turkey/1/2005(H5N1)-AS03B (AS03B is an Adjuvant System containing α-tocopherol and squalene in an oil-in-water emulsion [5.93 mg tocopherol]) in infants and children aged 6 to <36 months that was given 6 months following 2-dose primary vaccination with A/Indonesia/05/2005(H5N1)-AS03B. Vaccines contained 1.9 µg of hemagglutinin antigen and AS03B. Hemagglutinin inhibition (HI) responses, microneutralization titers, and antineuraminidase antibody levels were assessed for 6 months following the booster vaccination. RESULTS: For each age stratum (defined on the basis of the subject's age at first vaccination as 6 to <12 months, 12 to <24 months, and 24 to <36 months) and overall (n=113), European influenza vaccine licensure criteria were fulfilled for responses to A/turkey/Turkey/1/2005(H5N1) 10 days following the booster vaccination. Local pain and fever increased with consecutive doses. Anamnestic immune responses were demonstrated for HI, neutralizing, and antineuraminidase antibodies against vaccine-homologous/heterologous strains. Antibody responses to vaccine-homologous/heterologous strains persisted in all children 6 months following the booster vaccination. CONCLUSIONS: Prevaccination of young children with a clade 2 strain influenza A(H5N1) AS03-adjuvanted vaccine followed by heterologous booster vaccination boosted immune responses to the homologous strain and a related clade, with persistence for at least 6 months. The results support a prime-boost vaccination approach in young children for pandemic influenza preparedness. CLINICAL TRIALS REGISTRATION: NCT01323946.
Keywords: pandemic; influenza; H5N1; children; booster
Description: Presented in part: Options for the Control of Influenza VIII Conference, Cape Town, South Africa, 5–10 September 2013
Rights: © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (, which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact
DOI: 10.1093/infdis/jiu359
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