Immunogenicity of Varicella Vaccine and Immunologic Predictors of Response in a Cohort of Elderly Nursing Home Residents

J Infect Dis. 2016 Dec 15;214(12):1905-1910. doi: 10.1093/infdis/jiw462. Epub 2016 Oct 5.

Abstract

Background: Little is known about the immunogenicity of live-attenuated Oka/Merck varicella zoster virus (VZV)-containing vaccine (hereafter, "varicella vaccine") in frail nursing homes residents nor about immune phenotypes associated with a response.

Methods: A cohort of 190 frail nursing home residents aged 80-102 years and a cohort of 50 community-dwelling seniors aged 60-75 years (a comparison group) received varicella vaccine. Interferon γ (IFN-γ) enzyme-linked immunospot assays were performed before and 6 weeks after vaccination. Cellular markers of immunosenescence were measured in the nursing home elderly.

Results: The average number of IFN-γ spot-forming cells at baseline was significantly lower in the elderly nursing home residents than in the community-dwelling seniors. However, following vaccination, the VZV immune response increased in both cohorts, and no difference was noted in the fold difference of the response between the 2 cohorts. Upon further examination of the elderly nursing home residents, we found that higher frequencies of regulatory T cells and cytomegalovirus-specific CD4+ T cells correlated negatively with the magnitude of VZV-specific responses.

Conclusions: The Oka/Merck varicella vaccine induces VZV immunity in elderly nursing home residents that is similar to that produced in community-dwelling seniors.

Clinical trials registration: NCT01328548.

Keywords: T cells; immunogenicity; nursing home; vaccine; varicella zoster.

MeSH terms

  • Aged, 80 and over
  • Chickenpox Vaccine / administration & dosage
  • Chickenpox Vaccine / immunology*
  • Cohort Studies
  • Enzyme-Linked Immunospot Assay
  • Female
  • Humans
  • Interferon-gamma / metabolism*
  • Leukocytes, Mononuclear / immunology*
  • Male
  • Nursing Homes*

Substances

  • Chickenpox Vaccine
  • Interferon-gamma

Associated data

  • ClinicalTrials.gov/NCT01328548