Vaccine for Prevention of Mild and Moderate-to-Severe Influenza in Children

• Published in: The New England journal of medicine Vol. 369; no. 26; pp. 2481 - 2491
• Main Authors: Jain, Varsha K, Rivera, Luis, Zaman, Khalequ, Espos, Roberto A, Sirivichayakul, Chukiat, Quiambao, Beatriz P, Rivera-Medina, Doris M, Kerdpanich, Pirunghul, Ceyhan, Mehmet, Dinleyici, Ener C, Cravioto, Alejandro, Yunus, Mohammed, Chanthavanich, Pornthep, Limkittikul, Kriengsak, Kurugol, Zafer, Alhan, Emre, Caplanusi, Adrian, Durviaux, Serge, Boutet, Philippe, Ofori-Anyinam, Opokua, Chandrasekaran, Vijayalakshmi, Dbaibo, Ghassan, Innis, Bruce L
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 26.12.2013
• Subjects: Biological and medical sciences; Body temperature; Child; Child, Preschool; Children; Female; General aspects; Hemagglutination Inhibition Tests; Hepatitis A; Human viral diseases; Humans; Immunogenicity; Infectious diseases; Influenza; Influenza A; Influenza A virus - genetics; Influenza A virus - immunology; Influenza A virus - isolation & purification; Influenza B; Influenza B virus - genetics; Influenza B virus - immunology; Influenza B virus - isolation & purification; Influenza Vaccines - adverse effects; Influenza Vaccines - immunology; Influenza, Human - classification; Influenza, Human - diagnosis; Influenza, Human - immunology; Influenza, Human - prevention & control; Male; Medical sciences; Polymerase chain reaction; Proportional Hazards Models; Real-Time Polymerase Chain Reaction; Respiratory tract; Severity of Illness Index; Single-Blind Method; Vaccine efficacy; Vaccines; Vaccines, Inactivated - immunology; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; Lebanon; Human; Infection; Medicine; Prevention; Immunoprophylaxis; Viral disease; Influenza; Vaccine; Child
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa1215817

In a multinational trial in children, a quadrivalent influenza vaccine (with both Victoria and Yamagata influenza B lineages, only one of which is included in the current trivalent vaccine) had about 59% efficacy. The incidence of influenza among children is high, and the illness is associated with substantial increases in outpatient visits and hospitalizations during the influenza season. 1 – 4 Routine vaccination of children against influenza is recommended in the United States 5 and some other countries, despite limited evidence of the efficacy of inactivated influenza vaccine from randomized, controlled trials involving children. 6 When trivalent influenza vaccines (TIVs) are used, there is a possibility of a mismatch between circulating and vaccine B strains, which results in inadequate protection from the vaccine. 7 – 10 A quadrivalent vaccine containing both B lineages would eliminate B-lineage mismatch. This may . . .