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Safety, tolerability, and immunogenicity of inactivated trivalent seasonal influenza vaccine administered with a needle-free disposable-syringe jet injector
Authors:Simon Jakub K  Carter Mihaela  Pasetti Marcela F  Sztein Marcelo B  Kotloff Karen L  Weniger Bruce G  Campbell James D  Levine Myron M
Affiliation:a Division of Geomedicine, Department of Medicine, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, United States
b Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, United States
c National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
Abstract:

Background

Jet injectors (JIs) avoid safety drawbacks of needle-syringe (N-S) while generating similar immune responses. A new generation of disposable-syringe jet injectors (DSJIs) overcomes the cross-contamination risk of multi-use-nozzle devices used in 20th-century campaigns. In the first study in humans, the newly-US-licensed LectraJet® model M3 RA DSJI was compared to N-S.

Methods

Sixty healthy adults received one 0.5 mL intramuscular dose of the 2009-2010 seasonal, trivalent, inactivated influenza vaccine (TIV) in randomized, double-masked fashion by either DSJI (n = 30) or N-S (n = 30). Adverse reactions were monitored for 90 days after injection, and serologic responses assayed by hemagglutination inhibition (HI) at days 28 and 90.

Results

There were no related serious adverse events (SAEs), nor differing rates of unsolicited AEs between DSJI and N-S. Solicited erythema and induration occurred more often after DSJI, but were transient and well-tolerated; a trend was noted for fewer systemic reactions by DSJI. Pre-vaccination HI geometric mean titers (GMT) increased by 28 days for H1N1, H3N2, and B antigens by 13-, 14-, and 8-fold via DSJI, and by 7-, 10-, and 7-fold for N-S, respectively. No trending differences in GMT, seroconversion, or seroprotection were noted; sample sizes precluded non-inferiority assessment.

Conclusions

DSJI delivery of TIV is well-tolerated and immunogenic.
Keywords:AE, adverse event   CBC, complete blood count   CDC, centers for Disease Control and Prevention   CHMP, Committee for Human Medicinal Products   CI, confidence interval   DSJI, disposable-syringe jet injection/injector   EMEA, European Medicines Agency   FDA, U.S. Food and Drug Administration   FE, Fisher's exact   GAVI, Global Alliance for Vaccines and Immunization   GMT, geometric mean titers   HBV, hepatitis B virus   HCV, hepatitis C virus   IM, intramuscular   HIV, human immunodeficiency virus   HI, hemagglutination inhibition   JI, jet injector/injection   mm, millimeter   MUNJI, multi-use-nozzle jet injector   NA, not applicable   N-S, needle-syringe   PATH, Program for Appropriate Technology in Health   SAE, serious adverse event   TIV, trivalent (inactivated) influenza vaccine   URI, upper respiratory infection   USAID, United States Agency for International Development   WHO, World Health Organization
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