PET-CT Scans in Healthy Volunteers After Flu Vaccination

Until recently, all recipients of influenza vaccine received a killed form of virus,
typically in the same nondominant arm, each year before flu season. We hypothesize that
natural infection, and some forms of vaccination, could allow vaccine induced responses to
spread beyond the local lymph nodes near the vaccination site. From a practical perspective,
if vaccine induced proliferation of specific immune cells in sites distant from the
vaccination site lead to beneficial immune memory, it would suggest vaccination strategies
that could be as simple as alternating the injected arm from year to year, or alternating
inhaled vs. injected forms of vaccine.

This will be a 4 armed prospective study of individuals receiving unilateral FluShield i.m.
Healthy adult volunteers 21-55 will be grouped according to the following criteria: I.
Documented history of prior natural infection with influenza A or B within the past 5 years
(diagnostic test or high titer HA Ab in absence of vaccination); II. History of FluMist
vaccination within the past 2 years; III. History of TIV vaccination, any number of times,
but only in a single (e.g., non-dominant) arm. Within one month of screening and baseline
blood draws for PBMCs and Ab titers, individuals will receive FluShield injections. For those
individuals with prior history of unilateral TIV injections, half will receive their shots in
the same arm that has always been injected (Group IIIa). The other half of these individuals
will receive Flushield in the opposite (dominant) arm (Group IIIb).

Upon entering the study, 50cc of heparinized blood and 10 cc of serum will be drawn by
antecubital venipuncture. Within 4 weeks of this blood draw, volunteers will receive a
standard dose of i.m. TIV (FluShield). Four-seven days later they will have an FDG PET-CT
scan performed after an 8 hour fast.

Additional blood draws of 50cc heparinized blood and 10 cc serum will be obtained at 2, 4,
and 6 weeks post vaccination, and at 10-12 months post vaccination. After the last blood
draw, volunteers will also be asked questions pertaining to flu-like symptoms during the past
10 months.

Inclusion Criteria:

- Men and women 21-55 years old.

- Willingness to participate in the study for a full year including multiple blood draws
and PET-CT scanning

Exclusion Criteria:

- Diabetes

- Use of systemic steroids

- Pregnancy or unwillingness to practice birth control of some kind through the PET-CT
scanning period

- Recent vaccination for other reasons (e.g., traveler's vaccines)

- Significant intercurrent illness that might interfere with vaccination "take" or
interpretation of PET-CT scanning (e.g., chemotherapy for cancer)