Safety and immunogenicity of live attenuated and inactivated influenza vaccines in children with cancer

Silvana Carr, Kim J. Allison, Lee Ann Van De Velde, Kelly Zhang, Elizabeth Y. English, Amy Iverson, Najat C. Daw, Scott C. Howard, Fariba Navid, Carlos Rodriguez-Galindo, Jie Yang, Elisabeth E. Adderson, Jonathan A. Mccullers, Patricia M. Flynn

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

(See the editorial commentary by Halasa, on pages 1471-4.)Background.The safety and immunogenicity of live, attenuated influenza vaccine (LAIV) has not been compared to that of the standard trivalent inactivated vaccine (TIV) in children with cancer.Methods.Randomized study of LAIV versus TIV in children with cancer, age 2-21 years, vaccinated according to recommendations based on age and prior vaccination. Data on reactogenicity and other adverse events and blood and nasal swab samples were obtained following vaccination.Results.Fifty- five eligible subjects (mean age, 10.4 years) received vaccine (28 LAIV/27 TIV). Both vaccines were well tolerated. Rhinorrhea reported within 10 days of vaccination was similar in both groups (36% LAIV vs 33% TIV, P >. 999). Ten LAIV recipients shed virus; the latest viral shedding was detected 7 days after vaccination. Immunogenicity data were available for 52 subjects, or 26 in each group. TIV induced significantly higher postvaccination geometric mean titers against influenza A viruses (P <. 001), greater seroprotection against influenza A/H1N1 (P =. 01), and greater seroconversion against A/H3N2 (P =. 004), compared with LAIV. No differences after vaccination were observed against influenza B viruses.Conclusions.As expected, serum antibody response against influenza A strains were greater with TIV than with LAIV in children with cancer. Both vaccines were well tolerated, and prolonged viral shedding after LAIV was not detected.

Original languageEnglish (US)
Pages (from-to)1475-1482
Number of pages8
JournalJournal of Infectious Diseases
Volume204
Issue number10
DOIs
StatePublished - Nov 15 2011

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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