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J Infect Dis. 2015 Feb 1;211(3):352-60. doi: 10.1093/infdis/jiu458. Epub 2014 Aug 26.

Live attenuated and inactivated influenza vaccines in children.

Author information

1
Department of Pediatrics.
2
Department of Community and Family Medicine.
3
Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth.
4
Department of Thayer School of Engineering at Dartmouth, Hanover, New Hampshire.
5
Department of Medicine, University of Rochester Medical Center, New York.
6
Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

Abstract

BACKGROUND:

Live attenuated influenza vaccine (LAIV) and inactivated influenza vaccine (IIV) are available for children. Local and systemic immunity induced by LAIV followed a month later by LAIV and IIV followed by LAIV were investigated with virus recovery after LAIV doses as surrogates for protection against influenza on natural exposure.

METHODS:

Fifteen children received IIV followed by LAIV, 13 an initial dose of LAIV, and 11 a second dose of LAIV. The studies were done during autumn 2009 and autumn 2010 with the same seasonal vaccine (A/California/07/09 [H1N1], A/Perth/16/09 [H3N2], B/Brisbane/60/08).

RESULTS:

Twenty-eight of 39 possible influenza viral strains were recovered after the initial dose of LAIV. When LAIV followed IIV, 21 of 45 viral strains were identified. When compared to primary LAIV infection, the decreased frequency of shedding with the IIV-LAIV schedule was significant (P = .023). With LAIV-LAIV, the fewest viral strains were recovered (3/33)--numbers significantly lower (P < .001) than shedding after initial LAIV and after IIV-LAIV (P < .001). Serum hemagglutination inhibition antibody responses were more frequent after IIV than LAIV (P = .02). In contrast, more mucosal immunoglobulin A responses were seen with LAIV.

CONCLUSIONS:

LAIV priming induces greater inhibition of virus recovery on LAIV challenge than IIV priming. The correlate(s) of protection are the subject of ongoing analysis.

CLINICAL TRIALS REGISTRATION:

NCT01246999.

KEYWORDS:

children; influenza; vaccines

PMID:
25165161
PMCID:
PMC4296173
DOI:
10.1093/infdis/jiu458
[Indexed for MEDLINE]
Free PMC Article
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