Influenza Virus Detection Following Administration of Live-Attenuated Intranasal Influenza Vaccine in Children With Cystic Fibrosis and Their Healthy Siblings

Constantina Boikos; Lawrence Joseph; Christine Martineau; Jesse Papenburg; David Scheifele; Larry C Lands; Gaston De Serres; Mark Chilvers; Caroline Quach

doi:10.1093/ofid/ofw187

Influenza Virus Detection Following Administration of Live-Attenuated Intranasal Influenza Vaccine in Children With Cystic Fibrosis and Their Healthy Siblings

Open Forum Infect Dis. 2016 Aug 30;3(4):ofw187. doi: 10.1093/ofid/ofw187. eCollection 2016 Oct.

Authors

Constantina Boikos¹, Lawrence Joseph¹, Christine Martineau², Jesse Papenburg³, David Scheifele⁴, Larry C Lands⁵, Gaston De Serres⁶, Mark Chilvers⁷, Caroline Quach⁸

Affiliations

¹ Department of Epidemiology , Biostatistics & Occupational Health, McGill University , Montreal.
² Laboratoire de santé publique du Québec , Institut national de santé publique du Québec.
³ Department of Pediatrics, Division of Infectious Diseases, Montreal Children's Hospital, McGill University; McGill University Health Centre, Vaccine Study Centre, Research Institute of the MUHC, Montreal, Quebec.
⁴ Vaccine Evaluation Center, Child & Family Research Institute, University of British Columbia.
⁵ Meakins Christie Laboratories, Department of Pediatrics, Division of Respiratory Medicine , Montreal Children's Hospital, McGill University , Montreal , Quebec.
⁶ Direction des risques biologiques et de la santé au travail , Institut national de santé publique du Québec.
⁷ Division of Respiratory Medicine, Department of Pediatrics, Faculty of Medicine , University of British Columbia , Canada.
⁸ Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal; Department of Pediatrics, Division of Infectious Diseases, Montreal Children's Hospital, McGill University; McGill University Health Centre, Vaccine Study Centre, Research Institute of the MUHC, Montreal, Quebec; Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec.

Abstract

Background. We aimed to explore the detection profile of influenza viruses following live-attenuated intranasal influenza vaccination (LAIV) in children aged 2-19 years with and without cystic fibrosis (CF). Methods. Before the 2013-2014 influenza season, flocked nasal swabs were obtained before vaccination and 4 times in the week of follow-up from 76 participants (n_CF: 57; n_healthy: 19). Influenza was detected by reverse transcription polymerase chain reaction (RT-PCR) assays. A Bayesian hierarchical logistic regression model was used to estimate the effect of CF status and age on influenza detection. Results. Overall, 69% of the study cohort shed influenza RNA during follow-up. The mean duration of RT-PCR detection was 2.09 days (95% credible interval [CrI]: 1.73-2.48). The odds of influenza RNA detection on day 1 following vaccination decreased with age in years (odds ratio [OR]: 0.82 per year; 95% CrI: 0.70-0.95), and subjects with CF had higher odds of influenza RNA detection on day 1 of follow-up (OR: 5.09; 95% CrI: 1.02-29.9). Conclusion. Despite the small sample size, our results indicate that LAIV vaccine strains are detectable during the week after LAIV, mainly in younger individuals and vaccinees with CF. It remains unclear whether recommendations for avoiding contact with severely immunocompromised patients should differ for these groups.

Keywords: childhood vaccination; cystic fibrosis; influenza; live-attenuated influenza virus vaccine; viral detection.