Concomitant administration of seasonal influenza and COVID-19 mRNA vaccines

ABSTRACT

Current clinical guidelines support the concomitant administration of seasonal influenza vaccines and COVID-19 mRNA boosters vaccine. Whether dual vaccination may impact vaccine immunogenicity due to an interference between influenza or SARS-CoV-2 antigens is unknown. We aimed to understand the impact of mRNA COVID-19 vaccines administered concomitantly on the immune response to influenza vaccines. For this, 128 volunteers were vaccinated during the 22-23 influenza season. Three groups of vaccination were assembled: FLU vaccine only (46, 35%) versus volunteers that received the mRNA bivalent COVID-19 vaccines concomitantly to seasonal influenza vaccines, FluCOVID vaccine in the same arm (42, 33%) or different arm (40, 31%), respectively. Sera and whole blood were obtained the day of vaccination, +7, and +28 days after for antibody and T cells response quantification. As expected, side effects were increased in individuals who received the FluCOVID vaccine as compared to FLU vaccine only based on the known reactogenicity of mRNA vaccines. In general, antibody levels were high at 4 weeks post-vaccination and differences were found only for the H3N2 virus when administered in different arms compared to the other groups at day 28 post-vaccination. Additionally, our data showed that subjects that received the FluCOVID vaccine in different arm tended to have better antibody induction than those receiving FLU vaccines for H3N2 virus in the absence of pre-existing immunity. Furthermore, no notable differences in the influenza-specific cellular immune response were found for any of the vaccination groups. Our data supports the concomitant administration of seasonal influenza and mRNA COVID-19 vaccines.

KEYWORDS:

• Vaccination
• influenza
• COVID-19
• mRNA vaccine
• seasonal vaccination

Acknowledgements

We thank Richard Cadagan for excellent technical assistance. This work was partly supported by Consejería de Transformación Económica, Industria, Conocimiento y Universidades and FEDER. It is also partly supported by CRIPT (Center for Research on Influenza Pathogenesis and Transmission), a NIAID funded Center of Excellence for Influenza Research and Response (CEIRR, contract # 75N93021C00014) to A.G.-S and T.A.; and by SEM-CIVIC, a NIAID funded Collaborative Influenza Vaccine Innovation Center (contract #75N93019C00051) to A.G.-S. T. A was also funded by the American Lung Association. JSC and EC also were supported by CIBERINFEC – Consorcio Centro de Investigación Biomédica en Red, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea – NextGenerationEU (CB21/13/00006).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

T.A, J.S–C, A.G.-S and E.C. conceived, designed and supervised the study. T.A supervised and provided training to A.R. A.R. performed all the antibody quantification experiments: grown influenza viruses for hemagglutination inhibition assays, performed ELISA assays against Wuhan-like and Omicron spikes and calculated antibody titers with help of T.A. C. S-R, MM. M-G, MJ. S–C, E.C included the volunteers and were responsible of their clinical follow-up. M.B processed samples and collected clinical data, performed flow cytometry experiments, analyzed data, wrote manuscript and provided figures. A. E provided influenza virus stocks. T.A analyzed data, wrote the manuscript and prepared figures. All authors reviewed the manuscript.

Declaration of interest statement

The A.G.-S. laboratory has received research support from GSK, Pfizer, Senhwa Biosciences, Kenall Manufacturing, Blade Therapeutics, Avimex, Johnson & Johnson, Dynavax, 7Hills Pharma, Pharmamar, ImmunityBio, Accurius, Nanocomposix, Hexamer, N-fold LLC, Model Medicines, Atea Pharma, Applied Biological Laboratories and Merck, outside of the reported work. A.G.-S. has consulting agreements for the following companies involving cash and/or stock: Castlevax, Amovir, Vivaldi Biosciences, Contrafect, 7Hills Pharma, Avimex, Pagoda, Accurius, Esperovax, Farmak, Applied Biological Laboratories, Pharmamar, CureLab Oncology, CureLab Veterinary, Synairgen, Paratus and Pfizer. A.G.-S. has been an invited speaker in meeting events organized by Seqirus, Janssen, Abbott and Astrazeneca. A.G.-S. is inventor on patents and patent applications on the use of antivirals and vaccines for the treatment and prevention of virus infections and cancer, owned by the Icahn School of Medicine at Mount Sinai, New York.

Additional information

Funding

This work was supported by American Lung Association: [COVID-1034091]. Centro de Investigación Biomedica en Red de Enfermedades Infecciosas, CIBERINFEC, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovacion and Union Europea – NextGeneration EU (Grant Number CB21/13/00006); Consejeria de Economia, Conocimiento, Empresas y Universidad, Secretaria General de Universidades, Investigacion y Tecnologia, Junta de Andalucia, Spain (P18-RT-3320). SEM-CIVIC National Institute of Allergy and Infectious Diseases: [Grant Number 75N93019C00051]. CEIRR-CRIPT: [75N93021C00014].