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Vaccine failure and serologic response to live attenuated and inactivated influenza vaccines in children during the 2013-2014 season.
Vaccine. 2018 02 21; 36(9):1214-1219.V

Abstract

BACKGROUND

Recent observational studies in the United States indicated live attenuated influenza vaccine (LAIV) was less effective in children against clinical influenza infection caused by A(H1N1)pdm09 relative to inactivated influenza vaccine (IIV). During the 2013-2014 influenza season, we conducted an observational study among children aged 5-17 years to compare serologic responses to LAIV and IIV and explore factors associated with vaccine failure.

METHODS

One hundred and sixty-one children received one dose of trivalent IIV or quadrivalent LAIV according to parental preference. Baseline and postvaccination serum samples were tested with hemagglutination inhibition (HI) assays against vaccine reference strains. Geometric mean titers (GMT), geometric mean fold rise (GMFR), seroconversion, and seroprotection (HI titer ≥ 40) were used to assess response to vaccine. Active surveillance for acute respiratory illness was conducted during the influenza season and influenza cases were confirmed by reverse transcription polymerase chain reaction (RT-PCR). Logistic regression was used to examine the association between vaccine type and vaccine failure.

RESULTS

LAIV and IIV recipients were similar with respect to demographics and baseline GMT for each vaccine strain. RT-PCR confirmed influenza (vaccine failure) occurred in 8 (13%) of 62 LAIV recipients and 3 (3%) of 99 IIV recipients (p = .02). Postvaccination GMFR for A(H1N1)pdm09 was higher for IIV vs LAIV receipt (GMFR 3.3 vs. 0.8, p < .0001). Postvaccination titers against A(H1N1)pdm09 were ≥40 for 91% and 44% of IIV and LAIV recipients, respectively (p < .0001). Among 13 IIV and 18 LAIV recipients with seronegative baseline titer against A(H1N1pdm09), 54% and 0% seroconverted, respectively. LAIV receipt was the only factor associated with A(H1N1)pdm09 vaccine failure in the age-adjusted multivariable model (odds ratio 4.5, 95% CI 1.1-18.2).

CONCLUSION

Receipt of LAIV generated minimal HI antibody response in children, including among those seronegative at baseline. LAIV recipients had significant increased risk of A(H1N1)pdm09 infection compared to IIV recipients.

Authors+Show Affiliations

Marshfield Clinic Research Institute, Marshfield, WI, USA. Electronic address: King.jennifer@marshfieldresearch.org.Marshfield Clinic Research Institute, Marshfield, WI, USA.Marshfield Clinic Research Institute, Marshfield, WI, USA.Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA.Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA.Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA.Marshfield Clinic Research Institute, Marshfield, WI, USA.

Pub Type(s)

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

Language

eng

PubMed ID

29395525

Citation

King, Jennifer P., et al. "Vaccine Failure and Serologic Response to Live Attenuated and Inactivated Influenza Vaccines in Children During the 2013-2014 Season." Vaccine, vol. 36, no. 9, 2018, pp. 1214-1219.
King JP, McLean HQ, Meece JK, et al. Vaccine failure and serologic response to live attenuated and inactivated influenza vaccines in children during the 2013-2014 season. Vaccine. 2018;36(9):1214-1219.
King, J. P., McLean, H. Q., Meece, J. K., Levine, M. Z., Spencer, S. M., Flannery, B., & Belongia, E. A. (2018). Vaccine failure and serologic response to live attenuated and inactivated influenza vaccines in children during the 2013-2014 season. Vaccine, 36(9), 1214-1219. https://doi.org/10.1016/j.vaccine.2018.01.016
King JP, et al. Vaccine Failure and Serologic Response to Live Attenuated and Inactivated Influenza Vaccines in Children During the 2013-2014 Season. Vaccine. 2018 02 21;36(9):1214-1219. PubMed PMID: 29395525.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaccine failure and serologic response to live attenuated and inactivated influenza vaccines in children during the 2013-2014 season. AU - King,Jennifer P, AU - McLean,Huong Q, AU - Meece,Jennifer K, AU - Levine,Min Z, AU - Spencer,Sarah M, AU - Flannery,Brendan, AU - Belongia,Edward A, PY - 2017/06/29/received PY - 2017/12/19/revised PY - 2018/01/09/accepted PY - 2018/2/6/pubmed PY - 2018/10/13/medline PY - 2018/2/4/entrez KW - Children KW - Hemagglutination inhibition KW - Immune response KW - Influenza vaccine SP - 1214 EP - 1219 JF - Vaccine JO - Vaccine VL - 36 IS - 9 N2 - BACKGROUND: Recent observational studies in the United States indicated live attenuated influenza vaccine (LAIV) was less effective in children against clinical influenza infection caused by A(H1N1)pdm09 relative to inactivated influenza vaccine (IIV). During the 2013-2014 influenza season, we conducted an observational study among children aged 5-17 years to compare serologic responses to LAIV and IIV and explore factors associated with vaccine failure. METHODS: One hundred and sixty-one children received one dose of trivalent IIV or quadrivalent LAIV according to parental preference. Baseline and postvaccination serum samples were tested with hemagglutination inhibition (HI) assays against vaccine reference strains. Geometric mean titers (GMT), geometric mean fold rise (GMFR), seroconversion, and seroprotection (HI titer ≥ 40) were used to assess response to vaccine. Active surveillance for acute respiratory illness was conducted during the influenza season and influenza cases were confirmed by reverse transcription polymerase chain reaction (RT-PCR). Logistic regression was used to examine the association between vaccine type and vaccine failure. RESULTS: LAIV and IIV recipients were similar with respect to demographics and baseline GMT for each vaccine strain. RT-PCR confirmed influenza (vaccine failure) occurred in 8 (13%) of 62 LAIV recipients and 3 (3%) of 99 IIV recipients (p = .02). Postvaccination GMFR for A(H1N1)pdm09 was higher for IIV vs LAIV receipt (GMFR 3.3 vs. 0.8, p < .0001). Postvaccination titers against A(H1N1)pdm09 were ≥40 for 91% and 44% of IIV and LAIV recipients, respectively (p < .0001). Among 13 IIV and 18 LAIV recipients with seronegative baseline titer against A(H1N1pdm09), 54% and 0% seroconverted, respectively. LAIV receipt was the only factor associated with A(H1N1)pdm09 vaccine failure in the age-adjusted multivariable model (odds ratio 4.5, 95% CI 1.1-18.2). CONCLUSION: Receipt of LAIV generated minimal HI antibody response in children, including among those seronegative at baseline. LAIV recipients had significant increased risk of A(H1N1)pdm09 infection compared to IIV recipients. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/29395525/Vaccine_failure_and_serologic_response_to_live_attenuated_and_inactivated_influenza_vaccines_in_children_during_the_2013_2014_season_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(18)30050-1 DB - PRIME DP - Unbound Medicine ER -