Live Attenuated and Inactivated Influenza Vaccines in Children

• Published in: The Journal of infectious diseases Vol. 211; no. 3; pp. 352 - 360
• Main Authors: Ilyushina, Natalia A., Haynes, Brenda C., Hoen, Anne G., Khalenkov, Alexey M., Housman, Molly L., Brown, Eric P., Ackerman, Margaret E., Treanor, John J., Luke, Catherine J., Subbarao, Kanta, Wright, Peter F.
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.02.2015
• Subjects: Antibodies, Viral - immunology; Antibody Formation - immunology; Child; Child, Preschool; Female; Hemagglutination Inhibition Tests - methods; Humans; Immunoglobulin A - immunology; Influenza A Virus, H1N1 Subtype - immunology; Influenza A Virus, H3N2 Subtype - immunology; Influenza B virus - immunology; Influenza Vaccines - immunology; Influenza, Human - immunology; Influenza, Human - prevention & control; Major and Brief Reports; Male; Vaccines, Attenuated - immunology; Vaccines, Inactivated - immunology; Viral Vaccines - immunology; VIRUSES; INE, USA, California; Australia, Western Australia, Perth; Australia, Queensland, Brisbane; influenza; children; vaccines
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jiu458

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 I l 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.