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Clin Infect Dis. 2018 Feb 10;66(5):665-672. doi: 10.1093/cid/cix869.

2015-2016 Vaccine Effectiveness of Live Attenuated and Inactivated Influenza Vaccines in Children in the United States.

Author information

1
Wake Forest School of Medicine, Winston-Salem, North Carolina.
2
MedImmune, Gaithersburg, Maryland.
3
Marshfield Clinic Research Institute, Marshfield, Wisconsin.
4
Akron Children's Hospital, Ohio.
5
Baylor Scott & White Health, Texas A&M Health Science Center College of Medicine, Temple.
6
Vanderbilt University Medical Center, Nashville, Tennessee.
7
Kaiser Permanente Center for Health Research, Portland, Oregon.
8
HealthPartners Como Clinic, St Paul, Minnesota.
9
University of Florida, Gainesville.

Abstract

Background:

In the 2015-2016 season, quadrivalent live attenuated influenza vaccine (LAIV) and both trivalent and quadrivalent inactivated influenza vaccine (IIV) were available in the United States.

Methods:

This study, conducted according to a test-negative case-control design, enrolled children aged 2-17 years presenting to outpatient settings with fever and respiratory symptoms for <5 days at 8 sites across the United States between 30 November 2015 and 15 April 2016. A nasal swab was obtained for reverse-transcriptase polymerase chain reaction (RT-PCR) testing for influenza, and influenza vaccination was verified in the medical record or vaccine registry. Influenza vaccine effectiveness (VE) was estimated using a logistic regression model.

Results:

Of 1012 children retained for analysis, most children (59%) were unvaccinated, 10% received LAIV, and 31% received IIV. Influenza A (predominantly antigenically similar to the A/California/7/2009 strain) was detected in 14% and influenza B (predominantly a B/Victoria lineage) in 10%. For all influenza, VE was 46% (95% confidence interval [CI], 7%-69%) for LAIV and 65% (48%-76%) for IIV. VE against influenza A(H1N1)pdm09 was 50% (95% CI, -2% to 75%) for LAIV and 71% (51%-82%) for IIV. The odds ratio for vaccine failure with RT-PCR-confirmed A(H1N1)pdm09 was 1.71 (95% CI, 0.78-3.73) in LAIV versus IIV recipients.

Conclusions:

LAIV and IIV demonstrated effectiveness against any influenza among children aged 2-17 years in 2015-2016. When compared to all unvaccinated children, VE against influenza A(H1N1)pdm09 was significant for IIV but not LAIV.

Clinical Trials Registration:

NCT01997450.

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