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We read with interest the recent article by Carson et al¹ on immune function and vaccine responses in healthy elderly subjects. Given the increasing proportion of people older than 65 years and the importance of influenza vaccination for the prevention of morbidity and mortality in this population, improved understanding of age-related functional changes of the immune response is important. However, as a result of a number of methodologic issues, we believe that the conclusions made by Dr Carson and colleagues need to be cautiously interpreted.

The serologic studies were only performed at 1 postvaccination time point. As antibody titers are known to decrease more rapidly in the elderly than in healthy young people,² antibody titers should have been measured at serial time points in order to account for this difference between the 2 age groups. The absolute IgG antibody titers in older subjects, shown in Carson and colleagues' Figure 2, . . . [Full Text of this Article]

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