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Live attenuated influenza vaccine use and safety in children and adults with asthma.
Ann Allergy Asthma Immunol. 2017 04; 118(4):439-444.AA

Abstract

BACKGROUND

Live attenuated influenza vaccine (LAIV) might increase the risk of wheezing in persons with asthma or children younger than 5 years with a history of recurrent wheezing.

OBJECTIVE

To describe the use and assess the safety of LAIV in persons with asthma in the Vaccine Safety Datalink population.

METHODS

We identified persons with asthma using diagnosis codes and medication records in 7 health care organizations over 3 influenza seasons (2008-2009 through 2010-2011) and determined their influenza vaccination rates. Using the self-controlled risk interval method, we calculated the incidence rate ratio of medically attended respiratory events in the 14 days after LAIV compared with 29 to 42 days after vaccination in persons 2 through 49 years old.

RESULTS

In our population of 6.3 million, asthma prevalence was 5.9%. Of persons with asthma, approximately 50% received any influenza vaccine but less than 1% received LAIV. The safety study included 12,354 LAIV doses (75% in children; 93% in those with intermittent or mild persistent asthma). The incidence rate ratio for inpatient and emergency department visits for lower respiratory events (including asthma exacerbation and wheezing) was 0.98 (95% confidence interval 0.63-1.51) and the incidence rate ratio for upper respiratory events was 0.94 (95% confidence interval 0.48-1.86). The risk of lower respiratory events was similar for intermittent and mild persistent asthma, across age groups, and for seasonal trivalent LAIV and 2009 H1N1 pandemic monovalent LAIV.

CONCLUSION

LAIV use in asthma was mostly in persons with intermittent or mild persistent asthma. LAIV was not associated with an increased risk of medically attended respiratory adverse events.

Authors+Show Affiliations

Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: jduffy@cdc.gov.Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia.Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia.Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California, Oakland, California.Marshfield Clinic Research Foundation, Marshfield, Wisconsin.Group Health Research Institute, Seattle, Washington.Kaiser Permanente Southern California, Pasadena, California.Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.HealthPartners Institute, Minneapolis, Minnesota.Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

28390584

Citation

Duffy, Jonathan, et al. "Live Attenuated Influenza Vaccine Use and Safety in Children and Adults With Asthma." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 118, no. 4, 2017, pp. 439-444.
Duffy J, Lewis M, Harrington T, et al. Live attenuated influenza vaccine use and safety in children and adults with asthma. Ann Allergy Asthma Immunol. 2017;118(4):439-444.
Duffy, J., Lewis, M., Harrington, T., Baxter, R., Belongia, E. A., Jackson, L. A., Jacobsen, S. J., Lee, G. M., Naleway, A. L., Nordin, J., & Daley, M. F. (2017). Live attenuated influenza vaccine use and safety in children and adults with asthma. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 118(4), 439-444. https://doi.org/10.1016/j.anai.2017.01.030
Duffy J, et al. Live Attenuated Influenza Vaccine Use and Safety in Children and Adults With Asthma. Ann Allergy Asthma Immunol. 2017;118(4):439-444. PubMed PMID: 28390584.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Live attenuated influenza vaccine use and safety in children and adults with asthma. AU - Duffy,Jonathan, AU - Lewis,Melissa, AU - Harrington,Theresa, AU - Baxter,Roger, AU - Belongia,Edward A, AU - Jackson,Lisa A, AU - Jacobsen,Steven J, AU - Lee,Grace M, AU - Naleway,Allison L, AU - Nordin,James, AU - Daley,Matthew F, AU - ,, PY - 2016/11/30/received PY - 2017/01/26/revised PY - 2017/01/31/accepted PY - 2017/4/10/entrez PY - 2017/4/10/pubmed PY - 2017/8/5/medline SP - 439 EP - 444 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann Allergy Asthma Immunol VL - 118 IS - 4 N2 - BACKGROUND: Live attenuated influenza vaccine (LAIV) might increase the risk of wheezing in persons with asthma or children younger than 5 years with a history of recurrent wheezing. OBJECTIVE: To describe the use and assess the safety of LAIV in persons with asthma in the Vaccine Safety Datalink population. METHODS: We identified persons with asthma using diagnosis codes and medication records in 7 health care organizations over 3 influenza seasons (2008-2009 through 2010-2011) and determined their influenza vaccination rates. Using the self-controlled risk interval method, we calculated the incidence rate ratio of medically attended respiratory events in the 14 days after LAIV compared with 29 to 42 days after vaccination in persons 2 through 49 years old. RESULTS: In our population of 6.3 million, asthma prevalence was 5.9%. Of persons with asthma, approximately 50% received any influenza vaccine but less than 1% received LAIV. The safety study included 12,354 LAIV doses (75% in children; 93% in those with intermittent or mild persistent asthma). The incidence rate ratio for inpatient and emergency department visits for lower respiratory events (including asthma exacerbation and wheezing) was 0.98 (95% confidence interval 0.63-1.51) and the incidence rate ratio for upper respiratory events was 0.94 (95% confidence interval 0.48-1.86). The risk of lower respiratory events was similar for intermittent and mild persistent asthma, across age groups, and for seasonal trivalent LAIV and 2009 H1N1 pandemic monovalent LAIV. CONCLUSION: LAIV use in asthma was mostly in persons with intermittent or mild persistent asthma. LAIV was not associated with an increased risk of medically attended respiratory adverse events. SN - 1534-4436 UR - https://www.unboundmedicine.com/medline/citation/28390584/Live_attenuated_influenza_vaccine_use_and_safety_in_children_and_adults_with_asthma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1081-1206(17)30101-1 DB - PRIME DP - Unbound Medicine ER -