[IgE-response after administration of pandemic vaccine strain A/California/7/2009 (H1N1)v].

Changes in total and allergy-specific IgE (IgE-antibodies) in 70 healthy volunteers vaccinated with influenza vaccine subunit strain A/California/7/2009/(H1N1)v. Safety of this vaccine was shown. Repeated second dose administration is not accompanied by increase in IgE-antibodies to egg components. Vaccine injection results in decrease of total IgE in patients with elevated IgE at baseline.

[Study of tolerability and reactogenicity of pandemic vaccines against influenza type A/H1N1].

AIM: To study tolerability and safety of pandemic vaccines against influenza A/H1N1 "INFLUVIR" and "PANDEFLU" on limited group of volunteers during phase I clinical trial. MATERIALS AND METHODS: Thirty healthy volunteers were participated in phase I clinical trial. Clinical and laboratory tests of volunteers randomized to 2 groups (20 persons received vaccine and 10 persons - placebo) were performed. "INFLUVIR" vaccine was administered by intranasal route. Volunteers were hospitalized and followed up for development of local and systemic adverse events during 7 days after vaccination. "PANDEFLU" was administered intramuscularly; vaccinees were followed for 7 days in outpatient settings. RESULTS. Phase I clinical trial showed good tolerability and low reactogenicity of "INFLUVIR" and "PANDEFLU" vaccines. There were no moderate and severe local and systemic adverse events registered. CONCLUSION: On the basis of performed phase I clinical trial, phase II trial was recommended to perform in order to assess the reactogenicity, safety and immunogenicity of studied vaccines.

[Clinical trial of safety and immunogenicity of new influenza vaccine Grifor in children].

AIM: Assessment of reactogenicity, safety and immunogenicity after single intramuscular immunization of children with Grifor vaccine. MATERIALS AND METHODS: Reactogenicity, safety, and immunogenicity of Grifor vaccine compared with Vaxigrip vaccine was evaluated during phase III clinical trial in the Institute of Influenza. Thirty-six children aged 12 - 17 years, divided on 2 groups, participated in single blind comparative prospective randomized trial. Seroconversion factor, seroconversion and seroprotection levels were evaluated by hemagglutination inhibition assay. RESULTS: Results of study of systemic and local reactogenicity in children during first 7 days after immunization with Grifor and Vaxigrip vaccine showed good tolerability, areactogenicity and safety of both vaccines. Complete blood count, serum biochemistry and urinalysis results as well as serum IgE level did not change after vaccination. After immunization with Grifor vaccine, seroconversion rate to influenza virus subtypes A/H1N1, A/H3N2, and B was 70%, 50%, and 70% respectively, seroprotection rate--90%, 80%, and 85% respectively, and seroconversion factor--6.5, 2.7, and 4.0 respectively. CONCLUSION: This trial, which was performed in tightly controlled conditions, had demonstrated that Grifor vaccine is safe and highly immunogenic against influenza viruses A and B and satisfies criteria of both Federal Service for Surveillance for Protection of Consumers Rights and Human Welfare and CHMP of EMA. Obtained results allow to recommend the Grifor vaccine for use in pediatric practice according to national immunization schedule.

[Clinical trial of new inactivated influenza vaccine "Grifor"].

AIM: To confirm and prove on the extended contingent of volunteers the non-reactogenicity, safety and immunogenicity of "Grifor" vaccine in comparative trial with registered in Russia commercial vaccine "Vaxigrip". MATERIALS AND METHODS: Phase II clinical trial was performed on the research bases of Mechnikov Institute of Vaccines and Sera and Institute of Influenza. In single-blind comparative prospective randomized trial 300 adult volunteers (150 volunteers on each base) aged 18 - 60 y.o. were divided on 3 equivalent groups. Assessment of antigenic characteristics of "Grifor" vaccine was performed using hemagglutination inhibition assay (HAI) with chicken erythrocytes measuring geometric mean titer (GMT), seroconversion factor as well as level of seroconversion and seroprotection. RESULTS: Previously performed studies proved non-reactogenicity, safety and high immunogenicity of "Grifor", whereas this comparative trial performed with commercial vaccine "Vaxigrip" did not reveal significant advantage in any of studied vaccine. CONCLUSION: "Grifor" vaccine meet the requirements of both EMEA CPMP and methodic guidelines MY 3.3.2. 1758-03 for inactivated influenza vaccines, which allows to register vaccine "Grifor" in Russian Federation.

[Cycloferon, as an agent in the therapy and urgent prophylaxis of influenza and acute respiratory tract viral infection (multicentre randomized controlled comparative study)].

Data on the study of the efficacy of the tablets of cycloferon, an early inductor of types 1 and 2 interferon, in the treatment of influenza and acute respiratory tract viral infections in adults are presented. The study enrolled 522 patients with moderate influenza of type A (H1N1) verified in 61% of the patients and type A (H3N2) verified in 7.5% of the cases. The patients were randomized with the envelope procedure. In the patients treated with cycloferon the intensity and period of the fever were stopped earlier and averaged from 1.8 to 3 days vs. 5 days in the reference group (symptomatic therapy). The improvement signs in the general state of the patients treated with cycloferon were noted on the 2nd day. The influenza complication as pneumonia was recorded in 2.2% of the patients treated with cycloferon, whereas in the patients under the symptomatic therapy the complications as bronchitis, pneumonia, angina were stated in 21.4% of the cases. For urgent prophylaxis of the influenza and respiratory tract viral infections (epidemiologic study) a group of 3717 subjects randomized with the table of random numbers was observed. 2080 patients were treated with cycloferon and 1637 patients were under the symptomatic therapy. The results were evaluated by the efficacy index and the protection estimate (T. A. Semenenko, 1991). The total efficacy index and the protection estimate in all the patients of the group were 4.9 and 79.8% respectively. The complicated forms of the disease were recorded in 1.5% of the patients treated with cycloferon and in 10.5 and 11.3% of the patients not treated with cycloferon.

[Comparative clinical trial of vaccines against avian influenza].

Scientic-production association "Microgen" has finished 1st phase of clinical trials of candidate vaccines against avian influenza in order to assess their reactogenicity, safety, and immunogenicity. Two vaccines constructed from NIBRG-14 vaccine strain [A/Vietnam/1 194/2004 (H5N1)], obtained from World Health Organization, were studied: "OrniFlu" (inactivated subunit influenza vaccine adsorbed on aluminium hydroxide) and inactivated polymer-subunit influenza vaccine with polyoxydonium (IPSIV). Clinical trial of the vaccines with different quantity of antigen (15, 30, and 45 mcg of H5N1 virus hemagglutinin) was carried out in Influenza Research Institute (St. Petersburg) and in Mechnikov Research Institute of Vaccines and Sera (Moscow). Analysis of results allowed to conclude that both vaccines were safe, well tolerated and characterized by low reactogenicity. Two-doses vaccination schedule was needed to meet required seroconversion and seroprotection rates (> or =1:40 in > or =70% of vaccinated volunteers). "Orni-Flu" vaccine containing 15 mcg of hemagglutinin and optimal quantity of aluminium hydroxide (0.5 mg) in one dose as well as IPSIV containing 45 mcg of hemagglutinin and 0.75 mg of polyoxydonium in one dose were most immunogenic after 2 doses - seroprotection rates in microneutralization assay were 72.2% and 77.0% respectively. Marked influence of aluminium hydroxide content on immunogenicity of the "OrniFlu" vaccine was confirmed in the study. Optimal quantity of adjuvant was 0.5 mg per dose. According to basic concept of vaccine development, preference is given to vaccine that under minimal quantity of antigen induces sufficient specific immune response and is safe in volunteers. "OrniFlu" vaccine containing 15 mcg of H5N1 virus hemagglutinin and optimal quantity of aluminium hydroxide (0.5 mg) corresponded to these requirements that allowed researchers to recommend it for clinical trials of 2nd phase.

[The investigation of the safety, genetic stability and immunogenicity of live influenza vaccine for adults in vaccination of 3-6 years old children]. / Izuchenie bezvrednosti, geneticheskoi stabil'nosti i immunogennosti zhivoi grippoznoi vaktsiny dlia vzroslykh pri vaktsinatsii detei 3-6 let.

The study of the based on the A/Leningrad/134/17/57/(H2N2) attenuated adult live influenza vaccine (LIV) investigated features for immunization of the children, aged 3-6 years. During autumn, 1999, out of 256 children, aged 3-6 years, residents of the Leningrad region, who attended the kindergarten, 184 children were immunized with 1 or 2 doses of the live influenza vaccine, and 72 ones were given placebo. There were no any moderate or strong temperature reactions revealed after the inoculation. The LIV was shown to be genetically stable. After a single dose of the vaccine seroconversion to influenza type A virus and to influenza type B virus was observed respectively in 58% and in 39% of seronegative 3-6 year old vaccinees. The twofold LIV administration failed to give any advantages in stimulation of the immune response. During 6 months after immunization the morbidity rate in vaccinees did not exceed the morbidity rate in unvaccinated children. Thus LIV for adults proved safe and immunogenic and can be recommended for single dose immunization both of adults and children.

[Emergency prevention of influenza with remantadin]. / Ekstrennaia profilaktika grippa remantadinom.

Prophylactic efficacy of remantadin was studied during influenza epidemics caused by types A (H3N2) and B viruses. More than 15,000 persons were observed. Daily administration of remantadin ensured a decrease in influenza A (but not influenza B) morbidity 1.5-4.5 times in different groups (planned prophylaxis) and 6.5-10.3 times in family foci (focal prophylaxis). The protective effect of remantadin is mainly due to its capacity of suppressing the toxic manifestations of influenza infection, which is accompanied by a decrease in the frequency and duration of clinically pronounced disease and an increase in the proportion of asymptomatic forms.

[Vaccine prophylaxis in elderly patients]. / O taktike vaktsinoprofilaktiki u pozhilykh liudei.

In 1997-1999 observation was made on elderly people living in old people's homes and in families, as well as groups of young males living in hostel-type homes, altogether 4,518 subjects. Standard inactivated whole-virion influenza vaccine was introduced in a dose of 0.5 ml subcutaneously in a single injection or intranasally in two administrations. In control groups placebo was used. The frequency of seroconversions to vaccine strains of influenza viruses was significantly less in elderly people than in young people following both subcutaneous and intranasal immunization (on the average, by 15-20%). In young people the prophylactic effectiveness of the vaccine introduced intranasally was the same as after subcutaneous immunization with the effectiveness index (EI) being equal to 2.1-2.8. In elderly people the effectiveness of the vaccine after subcutaneous immunization was the same as in young people (EI = 1.7-2.7), but insufficient after intranasal immunization (EI < or = 1.6). The preparation "Amber elixir plus" enhanced the effectiveness of immunization against influenza in elderly people.

[The immunoprophylaxis of influenza among elderly persons]. / Immunoprofilaktika grippa sredi liudei pozhilogo vozrasta.

During three seasons at the period of 1992-1996 immunization of elderly persons, living in homes for old people, against influenza with inactivated influenza vaccine (IIV) was carried out. Altogether 856 persons were immunized intranasally, 581 persons constituting the control group. For comparison, 4,825 healthy young adults aged 18-24 years were immunized under similar conditions. The study revealed that the intranasal immunization of elderly persons with IIV, made in two administrations, was safe and stimulated sufficient humoral and secretory immunity: the level of seroconversions was 24.3-41.0% to type A(H1N1) influenza virus, 29.6-50.7% to type A(H3N2) influenza virus, 39.3-59.6% to type B influenza virus; the level of diagnostic IgA conversions was 31-38%. Immunization produced a pronounced prophylactic effect (the effectiveness index 1.6-1.7), as well as decreased the total mortality level by half. The tactics of the immunization of persons from high risk groups against influenza in medical practice is discussed.

[The use of the radial hemolysis reaction for demonstrating antibodies to the surface antigens of the influenza virus in assessing postvaccinal immunity]. / Ispol'zovanie reaktsii radial'nogo gemoliza dlia indikatsii antitel k poverkhnostnym antigenam virusa grippa pri otsenke postvaktsinal'nogo immuniteta.

Two serological tests--single radial hemolysis (RSH) and hemagglutination inhibition (HI) were used to evaluate the different techniques (intranasal, intradermal and combined methods) of application of inactivated influenza vaccines. When seroconversion to hemagglutinin (HA) was determined sensitivity of SRH proved to be higher as compared with HI by 6.7-41.4%. This test has also shown that the frequency of the seroconversion to HA was 2.1-5.6 times higher than that to neuraminidase (NA). It is important to standardize both HA and NA components in the influenza vaccine. It is interesting to study the local and cell immunity after intranasal inoculation of influenza vaccine because of the low postvaccinal level of serum antibodies and in connection with some publications concerning the protective role of this immunization method.