Induction of trained immunity by influenza vaccination - impact on COVID-19

PLoS Pathog. 2021 Oct 25;17(10):e1009928. doi: 10.1371/journal.ppat.1009928. eCollection 2021 Oct.

Abstract

Non-specific protective effects of certain vaccines have been reported, and long-term boosting of innate immunity, termed trained immunity, has been proposed as one of the mechanisms mediating these effects. Several epidemiological studies suggested cross-protection between influenza vaccination and COVID-19. In a large academic Dutch hospital, we found that SARS-CoV-2 infection was less common among employees who had received a previous influenza vaccination: relative risk reductions of 37% and 49% were observed following influenza vaccination during the first and second COVID-19 waves, respectively. The quadrivalent inactivated influenza vaccine induced a trained immunity program that boosted innate immune responses against various viral stimuli and fine-tuned the anti-SARS-CoV-2 response, which may result in better protection against COVID-19. Influenza vaccination led to transcriptional reprogramming of monocytes and reduced systemic inflammation. These epidemiological and immunological data argue for potential benefits of influenza vaccination against COVID-19, and future randomized trials are warranted to test this possibility.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 / epidemiology
  • COVID-19 / immunology*
  • COVID-19 / prevention & control
  • Cross Protection / physiology*
  • Cytokines / immunology
  • Cytokines / metabolism
  • Down-Regulation
  • Imidazoles / immunology
  • Immunity, Innate / physiology*
  • Incidence
  • Influenza Vaccines / administration & dosage*
  • Influenza Vaccines / immunology
  • Netherlands / epidemiology
  • Personnel, Hospital
  • Poly I-C / immunology
  • Proteomics
  • Risk Factors
  • Sequence Analysis, RNA

Substances

  • Cytokines
  • Imidazoles
  • Influenza Vaccines
  • Poly I-C
  • resiquimod