Comparison of the trivalent live attenuated vs. inactivated influenza vaccines among U.S. military service members

Eick, Angelia A.; Wang, Zhong; Hughes, Hayley; Ford, Stephen M.; Tobler, Steven K.

doi:10.1016/j.vaccine.2009.03.088

Cited by 43 publications

(45 citation statements)

References 36 publications

(51 reference statements)

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“…It is possible that variations in study endpoint and population, and season‐to‐season variability may contribute to the conflicting results regarding the relative efficacy of LAIV and TIV in adults 14 , 19 , 28 . In the more robust pediatric data, there is evidence to suggest that LAIV efficacy does not decline with increasing age.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, comparative studies in adults ≥18 years of age have demonstrated variable results; studies have demonstrated comparable protection of the two vaccines, 12 , 13 , 14 , 15 , 16 greater protection with TIV, 17 , 18 , 19 and, in some cases, greater protection with LAIV 19 . For studies that have demonstrated greater protection with TIV in adults, authors have speculated that LAIV may be less effective in older individuals because of prior infections with similar wild‐type influenza strains 15 , 17 , 18 , 19 …”

Section: Introductionmentioning

confidence: 99%

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Efficacy of live attenuated influenza vaccine in children 6 months to 17 years of age

Belshe

Toback²,

Yi³

et al. 2010

Influenza Resp Viruses

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Please cite this paper as: Belshe et al. (2010). Efficacy of live attenuated influenza vaccine in children 6 months to 17 years of age. Influenza and Other Respiratory Viruses 4(3), 141–145. Background It has been suggested that live attenuated influenza vaccine (LAIV) may be less effective in older individuals because of prior wild‐type influenza infections. LAIV is currently approved in the United States, South Korea and Hong Kong for individuals 2–49 years of age. Objective To examine data from previously published pediatric studies to determine the efficacy of LAIV in various age groups. Methods Four studies in which the subject age range exceeded 36 months were identified: one 2‐year study comparing LAIV with placebo and three 1‐year studies comparing LAIV with trivalent inactivated influenza vaccine (TIV). Efficacy against any strain regardless of antigenic similarity to vaccine was analyzed by age; age groups were based on the study design and sample size. A logistic regression model was used to assess whether age, as a continuous variable, was an effect modifier on LAIV efficacy. Results The efficacy of LAIV did not vary with age in children aged 15–84 months compared with placebo or in children aged 6 months to 17 years compared with TIV. Conclusions The available data from prospective, randomized studies in children does not support the concept that prior repeated exposure to influenza, either through wild‐type infection or vaccination with live, attenuated or inactivated vaccines, reduces the efficacy of LAIV compared with placebo or TIV. The decreased immunologic responses to LAIV reported in older individuals or those with pre‐existing immunity do not appear to translate into reduced protection from influenza in children.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of live attenuated influenza vaccine in children 6 months to 17 years of age

Belshe

Toback²,

Yi³

et al. 2010

Influenza Resp Viruses

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show abstract

“…However, in a retrospective cohort study comparing LAIV3 and IIV3 among 701,753 nonrecruit military personnel and 70,325 new recruits, among new recruits, incidence of ILI was lower among those who received LAIV3 than IIV3. The previous vaccination status of the recruits was not stated; it is possible that this population was relatively naïve to vaccination compared with previous service members who were more likely to have been vaccinated routinely each year (261).…”

Section: Comparisons Of Laiv3/4 and Iiv Efficacy Or Effectivenessmentioning

confidence: 99%

Prevention and Control of Seasonal Influenza with Vaccines

Grohskopf

Sokolow²,

Broder³

et al. 2016

MMWR Recomm. Rep.

374

279

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“…Three randomized, controlled efficacy trials in children of Ͼ6 months and Յ18 years of age consistently demonstrated that LAIV was significantly more protective than IIV (4)(5)(6)(7). Similarly, for adults older than 16 years, some comparative trials showed that LAIV was at least as effective as IIV (8)(9)(10). However, 2 adult trials showed that IIV was more protective than LAIV (11)(12)(13), and thus there is some controversy over whether LAIV can be as effective as a well-matched IIV seasonal vaccine for adults with previously extensive influenza virus exposure (2,14).…”

mentioning

confidence: 97%

Comparisons of the Humoral and Cellular Immune Responses Induced by Live Attenuated Influenza Vaccine and Inactivated Influenza Vaccine in Adults

Hoft

Lottenbach

Blazevic

et al. 2017

Clin Vaccine Immunol

110

105

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Both live attenuated influenza vaccines (LAIV) and inactivated influenza vaccines (IIV) induce protective immunity against influenza. There is evidence that LAIV induces superior protection in children, whereas IIV may induce superior protection in adults. The immune mechanisms responsible for these differences have not been identified. We previously compared LAIV and IIV in young children of 6 to 36 months of age, and we demonstrated that while both induced similar hemagglutination inhibition (HAI) antibody responses, only LAIV induced significant increases in T cell responses. In the present study, 37 healthy adult subjects of 18 to 49 years of age were randomized to receive seasonal influenza vaccination with LAIV or IIV. Influenza virus-specific HAI, T cell, and secretory IgA (sIgA) responses were studied pre- and postvaccination. In contrast to the responses seen in young children, LAIV induced only minimal increases in serum HAI responses in adults, which were significantly lower than the responses induced by IIV. Both LAIV and IIV similarly induced only transient T cell responses to replication-competent whole virus in adults. In contrast, influenza virus-specific sIgA responses were induced more strongly by LAIV than by IIV. Our previous studies suggest that LAIV may be more protective than IIV in young children not previously exposed to influenza virus or influenza vaccines due to increased vaccine-induced T cell and/or sIgA responses. Our current work suggests that in adults with extensive and partially cross-reactive preexisting influenza immunity, LAIV boosting of sIgA responses to hemagglutinin (HA) and non-HA antigenic targets expressed by circulating influenza virus strains may be an important additional mechanism of vaccine-induced immunity.

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Comparison of the trivalent live attenuated vs. inactivated influenza vaccines among U.S. military service members

Cited by 43 publications

References 36 publications

Efficacy of live attenuated influenza vaccine in children 6 months to 17 years of age

Efficacy of live attenuated influenza vaccine in children 6 months to 17 years of age

Prevention and Control of Seasonal Influenza with Vaccines

Comparisons of the Humoral and Cellular Immune Responses Induced by Live Attenuated Influenza Vaccine and Inactivated Influenza Vaccine in Adults

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