The doctrine of original antigenic sin: separating good from evil

AS Monto, RE Malosh, JG Petrie… - The Journal of infectious …, 2017 - academic.oup.com
The Journal of infectious diseases, 2017academic.oup.com
The term “original antigenic sin” was coined approximately 60 years ago to describe the
imprinting by the initial first influenza A virus infection on the antibody response to
subsequent vaccination. These studies did not suggest a reduction in the response to
current antigens but instead suggested anamnestic recall of antibody to earlier influenza
virus strains. Then, approximately 40 years ago, it was observed that sequential influenza
vaccination might lead to reduced vaccine effectiveness (VE). This conclusion was largely …
Abstract
The term “original antigenic sin” was coined approximately 60 years ago to describe the imprinting by the initial first influenza A virus infection on the antibody response to subsequent vaccination. These studies did not suggest a reduction in the response to current antigens but instead suggested anamnestic recall of antibody to earlier influenza virus strains. Then, approximately 40 years ago, it was observed that sequential influenza vaccination might lead to reduced vaccine effectiveness (VE). This conclusion was largely dismissed after an experimental study involving sequential administration of then-standard influenza vaccines. Recent observations have provided convincing evidence that reduced VE after sequential influenza vaccination is a real phenomenon. We propose that such reduction in VE be termed “negative antigenic interaction,” given that there is no age cohort effect. In contrast, the potentially positive protective effect of early influenza virus infection later in life continues to be observed. It is essential that we understand better the immunologic factors underlying both original antigenic sin and negative antigenic interaction, to support development of improved influenza vaccines and vaccination strategies.
Oxford University Press