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A comparison of 2 influenza vaccine schedules in 6- to 23-month-old children.
Pediatrics 2005; 115(4):1039-47Ped

Abstract

BACKGROUND

Trivalent inactivated influenza vaccine (TIV) is recommended for all children ages 6 to 23 months. Delivering 2 doses of TIV at least 4 weeks apart to young children receiving this vaccine for the first time is challenging.

METHODS

We compared the immunogenicity and reactogenicity of the standard 2-dose regimen of TIV administered in the fall with an early schedule of a single spring dose followed by a fall dose of the same vaccine in healthy toddlers 6 to 23 months of age. Children were recruited in the spring to be randomized into either the standard or early schedule. An additional group was also enrolled in the fall as part of a nonrandomized standard comparison group. The 2002-2003 licensed TIV was administered in the spring; the fall 2003-2004 vaccine contained the same 3 antigenic components. Reactogenicity was assessed by parental diaries and telephone surveillance. Blood was obtained after the second dose of TIV for all children. The primary outcome measure was antibody response to influenza A/H1N1, A/H3N2, and B after 2 doses of vaccine, as determined by hemagglutination-inhibition titers > or =1:32 and geometric mean titer (GMT).

RESULTS

Two hundred nineteen children were randomized to receive either the standard or early TIV schedule; 40 additional children were enrolled in the fall in the nonrandomized standard group. Response rates in the combined standard versus early groups were similar overall: 78% (GMT: 48) vs 76% (GMT: 57) to H1N1, 89% (GMT: 115) vs 88% (GMT: 129) to H3N2, and 52% (GMT: 24) vs 60% (GMT: 28) to B. Reactogenicity after TIV in both groups of children was minimal and did not differ by dose, age, or time between doses. Reaction rates were higher in those receiving TIV and concomitant vaccines compared with those receiving TIV alone. Overall rates of fever >38 degrees C axillary and injection-site pain, redness, or swelling were 5.4%, 3.1%, 0.9%, and 1.1%, respectively.

CONCLUSIONS

When the spring and fall influenza vaccines had the same 3 antigenic components, the early vaccine schedule resulted in similar immunogenicity and reactogenicity compared with the standard schedule. When the vaccine components do not change between years, initiating influenza vaccine in the spring at the time of routine office visits would facilitate full immunization of children against influenza earlier in the season.

Authors+Show Affiliations

Division of Pediatric Infectious Diseases, Allergy, and Rheumatology, University of Washington and Children's Hospital and Regional Medical Center, Seattle, Washington 98105, USA. jenglu@chmc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15805382

Citation

Englund, Janet A., et al. "A Comparison of 2 Influenza Vaccine Schedules in 6- to 23-month-old Children." Pediatrics, vol. 115, no. 4, 2005, pp. 1039-47.
Englund JA, Walter EB, Fairchok MP, et al. A comparison of 2 influenza vaccine schedules in 6- to 23-month-old children. Pediatrics. 2005;115(4):1039-47.
Englund, J. A., Walter, E. B., Fairchok, M. P., Monto, A. S., & Neuzil, K. M. (2005). A comparison of 2 influenza vaccine schedules in 6- to 23-month-old children. Pediatrics, 115(4), pp. 1039-47.
Englund JA, et al. A Comparison of 2 Influenza Vaccine Schedules in 6- to 23-month-old Children. Pediatrics. 2005;115(4):1039-47. PubMed PMID: 15805382.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of 2 influenza vaccine schedules in 6- to 23-month-old children. AU - Englund,Janet A, AU - Walter,Emmanuel B, AU - Fairchok,Mary P, AU - Monto,Arnold S, AU - Neuzil,Kathleen M, PY - 2005/4/5/pubmed PY - 2005/8/12/medline PY - 2005/4/5/entrez SP - 1039 EP - 47 JF - Pediatrics JO - Pediatrics VL - 115 IS - 4 N2 - BACKGROUND: Trivalent inactivated influenza vaccine (TIV) is recommended for all children ages 6 to 23 months. Delivering 2 doses of TIV at least 4 weeks apart to young children receiving this vaccine for the first time is challenging. METHODS: We compared the immunogenicity and reactogenicity of the standard 2-dose regimen of TIV administered in the fall with an early schedule of a single spring dose followed by a fall dose of the same vaccine in healthy toddlers 6 to 23 months of age. Children were recruited in the spring to be randomized into either the standard or early schedule. An additional group was also enrolled in the fall as part of a nonrandomized standard comparison group. The 2002-2003 licensed TIV was administered in the spring; the fall 2003-2004 vaccine contained the same 3 antigenic components. Reactogenicity was assessed by parental diaries and telephone surveillance. Blood was obtained after the second dose of TIV for all children. The primary outcome measure was antibody response to influenza A/H1N1, A/H3N2, and B after 2 doses of vaccine, as determined by hemagglutination-inhibition titers > or =1:32 and geometric mean titer (GMT). RESULTS: Two hundred nineteen children were randomized to receive either the standard or early TIV schedule; 40 additional children were enrolled in the fall in the nonrandomized standard group. Response rates in the combined standard versus early groups were similar overall: 78% (GMT: 48) vs 76% (GMT: 57) to H1N1, 89% (GMT: 115) vs 88% (GMT: 129) to H3N2, and 52% (GMT: 24) vs 60% (GMT: 28) to B. Reactogenicity after TIV in both groups of children was minimal and did not differ by dose, age, or time between doses. Reaction rates were higher in those receiving TIV and concomitant vaccines compared with those receiving TIV alone. Overall rates of fever >38 degrees C axillary and injection-site pain, redness, or swelling were 5.4%, 3.1%, 0.9%, and 1.1%, respectively. CONCLUSIONS: When the spring and fall influenza vaccines had the same 3 antigenic components, the early vaccine schedule resulted in similar immunogenicity and reactogenicity compared with the standard schedule. When the vaccine components do not change between years, initiating influenza vaccine in the spring at the time of routine office visits would facilitate full immunization of children against influenza earlier in the season. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15805382/A_comparison_of_2_influenza_vaccine_schedules_in_6__to_23_month_old_children_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=15805382 DB - PRIME DP - Unbound Medicine ER -