Simultaneous Zoster, Influenza Vaccines Significantly Effective for Older Adults
Researchers compared the safety and reactogenicity of simultaneous doses of recombinant zoster vaccine paired with 2 separate types of inactivated influenza vaccines.
When compared with simultaneous administration of recombinant zoster vaccine (RZV) and high-dose inactivated influenza vaccine (HD-IIV4), simultaneous administration of RZV and quadrivalent adjuvanted inactivated influenza vaccine (aIIV4) was similarly effective, based on data published in JAMA Network Open.1
“Novel nonaluminum adjuvants are powerful immunostimulants used in vaccine platforms to improve immunogenicity and efficacy. In recent years, the US Food and Drug Administration (FDA) licensed several vaccines with novel adjuvants,” wrote authors of the study. “For older adults, the need for safety data on simultaneous administration of vaccines with novel adjuvants has specific clinical relevance.”
To compare 2 routes of simultaneous administration, researchers conducted their study during the 2021-22 and 2022-23 flu seasons. | image credit: ink drop / stock.adobe.com
In 2017, FDA approved an adjuvanted version of the RZV for preventing herpes zoster in adults over the age of 50. A few years earlier, a trivalent adjuvanted influenza vaccine was approved for adults over 65, while 2020 saw approval for the aIIV4 version of the influenza vaccine.1
Then in 2022, based on CDC Advisory Committee on Immunization Practices (ACIP) guidelines, all adults 65 and older were recommended to receive 1 of the following vaccines based on preference: HD-IIV4, aIIV4, or a quadrivalent recombinant version of the influenza vaccine.
READ MORE: ACIP Publishes Final Pneumococcal Vaccine Recommendations
“We performed a randomized clinical trial to determine the safety of simultaneous doses of RZV and aIIV4 compared with simultaneous doses of RZV and HD-IIV4 among adults aged 65 years or older. The primary objective was to compare the proportion of participants with at least 1 severe (grade 3) solicited local or systemic reactogenicity event after RZV dose 1 in the RZV and aIIV4 group vs the RZV and HD-IIV4 group,” they continued.1
To compare both instances of simultaneous administration, researchers conducted their study during the 2021-22 and 2022-23 flu seasons. Using a noninferiority test to determine efficacy, all study participants received dose 1 of RZV administered intramuscularly. Participants were then separated into 2 groups to receive a dose of either aIIV4 or HD-aIIV4 administered simultaneously with RZV.
The trial included a total of 267 adult participants (median age, 71 years; 51.3% men; 92.5% White). The trial population was then separated, with 130 participants receiving simultaneous RZV and aIIV4, and the other 137 receiving RZV and HD-IIV4. Furthermore, participants were also randomized by flu season. Unlike randomization for vaccine type, 102 participants were randomized during the 2021-22 flu season and 165 participants for 2022-23.
Across all outcomes, participants receiving simultaneous administration of RZV and aIIV4 showed significantly similar outcomes with the group that received RZV and HD-IIV4. Indeed, local or systemic reactions, severe solicited reactogenicity events, and all other explored instances of adverse reactions were similar between the 2 groups, highlighting the success of both routes of simultaneous administration for the recombinant zoster and inactivated influenza vaccines.
“Consistent with our study’s safety hypothesis, we found that the proportion of participants with at least 1 severe (grade 3) solicited reactogenicity event was noninferior (not higher) in the simultaneous RZV dose 1 and aIIV4 group (11.5%) compared with the simultaneous RZV dose 1 and HD-IIV4 group (12.5%). The proportion of participants with at least 1 severe (grade 3) solicited local or systemic reactogenicity event evaluated separately was also noninferior (not higher) in the aIIV4 group vs the HD-IIV4 group.”
Combining the RZV and adjuvanted influenza vaccines for simultaneous administration is just one example of the growing opportunities for patients to keep themselves and other protected from infectious diseases. Despite universal acceptance of simultaneous administration in adults still being in its early stages, it has become commonplace in younger populations.
“While simultaneous administration of multiple childhood or travel vaccines during one visit has become the standard of care, co-administration of routine vaccines for adults is only slowly becoming common practice by health care providers,” according to authors of a study published in Human Vaccines & Immunotherapeutics.2
As more research is conducted on simultaneous administration of various vaccines, providers continue to recommend patients stay protected against various infectious diseases in order to keep the population as safe and healthy as possible.
“From a safety standpoint, the simultaneous administration of RZV and aIIV4 was an acceptable option for vaccine delivery among older adults,” concluded authors of the study.1
READ MORE: Immunization Resource Center
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