Influenza Vaccine Response in Adults Exposed to Perfluorooctanoate and Perfluorooctanesulfonate

Editors Highlight: Vaccines and their possible adverse effects have received a great deal of popular attention, often based on sketchy science. In this issue of ToxSci, Luster and colleagues provide an example of how quality toxicological research can reveal connections between vaccines, immune function, and environmental exposures. The authors examined a human population that was exposed to perfluorooctanoate (PFOS) and how they responded to vaccines for influenza viruses. The results showed that individuals with high levels of PFOS had weaker antibody responses. Even though an increase in self-reported infections was not observed in this study, the fact that such inadvertent exposures can blunt one of the most important public health interventions demands further attention. Elderly and infirm populations often receive higher doses of vaccines to generate a more robust antibody response. The reported findings suggest that individuals exposed to certain environmental contaminants may also require higher doses of vaccines, or at least titer checks to confirm appropriate vaccine response. Gary W. Miller.Supported by several epidemiological studies and a large number of animal studies, certain polyfluorinated alkyl acids are believed to be immunotoxic, affecting particularly humoral immunity. Our aim was to investigate the relationship between the antibody response following vaccination with an inactivated trivalent influenza vaccine and circulating levels of perfluorooctanoate (PFOA) and perfluorooctanesulfonate (PFOS). The study population consisted of 411 adults living in the mid-Ohio region of Ohio and West Virginia where public drinking water had been inadvertently contaminated with PFOA. They participated in a larger cross-sectional study in 2005/2006 and were followed up in 2010, by which time serum levels of PFOA had been substantially reduced but were still well above those found in the general population. Hemagglutination inhibition tests were conducted on serum samples collected preinfluenza vaccination and 213 days postvaccination in 2010. Serum samples were also analyzed for PFOA and PFOS concentrations (median: 31.5 and 9.2ng/ml, respectively). Questionnaires were conducted regarding the occurrence and frequency of recent (during the last 12 months) respiratory infections. Our findings indicated that elevated PFOA serum concentrations are associated with reduced antibody titer rise, particularly to A/H3N2 influenza virus, and an increased risk of not attaining the antibody threshold considered to offer long-term protection. Although the direct relationship between weakened antibody response and clinical risk of influenza is not clear, we did not find evidence for an association between self-reported colds or influenza and PFOA levels nor between PFOS serum concentrations and any of the endpoints examined.