High-Dose Trivalent Inactivated Flu Vaccine May Improve Seroconversion Rate


High-Dose Trivalent Inactivated Flu Vaccine May Improve Seroconversion Rate in Rheumatoid Arthritis

by Dr. C.H. Weaver M.D.

Results, presented at the 2018 American College of Rheumatology Annual Meeting, held in Chicago, Illinois, suggest that a high-dose trivalent inactivated influenza vaccine (HD-TIV) may improve post-vaccine vaccination responses compared with use of the standard dose quadrivalent inactivated influenza vaccine in patients with rheumatoid arthritis (RA).1 These results have important implications for other immunocompromised patients that benefit from influenza vaccination.

Doctors from McGill University in Canada conducted a clinical trial in adults with rheumatoid factor- or anti-cyclic citrullinated peptide antibody-positive RA. In the trial 279 individuals with RA were treated with either the standard quadrivalent influenza vaccine or the HD-TIV during the 2016-17 and 2017-18 “flu season” and directly compared. The participating individuals all had RA and were an average age of 61, 80% were women.

Overall both seroconversion and seroprotection rates were higher in the individuals who received the HD-TIV vaccine. According to Dr. Colmegna M.D. who presented the study results at ACR,

“The McGill study shows that HD-TIV provides better seroprotection against influenza in RA patients, and these results together with the fact that the HD-TIV was as safe as the SD-TIV may lead to changes in practice (i.e. recommendation to use HD instead of SD influenza vaccine in RA) and inform public health decisions.”

About the Influenza Vaccine


  1. Colmegna I, Useche M, Rodriguez K, et al. Efficacy of high-dose versus standard-dose influenza vaccine in seropositive rheumatoid arthritis patients. Presented at: ACR/ARHP 2018 Annual Meeting; October 19-24, 2018; Chicago, IL. Abstract 837.
  2. High-dose vaccine enhances production of antibodies against flu in RA patients [press release]. Chicago, IL: American College of Rheumatology. Published October 20, 2018. Accessed October 21, 2018.​

Rheumatoid Arthritis