Superior Relative Efficacy of Live Attenuated Influenza Vaccine Compared With Inactivated Influenza Vaccine in Young Children With Recurrent Respiratory Tract Infections

Ashkenazi, Shai; Vertruyen, André; Arı́stegui, Javier; Esposito, Susanna; McKeith, David Douglas; Klemola, Timo; Biolek, Jiri; Kühr, J.; Bujnowski, Tadeusz; Desgrandchamps, Daniel; Cheng, Sheau-Mei; Skinner, Jonathan; Gruber, William C.; Forrest, Bruce D.

doi:10.1097/01.inf.0000237829.66310.85

Cited by 292 publications

(195 citation statements)

References 18 publications

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“…Overall the frequency of grade 2 and grade 3 signs and symptoms, including pulmonary disease and asthma or wheezing, were equally distributed between the two treatment Arms. Injection site reactions for TIV were observed in 23% of recipients, including one grade 3 event, which is similar to that previously reported (23)(24)(25)(26). Mild upper respiratory symptoms were more commonly reported after LAIV (52%) than after TIV (31%), which has also been previously reported (23)(24)(25)(26).…”

Section: Discussionsupporting

confidence: 87%

“…Moreover, because of intranasal administration, LAIV has the potential to stimulate greater local anti-influenza immune responses than TIV (20)(21)(22). LAIV demonstrated greater reductions in influenza than TIV in HIV-uninfected children, against strains that were well-matched with strains in the vaccine, as well as against antigenically drifted strains not included in the vaccine administered (23)(24)(25)(26)(27)(28), and several studies have shown that the LAIV protective effect can extend beyond the year of administration (27,28).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Shedding of live vaccine virus, comparative safety, and influenza-specific antibody responses after administration of live attenuated and inactivated trivalent influenza vaccines to HIV-infected children

Levin

Song

Fenton

et al. 2008

Vaccine

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Shedding of live vaccine virus, comparative safety, and influenza-specific antibody responses after administration of live attenuated and inactivated trivalent influenza vaccines to HIV-infected children

Levin

Song

Fenton

et al. 2008

Vaccine

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“…Of the 4,372 studies initially identified (Figure), 18 RCTs [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39], 14 non-randomised clinical trials [40][41][42][43][44][45][46][47][48][49][50][51][52][53], and six observational studies [54][55][56][57][58][59] were eligible for inclusion. The clinical trial registry search yielded 12 additional relevant studies (five RCTs and seven nonrandomised trials).…”

Section: Resultsmentioning

confidence: 99%

Systematic review of fever, febrile convulsions and serious adverse events following administration of inactivated trivalent influenza vaccines in children

et al. 2015

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In 2010, increased febrile convulsions (FC) occurred after administration of inactivated trivalent influenza vaccine (TIV) in Australia. We systematically reviewed the rates of fever, FC and serious adverse events (SAEs) after TIV, focussing on published and unpublished clinical trial data from 2005 to 2012, and performed meta-analysis of fever rates. From 4,372 records in electronic databases, 18 randomised controlled trials (RCTs), 14 non-randomised clinical trials, six observational studies and 12 registered trials (five RCTs and seven non-randomised) were identified. In published RCTs, fever ≥ 38 °C rates after first dose of non-adjuvanted TIV were 6.7% and 6.9% for children aged 6-35 months and ≥ 3 years, respectively. Analysis of RCTs by vaccine manufacturer showed pooled fever estimates up to 5.1% with Sanofi or GlaxoSmithKline vaccines; bioCSL vaccines were used in two non-randomised clinical trials and one unpublished RCT and were associated with fever in 22.5-37.1% for children aged 6-35 months. In RCTs, FCs occurred at a rate of 1.1 per 1,000 vaccinated children. While most TIVs induced acceptably low fever rates, bioCSL influenza vaccines were associated with much higher rates of fever in young children. Future standardised study methodology and access to individual level data would be illuminating.

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“…LAIV provided levels of efficacy against influenza illness that, in the three comparative studies conducted, were significantly higher than those provided by TIV 1 , 3 , 7 . In contrast, comparative studies in adults ≥18 years of age have demonstrated variable results; studies have demonstrated comparable protection of the two vaccines, 12 , 13 , 14 , 15 , 16 greater protection with TIV, 17 , 18 , 19 and, in some cases, greater protection with LAIV 19 .…”

Section: Introductionmentioning

confidence: 90%

“…Multiple prospective, randomized, controlled studies have described the efficacy of live attenuated influenza vaccine (LAIV) in children and adolescents compared with placebo and with trivalent inactivated influenza vaccine (TIV) 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 . LAIV provided levels of efficacy against influenza illness that, in the three comparative studies conducted, were significantly higher than those provided by TIV 1 , 3 , 7 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of live attenuated influenza vaccine in children 6 months to 17 years of age

Belshe

Toback²,

Yi³

et al. 2010

Influenza Resp Viruses

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Please cite this paper as: Belshe et al. (2010). Efficacy of live attenuated influenza vaccine in children 6 months to 17 years of age. Influenza and Other Respiratory Viruses 4(3), 141–145. Background It has been suggested that live attenuated influenza vaccine (LAIV) may be less effective in older individuals because of prior wild‐type influenza infections. LAIV is currently approved in the United States, South Korea and Hong Kong for individuals 2–49 years of age. Objective To examine data from previously published pediatric studies to determine the efficacy of LAIV in various age groups. Methods Four studies in which the subject age range exceeded 36 months were identified: one 2‐year study comparing LAIV with placebo and three 1‐year studies comparing LAIV with trivalent inactivated influenza vaccine (TIV). Efficacy against any strain regardless of antigenic similarity to vaccine was analyzed by age; age groups were based on the study design and sample size. A logistic regression model was used to assess whether age, as a continuous variable, was an effect modifier on LAIV efficacy. Results The efficacy of LAIV did not vary with age in children aged 15–84 months compared with placebo or in children aged 6 months to 17 years compared with TIV. Conclusions The available data from prospective, randomized studies in children does not support the concept that prior repeated exposure to influenza, either through wild‐type infection or vaccination with live, attenuated or inactivated vaccines, reduces the efficacy of LAIV compared with placebo or TIV. The decreased immunologic responses to LAIV reported in older individuals or those with pre‐existing immunity do not appear to translate into reduced protection from influenza in children.

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Superior Relative Efficacy of Live Attenuated Influenza Vaccine Compared With Inactivated Influenza Vaccine in Young Children With Recurrent Respiratory Tract Infections

Abstract: CAIV-T was well tolerated in these children with RTIs and demonstrated superior relative efficacy compared with TIV in preventing influenza illness.

Cited by 292 publications

References 18 publications

Shedding of live vaccine virus, comparative safety, and influenza-specific antibody responses after administration of live attenuated and inactivated trivalent influenza vaccines to HIV-infected children

Shedding of live vaccine virus, comparative safety, and influenza-specific antibody responses after administration of live attenuated and inactivated trivalent influenza vaccines to HIV-infected children

Systematic review of fever, febrile convulsions and serious adverse events following administration of inactivated trivalent influenza vaccines in children

Efficacy of live attenuated influenza vaccine in children 6 months to 17 years of age

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