Skip to main content

Advertisement

SpringerLink
Log in
Menu
Find a journal Publish with us Track your research
Search
Cart
  1. Home
  2. Drugs & Aging
  3. Article

Is There a Role For a Mucosal Influenza Vaccine in the Elderly?

  • Leading Article
  • Published: 31 August 2012
  • Volume 15, pages 169–181, (1999)
  • Cite this article
Download PDF
Drugs & Aging Aims and scope Submit manuscript
Is There a Role For a Mucosal Influenza Vaccine in the Elderly?
Download PDF
  • Eilis M. Corrigan1 &
  • Robert L. Clancy2 

  • 255 Accesses

  • 14 Citations

  • Explore all metrics

Abstract

Influenza infection is an acute respiratory disease with a high morbidity and significant mortality, particularly among the elderly and individuals with chronic diseases. The majority of countries nowrecommend annual influenza vaccination for all people aged 65 years or older, and for those with high risk conditions. Most commercially available influenza vaccines are administered systemically and while these are effective in children and young adults, efficacy levels in elderly individuals have been reported to be much lower. Mucosal vaccines may offer an improved vaccine strategy for protection of the elderly. As the influenza virus causes a respiratory infection, it is potentially more beneficial to administer a vaccine that will boost protection in the mucosal surfaces of the upper and lower respiratory tract. Mucosal influenza vaccines are aimed at stimulating protective immunity in the respiratory tract via oral or intranasal immunisation.

This review examines our present knowledge of mucosal immunity and current strategies for mucosal vaccination. It also stresses that the use of serum antibody levels as a ‘surrogate marker’ for protection against influenza is potentially misleading; serum antibody, for example, may be a quite inappropriate marker to assess a mucosal vaccine. This marker does not reflect other immune responses to vaccination that are crucial for protection.

Article PDF

Download to read the full article text

Similar content being viewed by others

Mucosal Immunization and Adjuvants

Chapter © 2015

Early mucosal events promote distinct mucosal and systemic antibody responses to live attenuated influenza vaccine

Article Open access 05 December 2023

Mucosal Vaccination: Opportunities and Challenges

Chapter © 2013
Use our pre-submission checklist

Avoid common mistakes on your manuscript.

References

  1. Keren G, Segev S, Morag A, et al. Failure of influenza vaccination in the aged. J Med Virol 1988; 25: 85–9

    PubMed  CAS  Google Scholar 

  2. Patriarca PA, Weber JA, Parker RA, et al. Efficacy of influenza vaccine in nursing homes, reduction in illness and complications during an influenza A(H2N2) epidemic. JAMA 1985; 253: 1136–9

    PubMed  CAS  Google Scholar 

  3. Arden NH, Patriarca PA, Kendal AP. Experiences in the use and efficacy of inactivated influenza vaccine in nursing homes. In: Kendal AP, Patriarca PA, editor. Options for the control of influenza. New York: Alan R. Liss, 1986: 155–68

    Google Scholar 

  4. Nicholson KG. Influenza. Curr Opin Infect Dis 1994; 7: 168–72

    Google Scholar 

  5. Nicholson KG. Immunisation against influenza among people aged over 65 living at home in Leicestershire during winter 1991–1992. BMJ 1993; 306: 974–6

    PubMed  CAS  Google Scholar 

  6. Gross PA, Hermogenes AW, Sacks HS, et al. The efficacy of influenza vaccine in elderly persons: a meta-analysis and review of the literature. Ann Intern Med 1995; 123(7): 518–27

    PubMed  CAS  Google Scholar 

  7. Powers, DC, Belshe RB. Effect of age on cytotoxic T lymphocyte memory as well as serum and local antibody response elicited by inactivated influenza virus vaccine. J Infect Dis 1993; 167: 584–92

    PubMed  CAS  Google Scholar 

  8. Feery BJ, Evered MG, Morrison EL. Antibody responses to influenza virus subunit vaccine in the aged. Med J Aust 1976; 1: 540–2

    PubMed  CAS  Google Scholar 

  9. Hobson D, Curry RL, Beare AS, et al. The role of serum haemagglutination-inhibiting antibody in protection against challenge infection with influenza A2 and B viruses. J Hyg (Lond) 1972; 70: 767–77

    CAS  Google Scholar 

  10. Govaert TM, Sprenger MJW, Dinant GJ, et al. Immune response to influenza vaccination of elderly people: a randomized double-blind placebo-controlled trial. Vaccine 1994; 12: 1185–9

    PubMed  CAS  Google Scholar 

  11. Palache AM, Beyer WEP, Sprenger MJW, et al. Antibody response after influenza immunization with various vaccine doses: a double blind placebo controlled, multi-centre, dose-response study in elderly nursing home residents and young volunteers. Vaccine 1993; 11: 3–9

    PubMed  CAS  Google Scholar 

  12. Masurel N, Laufer J. A one year study of trivalent influenza vaccines in primed and unprimed volunteers: immunogenicity, clinical reactions and protection. J Hyg (Lond) 1984; 92: 263–76

    CAS  Google Scholar 

  13. Beyer WEP, Teunissen MWE, Diepersloot RJA, et al. Immunogenicity and reactogenicity of two doses of trivalent influenza split vaccine: an open randomized study in healthy, unprotected, adult volunteers. J Drug Ther Res 1986; 11: 369–74

    Google Scholar 

  14. Mostow SR, Schoenbaum SC, Dowdle WR, et al. Studies with inactivated influenza vaccines purified by zonal centrifugation: 1. Adverse reactions and serological responses. Bull World Health Organ 1969; 41: 525–30

    PubMed  CAS  Google Scholar 

  15. Strassburg MA, Greenland S, Sorvillo FJ, et al. Influenza in the elderly: report of an outbreak and a review of vaccine effectiveness reports. Vaccine 1986; 4: 38–44

    PubMed  CAS  Google Scholar 

  16. Gross PA, Quinnan GV, Weksler ME, et al. Immunisation of elderly people with high doses of influenza vaccine. J Am Geriatr Soc 1988; 36: 209–12

    PubMed  CAS  Google Scholar 

  17. Beyer WEP, Palache AM, Balijet M, et al. Antibody induction by influenza vaccines in the elderly: a review of the literature. Vaccine 1989; 7: 385–94

    PubMed  CAS  Google Scholar 

  18. Voth DW, Feldman HA, Steinschneider A. Comparative responses of elderly persons to aqueous and depot influenza vaccines. Arch Environ Health 1966; 13: 567–85

    Google Scholar 

  19. Hobson D, Baker FA, Curry RL. Effects of influenza vaccines in stimulating antibody in volunteers with prior immunity. Lancet 1973; II: 155–7

    Google Scholar 

  20. Ligthart GJ, Corberand JX, Fourniet Ch, et al. Admission criteria for immunogerontological studies in man: the SENIEUR protocol. Mech Ageing Dev 1984; 28: 47–55

    PubMed  CAS  Google Scholar 

  21. Beyer WEP, Palache AM, Sprenger MJW, et al. Effects of repeated annual influenza vaccination on vaccine sero-response in young and elderly adults. Vaccine 1996; 14: 1331–9

    PubMed  CAS  Google Scholar 

  22. Pyhala R, Kumpulainen V, Alanko S, et al. HI antibody kinetics in adult volunteers immunized repeatedly with inactivated trivalent influenza vaccine in 1990–1992. Vaccine 1994; 12: 947–52

    PubMed  CAS  Google Scholar 

  23. Davies JR, Grilli EA. Natural and vaccine induced antibody as a predictor of immunity in the face of natural challenge with influenza viruses. Epidemiol Infect 1989; 102: 325–33

    PubMed  CAS  Google Scholar 

  24. Hoskins TW, Davis JR, Smith AJ, et al. Assessment of inactivated influenza A vaccine after three outbreaks of influenza at Christ’s Hospital. Lancet 1979; I: 33–5

    Google Scholar 

  25. Masurel N, Ophof B, de Jong P. Antibody response to immunization with influenza A/USSR/77 (H1N1) virus in young individuals primed or unprimed for A/New Jersey/76 (H1N1) virus. J Hyg (Lond) 1981; 87: 201–9

    CAS  Google Scholar 

  26. Palache AM. Influenza subunit vaccine: ten years experience. EurJ Clin Res 1992; 3: 117–38

    Google Scholar 

  27. Feery BJ, Evered MG, Morrison EL. Different protection rates in various groups of volunteers given subunit influenza vaccine in 1976. J Infect Dis 1979; 39: 237–41

    Google Scholar 

  28. Govaert TM, Thijs CT, Masurel N, et al. The efficacy of influenza vaccination in elderly individuals: a randomized double-blind placebo-controlled trial. JAMA 1994; 272(21): 1661–5

    PubMed  CAS  Google Scholar 

  29. Nicholson KG, Wiselka MJ, May A. Influenza vaccination of the elderly: perceptions and policies of general practitioners and the outcome of the 1985–86 immunisation programme in Trent, UK. Vaccine 1987; 5: 302–6

    PubMed  CAS  Google Scholar 

  30. Kurinczuk JJ, Nicholson KG. Uptake of influenza vaccination by patients with serious cardiac disease. BMJ 1989; 299: 367

    PubMed  CAS  Google Scholar 

  31. Fedson DS, Wajda A, Nicol JP, et al. Clinical effectiveness of influenza vaccination in Manitoba. JAMA 1993; 270: 1956–61

    PubMed  CAS  Google Scholar 

  32. Foster DA, Talsma A, Furumoto-Dawson A, et al. Influenza vaccine effectiveness in preventing hospitalization for pneumonia in the elderly. Am J Epidemiol 1993; 136: 296–306

    Google Scholar 

  33. Monto AS, Ohmit SE, Foster DA, et al. Case-control study in Michigan on prevention of hospitalization by vaccination in 1989–1991. In: Hannoun C, Kendal AP, Klenk HD, et al., editors. Options for the control of influenza: II. Amsterdam: Elsevier, 1993: 135–41

    Google Scholar 

  34. Barker W, Raubertas R, Menegus M, et al. Case-control study of influenza vaccine effectiveness in preventing pneumonia hospitalization among older persons, Monroe Country, New York 1989–1992. In: Hannoun C, Kendal AP, Klenk HD, et al., editors. Options for the control of influenza: II. Amsterdam: Elsevier, 1993: 143–51

    Google Scholar 

  35. Strikas R, Cook P, Kuller L, et al. Case-control study in Ohio and Pennsylvania on prevention of hospitalization of influenza vaccination. In: Hannoun C, Kendal AP, Klenk HD, et al., editors. Options for the control of influenza: II. Amsterdam: Elsevier, 1993; 153–60

    Google Scholar 

  36. Nguyen-Van-Tam J, Nicholson K. Influenza immunisation: policies and practices of general practitioners in England 1991/92. Health Trends 1993; 25: 101–5

    PubMed  CAS  Google Scholar 

  37. Nichol KL, Margolis KL, Wuorenma J, et al. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med 1994; 331(12): 778–84

    PubMed  CAS  Google Scholar 

  38. Clements ML, Murphy BR. Development and persistence of local and systemic antibody responses in adults given live attenuated or inactivation influenza A virus vaccine. J Clin Microbiol 1986; 23: 66–72

    PubMed  CAS  Google Scholar 

  39. McElhaney JE, Meneilly GS, Lechelt KE, et al. Split-virus influenza vaccines: do they provide adequate immunity in the elderly? J Gerontol 1994; 49: M37–43

    PubMed  CAS  Google Scholar 

  40. Gorse GJ, Belshe RB, Munn NJ. Superiority of live attenuated compared with inactivated influenza A virus vaccines in older, chronically ill adults. Chest 1991; 100: 977–84

    PubMed  CAS  Google Scholar 

  41. Yap KL, Ada GL, McKenzie FC. Transfer of specific cytotoxic T lymphocytes protects mice inoculated with live influenza virus. Nature 1978; 273: 238–9

    PubMed  CAS  Google Scholar 

  42. Yap KL, Ada GL. Cytotoxic T cells in the lungs of mice infected with influenza Avirus. Scand J Immunol 1978; 7: 73–80

    PubMed  CAS  Google Scholar 

  43. McMichael AJ, Askonas BA. Influenza virus-specific cytotoxic T cells in man: induction and properties of the cytotoxic cell. Eur J Immunol 1978; 8: 705–11

    PubMed  CAS  Google Scholar 

  44. Lamb JR, Eckels DD, Phelan M, et al. Antigen-specific human T lymphocyte clones: viral antigen specificity of influenza virus-immune clones. J Immunol 1982; 128: 1428–32

    PubMed  CAS  Google Scholar 

  45. Mitchell DM, Callard RE. Fine specificity of the in vitro antibody response to influenza virus by human blood lymphocytes. J Immunol 1983; 131(3): 1229–33

    PubMed  CAS  Google Scholar 

  46. Clancy RL, Bienenstock J. Enteric infection and immunisation. In: Ferguson A, MacSween RNM, editors. Immunological aspects of the liver and gastrointestinal tract. Lancaster: Medical and Technical Publishing Co. Ltd, 1976: 121–53

    Google Scholar 

  47. Bienenstock N, Clancy RL. Bronchialmucosallymphoid tissue. In: Ogra PL, Lamm ME, McGhee JR, et al., editors. Handbook of mucosal immunology. San Diego (CA): Academic Press, 1994: 529–38

    Google Scholar 

  48. Kilian M, Russel MW. Function of mucosal immunoglobulins. In: Ogra PL, Lamm ME, McGhee JR, et al., editors. Handbook of mucosal immunology. San Diego (CA): Academic Press, 1994: 127–37

    Google Scholar 

  49. Svanborg C. Bacterial adherence and mucosal immunity. In: Ogra PL, Lamm ME, McGhee JR, et al., editors. Handbook of mucosal immunology. San Diego (CA): Academic Press, 1994: 71–8

    Google Scholar 

  50. Mazenec MB, Lamm ME, Lyn, et al. Intracellular neutralization of virus by immunoglobulin A antibodies. Proc Natl Acad Sci U S A 1992; 89: 6901–5

    Google Scholar 

  51. Kaetzel CS, Robinson JK, Chintalacharuvu KR, et al. The polymeric immunoglobulin receptor (secretory component) mediates transport of immune complexes across epithelial cells: a local defense function for IgA. Proc Natl Acad Sci U S A 1991; 88(19): 8796–800

    PubMed  CAS  Google Scholar 

  52. Taylor HP, Dimmock NJ. Mechanism of neutralization of influenza virus by secretory IgA is different from that of monomeric IgA or IgG. J Exp Med 1985; 161: 198–209

    PubMed  CAS  Google Scholar 

  53. Armstrong SJ, Dimmock NJ. Neutralization of influenza virus by low concentrations of hemagglutinin-specific polymerase immunoglobulin A inhibits viral fusion activity, but activation of the ribonucleoprotein is also inhibited. J Virol 1992; 66: 3823–32

    PubMed  CAS  Google Scholar 

  54. Cripps AW, Clancy RL, Murree-Allen K, et al. Quantitation of isotype specific haemophilus influenzae antibody in serum and saliva of normal subjects and chronic bronchitis. Asia Pac J Allergy Immunol 1986; 4: 5–11

    CAS  Google Scholar 

  55. Gleeson M, Cripps, A, Clancy RL. Ontogeny of the secretory immune system in man. Aust N Z J Med 1982; 12: 255–8

    PubMed  CAS  Google Scholar 

  56. Brandtzaeg P. Immune functions of human nasal mucosa and tonsils in health and disease. In: Bienenstock J, editor. Immunology of the lung and upper respiratory tract. New York: McGraw Hill, 1984: 28–95

    Google Scholar 

  57. Platts-Mills TAE, Ishizaka K. IgG and IgA diphtheria antitoxin responses from human tonsil lymphocytes. J Immunol 1975; 114: 1058–64

    PubMed  CAS  Google Scholar 

  58. Zahradnik JM, Karel JA, Martin RR, et al. Immune responses in serum and respiratory secretions following vaccination with a live cold-recombinant (CR35) and inactivated A/USSR/77 (H1N1) influenza virus vaccine. J Med Virol 1983; 11: 277–85

    PubMed  CAS  Google Scholar 

  59. Murphy BR, Nelson DL, Wright PF, et al. Secretory and systemic immunologie response in children infected with live attenuated influenza Avirus vaccine. Infect Immun 1982; 36: 1102–08

    PubMed  CAS  Google Scholar 

  60. Burlington DB, Clements ML, Meiklejohn G, et al. Haemagglutinin-specific antibody responses in immunoglobulin G,A and M isotypes as measured by enzyme-linked immunosorbent assay after primary or secondary infection of humans with influenza Avirus. Infect Immun 1983; 41: 540–5

    PubMed  CAS  Google Scholar 

  61. Waldman RH, Henney CS. Cell-mediated immunity and antibody responses in the respiratory tract after local and systemic immunization. J Exp Med 1971; 134: 482–9

    PubMed  CAS  Google Scholar 

  62. Clancy RL, Bienenstock J. The proliferative response of bronchus associated lymphoid tissue following local and systemic immunization. J Immunol 1974; 112: 1997–2001

    PubMed  CAS  Google Scholar 

  63. Clancy RL, Rawls W, Jagannath S. Appearance of cytotoxic cells within the bronchus following local infection with herpes simplex. J Immunol 1977; 119(3): 1102–5

    PubMed  CAS  Google Scholar 

  64. Buret A, Dunkley M, Clancy RL, et al. The protective role of pulmonary neutrophils in rats intestinally immunized with Pseudomonas. Adv Exp Med Biol 1995; 371B: 765–9

    PubMed  CAS  Google Scholar 

  65. Clancy RL, Pucci A. Human mucosal lymphocytes: memory for ‘recall’ antigens and non-specific suppression by T-lymphocytes. In: McGhee JR, Mestecky J, Babb JL, editors. Secretory immunity and infection in the series. New York: Plenum Press, 1978: 575–82

    Google Scholar 

  66. Husband AJ, Dunkley ML, Cripps AW, et al. Antigen-specific response among T lymphocytes following intestinal administration of alloantigens. Aust J Exp Biol Med Sci 1984; 62: 687–99

    PubMed  Google Scholar 

  67. Bender BS, Croghan T, Zhang L, et al. Transgenic mice lacking class I major histocompatibility complex-restricted T cells have delayed viral clearance and increased mortality after influenza virus challenge. J Exp Med 1992; 175: 1143–5

    PubMed  CAS  Google Scholar 

  68. Doherty PC, Allan W, Eichelberger M, et al. Roles of alpha beta and gamma delta T cell subsets in viral immunity. Annu Rev Immunol 1991; 10: 123–51

    Google Scholar 

  69. Ada GL, Jones PD. The immune response to influenza infection. Curr Top Microbiol Immunol 1986; 128: 1–54

    PubMed  CAS  Google Scholar 

  70. Lin Y-L, Askonas BA. Biological properties of an influenza A virus-specific killer T cell clone: inhibition of virus replication in vivo and induction of delayed-type hypersensitivity reactions. J Exp Med 1981; 154: 225

    PubMed  CAS  Google Scholar 

  71. Taylor PM, Askonas BA. Influenza nucleoprotein specific cytotoxic T cell clones are protective in vivo. Immunology 1986; 58: 417–20

    PubMed  CAS  Google Scholar 

  72. Lukacher AE, Braciale VL, Braciale TJ. In vivo effector function of influenza virus-specific cytotoxic T lymphocyte clones is highly specific. J Exp Med 1984; 160: 814–26

    PubMed  CAS  Google Scholar 

  73. Scherle PA, Palladino G, Gerhard W. Mice can recover from pulmonary influenza virus infection in the absence of class 1-restricted cytotoxic T cells. J Immunol 1992; 148: 212–17

    PubMed  CAS  Google Scholar 

  74. Dolin R, Murphy BR, Caplan EA. Lymphocyte blastogenic responses to influenza virus antigens after influenza infection and vaccination in humans. Infect Immun 1978; 19: 867–74

    PubMed  CAS  Google Scholar 

  75. Dowdle WR, Galphin JC, Coleman MT, et al. A simple double immunodiffusion test for typing influenza viruses. Bull World Health Organ 1974; 51: 213–5

    PubMed  CAS  Google Scholar 

  76. Schild GC. Evidence for a new type-specific structural antigen of the influenza virus particle. J Gen Virol 1972; 15: 99–103

    PubMed  CAS  Google Scholar 

  77. Schild GC, Pereira HG. Characterisation of the ribonucleoprotein and neuraminidase of influenza Avirus by immunodiffusion. J Gen Virol 1969; 4: 355–63

    PubMed  CAS  Google Scholar 

  78. Craig SW, Cebra JJ. Peyer’s patches: an enriched source of precursors for IgA-producing immunocytes in the rabbit. J Exp Med 1971; 134: 188

    PubMed  CAS  Google Scholar 

  79. Rudzik O, Clancy RL, Perey DYE, et al. Repopulation with IgA containing cells of bronchial and intestinal lamina propria after transfer of homologous Peyer’s patches and bronchial lymphocytes. J Immunol 1975; 114: 40–4

    PubMed  CAS  Google Scholar 

  80. Bienenstock J, Johnston N, Perey DYE. Bronchial lymphoid tissue: I. Morphologic characteristics. Lab Invest 1973; 28: 686–92

    PubMed  CAS  Google Scholar 

  81. Scicchitano R, Husband AJ, Clancy RL. Contribution of gut immunisation to the local immune response in the respiratory tract of sheep. Immunology 1984; 53: 375–84

    PubMed  CAS  Google Scholar 

  82. Kawanishi H, Sulzman LE, Strober W. Mechanisms regulating IgAclass-specific immunoglobulin production in murine gut-associated lymphoid tissues: I. J Exp Med 1983; 157: 433–50

    PubMed  CAS  Google Scholar 

  83. Kawanishi H, Sulzman LE, Strober W. Mechanisms regulating IgAclass-specific immunoglobulin production in murine gut-associated lymphoid tissues: II. J Exp Med 1983; 158: 649–69

    PubMed  CAS  Google Scholar 

  84. Kiyono H, McGhee JR, Mosteller LM, et al. Murine Peyer’s patch T cell clones. J Exp Med 1982; 156: 1115–30

    PubMed  CAS  Google Scholar 

  85. Kiyono H, Cooper MD, Kearney JF, et al. Isotype specificity of helper T-cell clones. J Exp Med 1984; 159: 798–811

    PubMed  CAS  Google Scholar 

  86. Dunkley ML, Husband AJ, Underdown BJ. Cognate T-cell help in the induction of IgAresponses in vivo. Immunology 1990; 71: 16–9

    PubMed  CAS  Google Scholar 

  87. Husband AJ, Gowans JL. The origin and antigen-dependent distribution of IgA-containing cells in the intestine. J Exp Med 1978; 148: 1146–60

    PubMed  CAS  Google Scholar 

  88. Mestecky J, McGhee JR. Immunoglobulin A (IgA): molecular and cellular interactions involved in IgAbiosynthesis and immune response. Adv Immunol 1987; 40: 153–245

    PubMed  CAS  Google Scholar 

  89. Brandtzaeg P. Overview of the mucosal immune system. Curr Top Microbiol Immunol 1989; 146: 13–25

    PubMed  CAS  Google Scholar 

  90. Quillan Jr JJ, Francis T. Serological response to intranasal administration of inactive influenza virus in children. J Clin Invest 1947; 26: 1079–87

    Google Scholar 

  91. Kasal JA, Hume EB, Fulk RV, et al. Antibody response in nasal secretions and serum of elderly persons following local or parenteral administration of inactivated influenza virus vaccine. J Immunol 1969; 102: 555–62

    Google Scholar 

  92. Fulk RV, Fedson DS, Hubert MA, et al. Antibody responses in children and elderly persons following local or parenteral administration of an inactivated influenza virus vaccine: A/Hong Kong/68 variant. J Immunol 1969; 102: 1102–5

    PubMed  CAS  Google Scholar 

  93. Walderman RH, Kasal JA, Fulk RV, et al. Influenza antibody in human respiratory secretions after subcutaneous or respiratory immunization with inactivated virus. Nature 1968; 218: 594–5

    Google Scholar 

  94. Walderman RH, Mann JJ, Small Jr PA, et al. Immunization against influenza: prevention of illness in man by aerosolized inactivated vaccine. JAMA 1969; 207: 520–4

    Google Scholar 

  95. Fulk RV, Fedson DS, Hubert MA, et al. Antibody responses in serum and nasal secretions according to age of recipient and methods of administration of A2Hong Kong/68 inactivated influenza virus. J Immunol 1970; 104: 8–13

    PubMed  CAS  Google Scholar 

  96. Liew FY, Russell SM, Appleyard G, et al. Cross-protection in mice infected with influenza A virus by the respiratory route is correlated with local IgA antibody rather than serum antibody or cytotoxic T cell reactivity. Eur J Immunol 1984; 14: 350–6

    PubMed  CAS  Google Scholar 

  97. Donabedian AM, DeBorde DC, Maassab HF. Genetics of cold-adapted B/Ann Arbor/I/66 influenza virus reassortants: the acidic polymerase (PA) protein gene confers temperature sensitivity and attenuated virulence. Microb Pathog 1987; 3: 97–108

    PubMed  CAS  Google Scholar 

  98. Belshe RB, Van Voris LP, Bartram J, et al. Live attenuated influenza A virus vaccines in children: results of a field trial. J Infect Dis 1984; 150: 834–40

    PubMed  CAS  Google Scholar 

  99. Edwards KM, King JC, Steinhoff MC, et al. Safety and immunogenicity of live attenuated cold-adapted influenza B/Ann Arbor/I/86 reassortant virus vaccine in infants and children. J Infect Dis 1991; 163: 740–5

    PubMed  CAS  Google Scholar 

  100. Belshe RB, Swierkosz EM, Anderson EL, et al. Immunization of infants and young children with live attenuated trivalent cold-recombinant influenza A H1N1, H2N2, and B vaccine. J Infect Dis 1992; 165: 727–32

    PubMed  CAS  Google Scholar 

  101. Gruber WC, Kirschner K, Tollefson S, et al. Comparison of monovalent and trivalent live attenuated influenza vaccines in young children. J Infect Dis 1993; 168: 53–60

    PubMed  CAS  Google Scholar 

  102. Clements ML, Betts REF, Murphy BR. Advantage of live attenuated cold-adapted influenza A virus over inactivated vaccine for A/Washington/80 (H3N2) wild-type virus infection. Lancet 1984; I: 705–8

    Google Scholar 

  103. Rudenko LG, Slepushkin AN, Monta AS, et al. Efficacy of attenuated and inactivated influenza vaccines in school children and their unvaccinated contacts in Novgorod, Russia. J Infect Dis 1993; 168: 881–7

    PubMed  CAS  Google Scholar 

  104. Kuno-Sakai H, Kimura M, Ohta K, et al. Developments in mucosal influenza virus vaccines. Vaccine 1994; 12: 1303–10

    PubMed  CAS  Google Scholar 

  105. Johnson PR, Feldman S, Thompson JM, et al. Comparison of long-term systemic and secretory antobody responses in seronegative children given live, attenuated or inactivated influenza A vaccine. J Med Virol 1985; 17: 325–35

    PubMed  Google Scholar 

  106. Couch RB, Kasal JA, Six HR, et al. The basis for immunity to influenza in man. In: Nayak DP, Fox DF, editors. Genetic variation among influenza viruses. New York: Academic Press, Inc., 1981: 535–46

    Google Scholar 

  107. Puck JM, Glezen WP, Frank AL, et al. Protection of infants from infection with influenza Avirus by transplacentally acquired antibody. J Infect Dis 1980; 142: 844–9

    PubMed  CAS  Google Scholar 

  108. Ramphal R, Cogliano RC, Sahnds JW, et al. Serum antibody prevents lethal murine influenza pneumonitis but not tracheitis. Infect Immun 1980; 25: 992–7

    Google Scholar 

  109. Cate TR, Couch RB, Kasal JA, et al. Clinical trials of monovalent influenza A: New Jersey/76 virus vaccines in adults: reactogenicity, antibody response, and antibody persistence. J Infect Dis 1977; 136 Suppl.: 450–5

    Google Scholar 

  110. Clark A, Potter CW, Jennings R, et al. Acomparison of live and inactivated influenza A (H1N1) virus vaccines: 2. Long term immunity. J Hyg (Lond) 1983; 90: 361–70

    CAS  Google Scholar 

  111. Wright PF, Okabe KT, McKee Jr KT, et al. Cold-adapted recombinant influenza Avirus vaccines in seronegative young children. J Infect Dis 1982; 146: 71–9

    PubMed  CAS  Google Scholar 

  112. Powers DC, Sears SD, Murphy BR, et al. Systemic and local antibody responses in elderly subjects given live or inactivated influenza A virus vaccines. J Clin Microbiol 1989; 27: 2666–71

    PubMed  CAS  Google Scholar 

  113. Gorse GJ, Belshe RB, Munn NJ. Safety of and serum antobody response to cold-recombinant influenza Aand inactivated trivalent influenza virus vaccines in older adults with chronic disease. J Clin Microbiol 1986; 24: 336–42

    PubMed  CAS  Google Scholar 

  114. Wright PR, Murphy BR, Kervina M, et al. Secretory immunological response after intranasal inactivated influenza A virus vaccinations: evidence for immunoglobulin Amemory. Infect Immun 1983; 40: 1092–5

    PubMed  CAS  Google Scholar 

  115. Tamura S, Samegai Y, Kurata H, et al. Protection against influenza virus infection by vaccine inoculated intranasally with cholera toxin B subunit. Vaccine 1988; 6(5): 409–13

    PubMed  CAS  Google Scholar 

  116. Tamura S, Ito Y, Asanuma H, et al. Cross-protection against influenza virus infection afforded by trivalent inactivated vaccines inoculated intranasally with cholera toxin B subunit. J Immunol 1992; 149: 981–8

    PubMed  CAS  Google Scholar 

  117. Kimura M, Saka H, Takesue R, et al. Intranasal administration of influenza inactivated HA vaccine. Clin Virol 1987; 15: 407

    Google Scholar 

  118. Hashigucci K, Ogawa H, Ishidate T, et al. Antibody responses in volunteers induced by nasal influenza vaccine combined with Escherichia coli heat-labile enterotoxin B subunit containing a trace amount of the holotoxin. Vaccine 1996; 14: 113–9

    PubMed  CAS  Google Scholar 

  119. Higaki M, Takase T, Igarashi R, et al. Enhancement of immune response to intranasal influenza HA vaccine by microparticle resin. Vaccine 1998; 16: 741–5

    PubMed  CAS  Google Scholar 

  120. Kreuter J, Berg U, Soliva M, et al. Influence of the particle size on the adjuvant effect of particulate polymeric adjuvants. Vaccine 1986; 4: 125–9

    PubMed  CAS  Google Scholar 

  121. Treanor JJ, Mattison HR, Dumyati G, et al. Protective efficacy of combined live intranasal and inactivated influenza A virus vaccines in the elderly. Ann Intern Med 1992; 117: 625–33

    PubMed  CAS  Google Scholar 

  122. Bloom L, Rowley D. Local immune response in mice to V. Cholerae. Aust J Exp Biol Med Sci 1979; 57: 313

    PubMed  CAS  Google Scholar 

  123. Forrest BD, Labrooy JT, Dearlove CE, et al. Effect of parenteral immunization on the intestinal immune response to Salmonella typhi Ty21a. Infect Immun 1992; 60: 465–71

    PubMed  CAS  Google Scholar 

  124. Bergmann KC, Waldman RH. Occurrence of influenza specific antibodies in the lung after oral immunization in mice. Poumon Coeur 1982; 38: 289–92

    PubMed  CAS  Google Scholar 

  125. Bergmann KC, Waldman RH, Veltri RW. Oral immunization using influenza virus II respiratory secretion antibody and protection in mice. Am Rev Respir Dis 1982; 125(4 Suppl.): 67

    Google Scholar 

  126. Bergmann KC, Lachmann B, Noack K. Lung mechanics in orally immunized mice after aerolized exposure to influenza virus. Respiration 1984; 46: 218–21

    PubMed  CAS  Google Scholar 

  127. Bergmann KC, Waldman RH. Antibodies against influenza and stimulated macrophages in the lung lavage fluid of mice following oral immunization. Allerg Immunol (Leipz) 1983; 29: 215–22

    CAS  Google Scholar 

  128. Waldman RH, Bergmann KC, Stone J, et al. Age dependent antibody response in mice and humans following oral influenza immunization. J Clin Immunol 1987; 7: 327–32

    PubMed  CAS  Google Scholar 

  129. Tischner H, Pohl WD, Bergmann KC, et al. Orale immunisierung gegen influenza bei kindern mit chronischen atem-trakterkrankungen. Z Klin Med 1985; 40: 1989–92

    Google Scholar 

  130. Waldman RH, Stone J, Lazzell VA, et al. Regulation of the immune response to orally administered antigens. 8th International Congress on Immunology: 1982; Amherst (NY). Basel: Karger, 1983: 186–94

    Google Scholar 

  131. Clancy RL, Cripps AW, Husband AJ, et al. Specific immune response in the respiratory tract following an oral polyvalent bacterial vaccine. Infect Immun 1983; 39(2): 491–6

    PubMed  CAS  Google Scholar 

  132. Cornes JS. Number, size and distribution of Peyer’s patches in the human small intestine. Gut 1965; 6: 225–33

    PubMed  CAS  Google Scholar 

  133. Moldoveanu Z, Novak M, Huang W-Q, et al. Oral immunization with influenza virus in biodegradable microspheres. J Infect Dis 1993; 167: 84–90

    PubMed  CAS  Google Scholar 

  134. Bland PW, Warren LG. Antigen presentation by epithelial cells of the rat small intestine. Immunology 1986; 58: 9–14

    PubMed  CAS  Google Scholar 

  135. Michalek SM, Childers NK, Katz J, et al. Liposomes as oral adjuvants. Curr Top Microbiol Immunol 1989; 146: 51–8

    PubMed  CAS  Google Scholar 

  136. Jackson S, Mestecky J, Childers NK, et al. Liposomes containing anti-idiotypic antibodies: an oral vaccine to induce protective secretory immune responses specific for pathogens of mucosal surfaces. Infect Immun 1990; 58: 1932–6

    PubMed  CAS  Google Scholar 

  137. Guzman CA, Molinari G, Fountain MW, et al. Antibody responses in the serum and respiratory tract of mice following oral vaccination with liposomes coated with filamentous hemagglutinin and pertussis toxoid. Infect Immun 1993; 61(2): 573–9

    PubMed  CAS  Google Scholar 

  138. Eldridge JH, Gilley RM, Staas JK, et al. Biodegradable microspheres: vaccine delivery system for oral immunization. Curr Top Microbiol Immunol 1989; 146: 59–66

    PubMed  CAS  Google Scholar 

  139. Eldridge JH, Hammond CJ, Meulbroek JA, et al. Controlled vaccine release in the gut-associated lymphoid tissues: I. Orally administered biodegradable microcapsules target the Peyer’s patches. J Controlled Release 1990; 11: 205–14

    CAS  Google Scholar 

  140. Challacombe SJ, Rahman D, Jeffery H, et al. Enhanced secretory IgA and systemic IgG antibody responses after oral immunization with biodegradable microparticles containing antigen. Immunology 1992; 76: 164–8

    PubMed  CAS  Google Scholar 

  141. O’Hagan DT, McGhee JP, Holmgren J, et al. Biodegradable microparticles for oral immunization. Vaccine 1993; 11: 149–54

    PubMed  Google Scholar 

  142. Santiago N, Milstein S, Rivera T, et al. Oral immunization of rats with proteinoid microspheres encapsulating influenza virus antigens. Pharm Res 1993; 10: 1243–7

    PubMed  CAS  Google Scholar 

  143. Heritage PL, Loomes LM, Jianxiong J, et al. Novel polymer-grafted starch microparticles for mucosal delivery of vaccines. Immunology 1996; 88: 162–8

    PubMed  CAS  Google Scholar 

  144. Mowat AM, Donachie AM, Reid G, et al. Immunestimulating complexes containing quil A and protein antigen prime class I MHC-restricted T lymphocytes in vivo and are immunogenic by the oral route. Immunology 1991; 72: 317–22

    PubMed  CAS  Google Scholar 

  145. Mowat AM, Maloy KJ, Donachie AM. Immunestimulating complexes as adjuvants for inducing local and systemic immunity after oral immunization with protein antigens. Immunology 1993; 80: 527–34

    PubMed  CAS  Google Scholar 

  146. Mannino RJ. Protein cochleate vaccines. Vaccine 1989; 147–51

    Google Scholar 

  147. Ekman B, Sjoholm I. Improved stability of proteins immobilized in microparticles prepared by a modified emulsion polymerisation technique. J Pharm Sci 1978; 67: 693–6

    PubMed  CAS  Google Scholar 

  148. Pappo J, Ermak TM, Steger HJ. Monoclonal antibody-directed targeting of fluorescent polystyrene microspheres to Peyer’s patch M cells. Immunology 1991; 73: 277–80

    PubMed  CAS  Google Scholar 

  149. Eldridge JH, Staas JK, Meulbroek JA, et al. Biodegradable microspheres as a vaccine delivery system. Mol Immunol 1991; 28: 287–94

    PubMed  CAS  Google Scholar 

  150. O’Hagan DT, Jeffery H, Roberts MJJ, et al. Controlled release microparticles for vaccine development. Vaccine 1991; 9: 768–71

    PubMed  Google Scholar 

  151. Loh D, Ross AM, Hale AH, et al. Synthetic phospholipid vesicles containing a purified viral antigen and cell membrane proteins stimulate the development of cytotoxic T lymphocytes. J Exp Med 1979; 150(5): 1067–74

    PubMed  CAS  Google Scholar 

  152. Nerome K, Yoshioka Y, Ishida M, et al. Development of a new type of influenza subunit vaccine made by muramyldipeptide liposomes: enhancement of humoral and cellular immune responses. Vaccine 1990; 8: 504–9

    Google Scholar 

  153. Lomotan EA, Brown KA, Speaker TJ, et al. Aqueous-based microcapsules are detected primarily in gut-associated dendritic cells after oral inoculation of mice. Vaccine 1997; 15: 1959–62

    PubMed  CAS  Google Scholar 

  154. Liu LM, MacPherson GG. Lymph-borne (veiled) dendritic cells can acquire and present intestinally administered antigens. Immunology 1991; 73: 281–6

    PubMed  CAS  Google Scholar 

  155. Guery JC, Adorini L. Dendritic cells are the most efficient in presenting endogenous naturally processed self-epitopes to class II restricted T cells. J Immunol 1995; 154: 536–44

    PubMed  CAS  Google Scholar 

  156. Van Vugt E, Verdaasdonk MAM, Kamperdijk EWA, et al. Antigen presenting capacity of peritoneal macrophages and dendritic cells. In: Kamperdijk EWA, editor. Dendritic cells in fundamental and clinical immunology. New York: Plenum Press, 1993

    Google Scholar 

  157. Bhardwaj N, Young JW, Nisanian AJ, et al. Small amounts of superantigen, when presented on dendritic cells, are sufficient to initiate T cell responses. J Exp Med 1993; 178: 633–42

    PubMed  CAS  Google Scholar 

  158. Liu LM, MacPherson GG. Antigen acquisition by dendritic cells: intestinal dendritic cells acquire antigen administered orally and can prime naive T cells in vivo. J Exp Med 1993; 177: 1299–307

    PubMed  CAS  Google Scholar 

  159. Moser CA, Speaker TJ, Offit PA. Effect of microencapsulation on immunogenicity of a bovine herpes virus glycoprotein and inactivated influenza virus in mice. Vaccine 1997; 15: 1767–72

    PubMed  CAS  Google Scholar 

  160. Moldoveanu Z, Staas JK, Gilley, RM, et al. Immune responses to influenza virus in orally and systemically immunized mice. Curr Top Microbiol Immunol 1989; 46: 91–9

    Google Scholar 

  161. Pang G, Clancy RL, O’Reilly S, et al. Anovel particulate influenza virus vaccine stimulates durable and broad-based protection in mice following oral immunisation. J Virol 1992; 66(2): 1162–70

    PubMed  CAS  Google Scholar 

  162. Tomasi TB, Bienenstock J. Secretory immunoglobulins. In: Dixon FJ, Kunkel HG, editors. Advances in immunology. New York: Academic Press Inc., 1968: 1–96

    Google Scholar 

  163. Heremans JF. Immunoglobulin formation and function in different tissues. Curr Top Microbiol Immunol 1968; 45: 131

    PubMed  CAS  Google Scholar 

  164. Byleveld PM, Pang GT, Clancy RL, et al. Virus specific and polyclonal responses following challenge with influenza in immunised mice fed fish oil, linseed oil or beef tallow. J Nutrition. In press

  165. Wells MA, Daniel S, Djeu JY, et al. Recovery from a viral respiratory tract infection: IV Specificity of protection by cytotoxic T lymphocytes. J Immunol 1983; 130(6): 2908–14

    PubMed  CAS  Google Scholar 

  166. Butt HL, Clancy RL, Cripps AW, et al. Bacterial colonisation of the respiratory tract in chronic bronchitis. Aus N Z J Med 1990; 20: 35–8

    CAS  Google Scholar 

  167. Scheiblauer H, Reinacher M, Tashiro M, et al. Interactions between bacteria and influenza A virus in the development of influenza pneumonia. J Infect Dis 1992; 166: 783–91

    PubMed  CAS  Google Scholar 

  168. Heikkinen T, Waris M, Ruuskanen O. Efficacy of influenza vaccination in reducing otitis media in children. In: Hannoun C, Kendal AP, Klenk HD, et al., editors. Options for the control of influenza II. Amsterdam: Elsevier, 1993: 431–4

    Google Scholar 

  169. Walker JA, Kawaoka Y. Importance of conserved amino acids at the cleavage site of a virulent avian influenza A virus. J Gen Virol 1993; 74: 311–4

    PubMed  CAS  Google Scholar 

  170. Dunkley M, Clancy R. Arodent model of concurrentrespiratory infection with influenza virus and gram negative bacteria: synergistic infection and protection by oral immunization. Immunol Cell Biol 1997; 75(1): A7

    Google Scholar 

  171. Clancy R, Cripps, A, Murree-Allen K, et al. Protection against acute bronchitis in chronic obstructive lung disease induced by oral immunization with killed haemophilus influenzae. Lancet 1985; II: 1395–7

    Google Scholar 

  172. Lehmann D, Coakley KH, Coakley CA, et al. Reduction in the incidence of acute bronchitis by an oral Haemophilus influenzae vaccine in patients with chronic bronchitis in the highlands of Papua New Guinea. Am Rev Respir Dis 1991; 144: 324–30

    PubMed  CAS  Google Scholar 

  173. Clancy RL, Cripps AW. Specific protection against acute bronchitis associated with non-typable Haemophilus influenzae. J Infect Dis 1992; 165Suppl. 1: 5194–5

    Google Scholar 

  174. Moldoveanu Z, Clements ML, Prince SJ, et al. Human immune responses to influenza virus vaccines administered by systemic or mucosal routes. Vaccine 1995; 13(11): 1006–12

    PubMed  CAS  Google Scholar 

  175. Gorse GJ, Otto EE, Daughaday CC, et al. Influenza virus vaccination of patients with chronic lung disease. Chest 1997; 112: 1221–33

    PubMed  CAS  Google Scholar 

  176. Gorse GJ, Campbell MH, Otto EE, et al. Increased anti-influenza A virus cytotoxic T cell activity following vaccination of the chronically ill elderly with live attenuated or inactivated influenza virus vaccine. J Infect Dis 1995; 172: 1–10

    PubMed  CAS  Google Scholar 

  177. Gorse GJ, Belshe RB. Enhancement of anti-influenza A virus cytotoxicity following influenza A virus vaccination in older, chronically ill adults. J Clin Microbiol 1990; 28: 2539–50

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Australian Institute of Mucosal Immunology, Royal Newcastle Hospital, Newcastle, New South Wales, Australia

    Eilis M. Corrigan

  2. Discipline of Pathology, Faculty of Medicine & Health Sciences, Royal Newcastle Hospital, David Maddison Clinical Sciences Building, Newcastle, New South Wales, 2300, Australia

    Robert L. Clancy

Authors
  1. Eilis M. Corrigan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert L. Clancy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert L. Clancy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Corrigan, E.M., Clancy, R.L. Is There a Role For a Mucosal Influenza Vaccine in the Elderly?. Drugs Aging 15, 169–181 (1999). https://doi.org/10.2165/00002512-199915030-00001

Download citation

  • Published: 31 August 2012

  • Issue Date: September 1999

  • DOI: https://doi.org/10.2165/00002512-199915030-00001

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Keywords

  • Influenza
  • Adis International Limited
  • Influenza Virus
  • Influenza Vaccine
  • Influenza Vaccination
Use our pre-submission checklist

Avoid common mistakes on your manuscript.

Advertisement

Search

Navigation

  • Find a journal
  • Publish with us
  • Track your research

Discover content

  • Journals A-Z
  • Books A-Z

Publish with us

  • Journal finder
  • Publish your research
  • Open access publishing

Products and services

  • Our products
  • Librarians
  • Societies
  • Partners and advertisers

Our imprints

  • Springer
  • Nature Portfolio
  • BMC
  • Palgrave Macmillan
  • Apress
  • Your US state privacy rights
  • Accessibility statement
  • Terms and conditions
  • Privacy policy
  • Help and support
  • Cancel contracts here

44.200.94.150

Not affiliated

Springer Nature

© 2024 Springer Nature