SHIVERING 2 Trial Shows Tandem High-Dose Influenza Vaccines Significantly Improve Protection in Plasma Cell Dyscrasia Patients

Plasma cell dyscrasias (PCDs), like multiple myeloma, are hematologic disorders that lead to compromised immune responses, making vaccinations, particularly against influenza, less effective in patients with PCDs due to their altered immunity and the impacts of antimyeloma therapies. The SHIVERING 2 clinical trial compared tandem high-dose influenza vaccination with standard single-dose vaccination to further explore this approach’s efficacy for patients with PCDs.

The trial, conducted during the 2015-2016 flu season, included 122 patients with PCD. The results showed that the tandem high-dose vaccination significantly improved total seroprotection and seroconversion rates against influenza strains compared to the standard single-dose vaccination. Specifically, after the second vaccine dose, 86.3% of patients in the high-dose group achieved seroprotection against all three influenza strains, compared to 63.9% in the control group. At the flu season’s end, these benefits were sustained, especially against the H1N1 strain. The study also identified factors affecting vaccine response, such as gender, immunoglobulin treatment, and recent influenza infection. These findings suggest that a revised influenza vaccination strategy, incorporating tandem high-dose vaccines, could significantly benefit patients with PCD.

Reference: Branagan AR, Duffy E, Gan G, et al. Tandem high-dose influenza vaccination is associated with more durable serologic immunity in patients with plasma cell dyscrasias. Blood Adv. 2021 Mar 9;5(5):1535-1539. doi: 10.1182/bloodadvances.2020003880. PMID: 33683337; PMCID: PMC7948269.

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