Vaccines for preventing influenza in people with cystic fibrosis

Vaccinating High-Risk Children with the Intranasal Live-Attenuated Influenza Vaccine: the Quebec Experience

“…The recent Cochrane review however reported cough in 22% (11/49) and increase in sputum production in 33% (7/21) of participants with CF in the 5 to 6 days following IIV administration. [30][31][32] These proportions are higher than what was found in our cohort, where 7% of participants reported wheezing. In our cohort, there was no difference in the risk of wheezing when those on and not on inhaled corticosteroids were compared (RR 0.23; 95% CI: 0.03, 1.75).…”

“…A Cochrane systematic review assessed influenza vaccination in 96 patients with CF; [30] only two studies used LAIV (n = 47 total) [31,32]. Gruber et al [32] showed that LAIV immunogenicity was not different in children with CF and their family members.…”

“…AEFIs described with the use of LAIV in children with CF were fever (4/47; 8.5%), rhinorrhoea (18/47; 38.3%), cough (9/47; 19.1%), and increase in sputum production (5/ 20; 25%). According to the Cochrane review, AEFIs were not severe or persistent and no difference was found between types of influenza vaccine used, but a low statistical power could explain this lack of difference [30]. Children with CF are not considered immunosuppressed unless treated with immunosuppressive drugs, such as prolonged systemic corticosteroids; LAIV is therefore not contraindicated.…”

Toll-like receptors as therapeutic targets in cystic fibrosis

“…Prevention and therapeutic strategies for viral infection have proven controversial. A Cochrane Review from 2000 showed no increased protection with influenza vaccine in individuals with CF [89] ; conversely a recent trial has shown this may not be the case [90] . Despite this the vaccine has been shown to be safe and is currently recommended for individuals with CF.…”

Vaccine strategies against bacterial pathogens in cystic fibrosis patients

“…Yearly influenza vaccination is strongly recommended for CF patients aged above six months. However, there is no evidence based on randomized studies on the benefit of such vaccine for those patients [26]. Recent data does not suggest that influenza develops more frequently in CF patients than in healthy individuals [27].…”