Shedding of live vaccine virus, comparative safety, and influenza-specific antibody responses after administration of live attenuated and inactivated trivalent influenza vaccines to HIV-infected children

Abstract

HIV-infected children (N=243), >or=5 to <18 years old, receiving stable antiretroviral therapy, were stratified by immunologic status and randomly assigned to receive intranasal live attenuated influenza vaccine (LAIV) or intramuscular trivalent inactivated influenza vaccine (TIV). The safety profile after LAIV or TIV closely resembled the previously reported tolerability to these vaccines in children without HIV infection. Post-vaccination hemagglutination inhibition (HAI) antibody responses and shedding of LAIV virus were also similar, regardless of immunological stratum, to antibody responses and shedding previously reported for children without HIV infection. LAIV should be further evaluated for a role in immunizing HIV-infected children.

Figure 1. Vaccine virus shedding

N indicates the number of specimens obtained on the days indicated. LOD indicates the level of detection. Five specimens on days 2 to 4 contained two vaccine virus strains. Mean GMT for H1N1 = log₁₀ TCID₅₀ of 2.6; for H3N2 = 2.0; for B = 2.0. Replicates of samples below the limit of detection (<1 log₁₀ TCID₅₀/mL) were reported as 0.5 log₁₀ TCID₅₀/mL. *”Unidentified” indicates that the origin (vaccine strain vs wild type) of these two primary isolates on day 15 post-vaccination could not be identified due to insufficient virus in the sample. Neither of these isolates came from a subject that had virus isolated at an earlier time.