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November 11, 2015
Statins Appear to Reduce Immune Response to Flu Vaccine
Cincinnati—Statins might be beneficial in reducing cholesterol levels, but they also appear to have a less desirable effect: reducing immune response to influenza vaccine and the flu vaccine’s effectiveness at preventing serious illness in older adults. Two studies published recently in The Journal of Infectious Diseases raise questions that potentially could affect flu vaccine recommendations, guidelines for statin use during influenza vaccination season, and future vaccine clinical trials in seniors. One study, led by researchers from Cincinnati Children’s Hospital Medical Center, analyzed immune response data from an earlier clinical trial conducted during the 2009-2010 and 2010-2011 flu seasons. The industry-funded study, which employed data on nearly 7,000 older adults in four countries, looked at how statin use affected patients’ initial immune responses after immunization against flu. The level of antibodies to the flu vaccine strains in patients’ blood was measured 3 weeks after being vaccinated. The 65 and older statin users were found to have a significantly reduced immune response to vaccination compared to those not taking statins, Researchers note that the strongest effect was with patients on synthetic statins, not those naturally derived. “Apparently, statins interfere with the response to influenza vaccine and lower the immune response, and this would seem to also result in a lower effectiveness of influenza vaccines,” said lead author Steven Black, MD. If confirmed, the findings could support measures to counteract the effect of statins, such as using high-dose flu vaccine or vaccines containing adjuvants to boost immune response in the elderly, the study authors suggest. The second study, conducted by researchers from Emory University in Atlanta, looked at how statins might be decreasing the effectiveness of flu vaccine at preventing serious respiratory illness. To do that, the study team analyzed flu season data from 2002 to 2011. The focus was on flu vaccination, statin prescriptions, and cases of medically attended, acute respiratory illness among nearly 140,000 people enrolled in a large managed care organization in Georgia. “What we found was a potential signal that the effectiveness of flu vaccine in older people may be compromised somewhat if they are on statins, compared to those who are not on statins,” lead author Saad B. Omer, MBBS, MPH, PhD, said in an Infectious Diseases Society of America press release. The second study was funded by Emory and the National Institute of Allergy and Infectious Diseases. Vaccine effectiveness for preventing serious respiratory illness was lower among patients taking statins compared to patients who were not on statins, particularly when flu was widespread in the state, according to the study. Authors of both studies called for more research on the issue, as did an accompanying editorial. Robert L. Atmar, MD, and Wendy A. Keitel, MD, of Baylor College of Medicine in Houston, write in a commentary that “the results of these studies should be viewed as hypothesis-generating and should prompt further investigations into whether statins reduce inactivated influenza vaccine immunogenicity and, if so, the mechanisms by which immune responses and associated vaccine effectiveness are adversely affected.”
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