Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2016 Feb;137(2):e20153279.
doi: 10.1542/peds.2015-3279. Epub 2016 Jan 5.

Seasonal Effectiveness of Live Attenuated and Inactivated Influenza Vaccine

Jessie R Chung  1 , Brendan Flannery  2 , Mark G Thompson  2 , Manjusha Gaglani  3 , Michael L Jackson  4 , Arnold S Monto  5 , Mary Patricia Nowalk  6 , H Keipp Talbot  7 , John J Treanor  8 , Edward A Belongia  9 , Kempapura Murthy  3 , Lisa A Jackson  4 , Joshua G Petrie  5 , Richard K Zimmerman  6 , Marie R Griffin  7 , Huong Q McLean  9 , Alicia M Fry  2
Affiliations
Observational Study

Seasonal Effectiveness of Live Attenuated and Inactivated Influenza Vaccine

Jessie R Chung et al. Pediatrics. 2016 Feb.

Abstract

Background: Few observational studies have evaluated the relative effectiveness of live attenuated (LAIV) and inactivated (IIV) influenza vaccines against medically attended laboratory-confirmed influenza.

Methods: We analyzed US Influenza Vaccine Effectiveness Network data from participants aged 2 to 17 years during 4 seasons (2010-2011 through 2013-2014) to compare relative effectiveness of LAIV and IIV against influenza-associated illness. Vaccine receipt was confirmed via provider/electronic medical records or immunization registry. We calculated the ratio (odds) of influenza-positive to influenza-negative participants among those age-appropriately vaccinated with either LAIV or IIV for the corresponding season. We examined relative effectiveness of LAIV and IIV by using adjusted odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression.

Results: Of 6819 participants aged 2 to 17 years, 2703 were age-appropriately vaccinated with LAIV (n = 637) or IIV (n = 2066). Odds of influenza were similar for LAIV and IIV recipients during 3 seasons (2010-2011 through 2012-2013). In 2013-2014, odds of influenza were significantly higher among LAIV recipients compared with IIV recipients 2 to 8 years old (OR 5.36; 95% CI, 2.37 to 12.13). Participants vaccinated with LAIV or IIV had similar odds of illness associated with influenza A/H3N2 or B. LAIV recipients had greater odds of illness due to influenza A/H1N1pdm09 in 2010-2011 and 2013-2014.

Conclusions: We observed lower effectiveness of LAIV compared with IIV against influenza A/H1N1pdm09 but not A(H3N2) or B among children and adolescents, suggesting poor performance related to the LAIV A/H1N1pdm09 viral construct.

PubMed Disclaimer

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Ms Gaglani has received an institutional contract with MedImmune/AstraZeneca. Dr Monto has consulted for GSK, Sanofi Pasteur, Noravax, Novartis, and Protein Sciences. Dr Nowalk receives grant funding from Pfizer and Merck. Dr Talbot has received research funding from Sanofi Pasteur, MedImmune, and Gilead and has served as an advisor for Teva Pharmaceuticals, Novartis, and VaxInnate. Drs Belongia and McLean receive research funding from MedImmune. Dr Zimmerman receives research funding from Sanofi Pasteur, Merck & Co Inc, and Pfizer, Inc. Dr Griffin has received research funding from MedImmune. Dr L Jackson’s institution has received research funding from Novartis. Dr Treanor has served on the board and consulted for Novartis. The other authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Adjusted odds ratios (aORs) and 95% CIs comparing odds of influenza among LAIV and IIV recipients by influenza season and age group. Adjusted models included age at enrollment (groups for overall estimates or years for age group-specific estimates), gender, study site, race or ethnicity, presence of high-risk health condition, parent- or guardian-rated general health status (not included in 2010–2011 models), interval from onset to enrollment, and calendar time (2-week intervals). REF, reference.
FIGURE 2
FIGURE 2
Adjusted odds ratios (aORs) and 95% CIs comparing odds of influenza among LAIV and IIV recipients by influenza type or subtype and season. Adjusted models included age at enrollment (groups), gender, study site, race or ethnicity, presence of high-risk health condition, parent- or guardian-rated general health status (not included in 2010–2011 models), interval from onset to enrollment, season (for combined estimates), and calendar time (2-week intervals defined by season). Estimates were not calculated when the total number of vaccinated cases for the season was <15. *Influenza A/H1N1pdm09 combined estimate includes data from 2010–2011 and 2013–2014. Influenza A/H3N2 combined estimate includes data from 2011–2012 and 2012–2013. REF, reference.
See this image and copyright information in PMC

References

    1. Fiore AE, Shay DK, Broder K, et al. ; Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices (ACIP) . Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008. MMWR Recomm Rep. 2008;57(RR-7):1–60 - PubMed
    1. Neuzil KM, Dupont WD, Wright PF, Edwards KM. Efficacy of inactivated and cold-adapted vaccines against influenza A infection, 1985 to 1990: the pediatric experience. Pediatr Infect Dis J. 2001;20(8):733–740 - PubMed
    1. Belshe RB, Edwards KM, Vesikari T, et al. ; CAIV-T Comparative Efficacy Study Group . Live attenuated versus inactivated influenza vaccine in infants and young children. N Engl J Med. 2007;356(7):685–696 - PubMed
    1. Fleming DM, Crovari P, Wahn U, et al. ; CAIV-T Asthma Study Group . Comparison of the efficacy and safety of live attenuated cold-adapted influenza vaccine, trivalent, with trivalent inactivated influenza virus vaccine in children and adolescents with asthma. Pediatr Infect Dis J. 2006;25(10):860–869 - PubMed
    1. Ashkenazi S, Vertruyen A, Arístegui J, et al. ; CAIV-T Study Group . Superior relative efficacy of live attenuated influenza vaccine compared with inactivated influenza vaccine in young children with recurrent respiratory tract infections. Pediatr Infect Dis J. 2006;25(10):870–879 - PubMed

Publication types