INCREASED ANTIINFLUENZA-A VIRUS CYTOTOXIC T-CELL ACTIVITY FOLLOWING VACCINATION OF THE CHRONICALLY ILL ELDERLY WITH LIVE ATTENUATED OR INACTIVATED INFLUENZA-VIRUS VACCINE

The possible enhancement of anti-influenza A virus memory cytotoxic T cell (CTL) responses to inactivated influenza virus vaccine by coadmin istration of intranasal live attenuated influenza A virus vaccine was investigated. Fifty elderly nursing home residents received inactivate d trivalent influenza virus vaccine intramuscularly and simultaneously were randomly assigned to receive either bivalent live attenuated inf luenza A virus vaccine or saline placebo intranasally in a blinded fas hion. A larger proportion of volunteers who received live attenuated v irus vaccine than of those who received placebo experienced a postvacc ination rise in anti-influenza A virus CTL activity (15 of 23 vs. 8 of 24; P < .05). Anti-influenza A virus cytotoxicity was primarily media ted by CD8(+) T cells and was influenza A virus-specific and HLA-restr icted. There was a possible advantage of administering live attenuated with inactivated virus vaccine because of enhanced memory antiinfluen za A virus CTL activity.