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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
UNITED STATES: Research Supports High-Dose Flu Vaccine for People with HIV
Dan Sapatkin
January 2, 2013
Philadelphia Inquirer (01.02.13)

Researchers report that Fluzone High-Dose, approved by the US Food and Drug Administration in 2009 for immunizing people 65 and older against the flu, is also effective in building a higher immune response among HIV-infected people. The University of Pennsylvania study compared the immune response of HIV-infected people who received the standard dose of Fluzone with a group of HIV-infected people who took Fluzone High-Dose, said Pablo Tebas, MD. The Fluzone High-Dose group developed more antibodies to the flu and had an immunization response more like healthy younger adults. Tebas noted that others with compromised immune systems—people with cancer, rheumatoid arthritis, and kidney failure—might also benefit from Fluzone High-Dose immunization. It was not clear from the results of the study whether people with AIDS (CD4 counts under 200) would receive the same immunization benefit from Fluzone High-Dose. At present, the FDA has only approved Fluzone High-Dose for use with people 65 and older. It is unlikely that insurance companies would reimburse the use of Fluzone High-Dose with HIV-infected people unless the immunization practices committee of the Centers for Disease Control and Prevention recommends this additional use. There must be a “compelling reason” for CDC to endorse a use other than that approved by FDA, said CDC’s Jean Clare Smith, MD. The National Institutes of Health (NIH)—not the Fluzone High-Dose maker Sanofi Pasteur—funded the University of Pennsylvania study. Researchers will request that CDC review the study and recommend the use of Fluzone High-Dose with HIV-infected people. The full report, “Improved Immunogenicity with High-Dose Seasonal Influenza Vaccine in HIV-Infected Persons: A Single-Center, Parallel, Randomized Trial,” was published in the journal Annals of Internal Medicine (2013; 158(1):19-26).