A recent study from the Miami Center for AIDS Research at the University of Miami raises questions about the clinical value of high-dose (HD) influenza vaccination in older people with HIV. While HD influenza vaccines are currently recommended for individuals aged ≥ 65 years to enhance immune responses, the new findings suggest that this strategy may offer limited additional benefit in people with HIV (PWH), particularly in improving antibody responses to H1N1 antigens. Researchers presented their results at the Conference on Retroviruses and Opportunistic Infections 2025 in San Francisco, CA.
The 237 participants enrolled in the study included both people with HIV (all virally suppressed) and people without HIV (PWoH), divided into young (18-40 years; PWH, n = 42 and PWoH, n = 56) and older (≥ 60 years) cohorts (PWH, n = 67 and PWoH, n = 72). All participants received a standard-dose (SD) influenza vaccine during one of three flu seasons (2020–2023), followed by a high-dose vaccine in the subsequent season. Serum hemagglutination inhibition (HAI) titers were measured at baseline, 28 days, and 180 days post-vaccination (DPV) against H1N1, B/Yamagata, and B/Victoria strains. H3N2 responses could not be evaluated due to poor red blood cell binding by contemporary strains.
At baseline, older participants exhibited lower titers to H3N2 and B/Victoria, but higher titers to B/Yamagata, compared with younger individuals. Following SD vaccination, all groups showed over two-fold increases in HAI titers; however, the magnitude of the response was attenuated in older adults and in PWH. At 28 DPV, H1N1 titers and fold-change were significantly lower in older adults and in PWH relative to their counterparts.
“Our data indicate that HD vaccine demonstrates limited efficacy in further enhancing immune responses of older PWH,” the study authors concluded.
By Kate Young
Reference:
Kupritz J, Davis S, Singh P, et al. Limited effectiveness of high-dose flu vaccine in augmenting immunity in older people with HIV [CROI Abstract 481]. Abstracts from the Conference on Retroviruses and Opportunistic Infections. CROI 2025. Abstract eBook. 2025;122.
Source : Consultant360
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