Co-administering RSV and influenza vaccines to seniors is safe: European research

Health Canada last year authorized two new vaccines to protect the elderly against respiratory syncytial virus (RSV)— and aims to vaccinate 80% of at-risk individuals, including seniors aged 65 and over, against seasonal flu.Meanwhile, a European study recently published in the journal Clinical Infectious Diseases has established that co-administration of these two vaccines is safe for the elderly. Seniors will therefore be able to receive both vaccines at a single appointment, facilitating the vaccination process—likely increasing the uptake for both vaccines.This randomized Phase III trial involved 1,045 participants in five countries (Belgium, Finland, France, Spain and the U.K.). While participants with stable chronic diseases were included, immunosuppressed individuals and those already vaccinated against RSV and/or influenza in the six months prior to the trial were excluded. Half of the participants received the perfused RSV F-protein vaccine and the adjuvanted quadrivalent influenza vaccine concomitantly, and the other half sequentially, one month apart.Stable immune responsesThe researchers observed that hemagglutination inhibition titres for three of the four influenza strains (A/Victoria (H1N1), B/Victoria and B/Yamagata) and neutralization titres for RSV-A and RSV-B subtypes generated by co-administration of RSV and influenza vaccines were non-inferior to those of sequential administration for three of the four influenza strains, one month after vaccination. However, this non-inferiority was not demonstrated in terms of hemagglutination inhibition titers for the A/Darwin (H3N2) strain. At the same time, the adverse events reported were mostly mild or moderate and transient. The rates of unsolicited and serious adverse events were balanced between the groups. Pain at the injection site was the most frequently reported adverse event in both groups. However, systemic adverse events were more frequent in the co-administered group, with fatigue affecting around 46% and myalgia 39% of co-administered individuals.One serious event, giant cell arteritis, occurred in the sequential group and was considered related to the flu vaccine, as it occurred 10 days after vaccination. Six other “fatal” adverse events occurred, all in the sequential group, but none were considered related to vaccination.Improving convenience These vaccines can thus be administered together in adults aged 65 and over, without clinically relevant interference with immune responses to either vaccine, and with a clinically acceptable safety and reactogenicity profile, the authors wrote. They welcomed the “particularly relevant results for clinical practice in the elderly,” given that “adjuvanted influenza vaccines are recommended in the elderly to overcome immunosenescence."Given the seasonal overlap of these two infections, "the ability to administer both vaccines during a single physician visit may improve convenience and increase uptake of both vaccines, ultimately reducing the heavy disease burden of influenza and RSV disease in the elderly,” the researchers concluded. A previous study had already demonstrated that RSV vaccine can be administered safely and without interfering with the immune response with two non-adjuvanted influenza vaccines. In addition, a prospective study showed that co-administration of RSV vaccine with a standard-dose quadrivalent seasonal influenza vaccine was well tolerated and safe in patients at high risk of heart failure. The trial used only GSK’s RSV vaccine and Seqirus’s influenza vaccine.This article was translated from its original French and was first published by our sister publication ProfessionSante.ca.

Co-administering RSV and influenza vaccines to seniors is safe: European research

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