Effectiveness of the live attenuated and the inactivated influenza vaccine in two-year-olds – a nationwide cohort study Finland, influenza season 2015/16

Although widely recommended, influenza vaccination of children is part of the national vaccination programme only in few countries. In addition to Canada and the United States (US), in Europe Finland and the United Kingdom have introduced live attenuated influenza vaccine (LAIV) for healthy children in their programmes. On 22 June 2016, the US Advisory Committee on Immunizations Practices, voted against further use of LAIV due to no observed vaccine effectiveness (VE) over three consecutive influenza seasons (2013/14 to 2015/16). We summarise the results of a nationwide, register-based cohort study (N=55,258 of whom 8,086 received LAIV and 4,297 TIV); all outcome (laboratory-confirmed influenza), exposure (vaccination) and confounding variable data were retrieved from four computerised national health registers, which were linked via a unique personal identity code assigned to all permanent Finnish residents regardless of nationality. Our study provides evidence of moderate effectiveness against any laboratory-confirmed influenza of the quadrivalent LAIV vaccine (VE: 51%; 95% confidence interval (CI): 28–66%) as well as the inactivated trivalent vaccine (VE: 61%; 95% CI: 31–78%) among two-year-olds during the influenza season 2015/16 in Finland. Based on these data, Finland will continue using LAIV for young children in its National Immunisation Programme this coming influenza season.

Download Full-text

Successes and failures of the live-attenuated influenza vaccine, can we do better?

10.1101/424275 ◽

2018 ◽

Author(s):

Laura Matrajt ◽

M. Elizabeth Halloran ◽

Rustom Antia

Keyword(s):

United States ◽

Influenza Vaccine ◽

Mathematical Models ◽

Viral Infections ◽

Influenza Season ◽

The United States ◽

Vaccine Effectiveness ◽

Effective Protection ◽

Live Attenuated Vaccines ◽

Live Attenuated Influenza Vaccine

Live-attenuated vaccines are usually highly effective against many acute viral infections. However, the effective- ness of the live attenuated influenza vaccine (LAIV) can vary widely, ranging from 0% effectiveness in some studies done in the United States to 50% in studies done in Europe. The reasons for these discrepancies remain largely unclear. In this paper we use mathematical models to explore how the efficacy of LAIV is affected by the degree of mismatch with the currently circulating influenza strain and interference with pre-existing immunity. The model incorporates two key antigenic distances - the distance between pre-existing immunity and the currently circulating strain as well as the LAIV strain. Our models show that a LAIV that is matched with the currently circulating strain is likely to have only modest efficacy. Our results suggest that the efficacy of the vaccine would be increased (optimized) if, rather than being matched to the circulating strain, it is antigenically slightly further from pre-existing immunity compared with the circulating strain. The models also suggest two regimes in which LAIV that is matched to circulating strains may provide effective protection. The first is in children before they have built immunity from circulating strains. The second is in response to novel strains (such as antigenic shifts) which are at substantial antigenic distance from previously circulating strains. Our models provide an explanation for the variation in vaccine effectiveness, both between children and adults as well as between studies of vaccine effectiveness observed during the 2014-15 influenza season in different countries.

Download Full-text

Evaluation of the safety of live attenuated influenza vaccine (LAIV) in children and adolescents with asthma and high-risk conditions: a population-based prospective cohort study conducted in England with the Clinical Practice Research Datalink

BMJ Open ◽

10.1136/bmjopen-2018-023118 ◽

2018 ◽

Vol 8 (12) ◽

pp. e023118 ◽

Cited By ~ 1

Author(s):

Herve Caspard ◽

Amy Steffey ◽

Raburn M Mallory ◽

Christopher S Ambrose

Keyword(s):

Cohort Study ◽

Clinical Practice ◽

High Risk ◽

Influenza Vaccine ◽

Children And Adolescents ◽

Influenza Season ◽

Risk Groups ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Live Attenuated Influenza Vaccine

ObjectivesTo assess the safety of live attenuated influenza vaccine (LAIV) in children in high-risk groups.DesignNon-interventional cohort study.SettingEngland during 2013–2014 and 2014–2015 influenza seasons.ParticipantsLAIV recipients identified from the Clinical Practice Research Datalink, aged 2–17 years, and with at least one underlying high-risk condition. LAIV recipients were matched with inactivated influenza vaccine (IIV) recipients and unvaccinated controls.Primary outcome measuresPrimary safety endpoints were any hospitalisation documented in the linked Hospital Episodes Statistics database within 42 days and up to 6 months after vaccination.Results11 463 children and adolescents were included: 4718 received the trivalent LAIV formulation during the 2013–2014 influenza season and 6745 received the quadrivalent formulation during the 2014–2015 influenza season. The risks of hospitalisation within 42 days were 231 per 1000 person-years (95% CI 193 to 275) in season 2013–2014 and 231 (95% CI 198 to 267) in season 2014–2015. These risks were not significantly different when compared with matched unvaccinated children (relative risks (RR) 0.96 (95% CI 0.78 to 1.19) in season 2013–2014, 0.90 (95% CI 0.76 to 1.07) in season 2014–2015) and consistently lower than after IIV administration (RR 0.47 (95% CI: 0.37 to 0.59) in season 2013–2014, 0.42 (95% CI 0.35 to 0.51) in season 2014–2015). A similar pattern was observed up to 6 months postvaccination with a risk of hospitalisation after LAIV administration that did not differ from what was observed in unvaccinated controls and was lower than after IIV administration.ConclusionsThis study did not identify new safety concerns associated with the administration of LAIV in children and adolescents with high-risk conditions. However, as with any other observational study, treatment administration was not randomly assigned and our findings may be confounded by differences between the groups at baseline.Trial registration numberEUPAS18527.

Download Full-text

Chickenpox: Presentation, transmission, complications and prevention

British Journal of School Nursing ◽

10.12968/bjsn.2019.14.10.482 ◽

2019 ◽

Vol 14 (10) ◽

pp. 482-485

Author(s):

Deborah Louise Duncan

Keyword(s):

Immunisation Programme ◽

The United States ◽

Childhood Vaccination ◽

Varicella Vaccination ◽

National Immunisation Programme ◽

Varicella Zoster ◽

National Immunisation ◽

Routine Childhood ◽

Vaccination Scheme ◽

The Uk

Varicella, commonly known as chickenpox is an acute and highly infectious disease, which is caused by the varicella zoster virus Varicella. The two chickenpox vaccines available in the UK are Varilrix and Varivax but are not included in the routine childhood vaccination scheme unless they are immunocompromised ( Gov.uk, 2018 ; PHE, 2019 ). The varicella vaccination has been associated with a dramatic reduction in chickenpox cases in countries such as the United States, where every child can be vaccinated ( Seward et al, 2002 ). Johnston et al (1997) ; however, suggest that approximately 2–3% of patients vaccinated per year can develop a mild form of chickenpox regardless of the vaccine given. The Joint Committee on Vaccination and Immunisation (2010) has not recommended it as part of the national immunisation programme but nearly a decade later perhaps it is time to revisit this topic.

Download Full-text

Mumps epidemic in Portugal despite high vaccine coverage - preliminary report

Eurosurveillance ◽

10.2807/esm.01.04.00160-en ◽

1996 ◽

Vol 1 (4) ◽

pp. 25-28 ◽

Cited By ~ 17

Author(s):

J A Dias ◽

M Cordeiro ◽

M A Afzal ◽

M G Freitas ◽

M. R. Morgado ◽

...

Keyword(s):

Preliminary Report ◽

Vaccine Coverage ◽

Immunisation Programme ◽

National Immunisation Programme ◽

National Immunisation ◽

Northern Portugal ◽

Health Centres ◽

Trivalent Vaccine

A measles, mumps, and rubella (MMR) trivalent vaccine was added to Portugal's National Immunisation Programme (NIP) in 1987. All vaccines are given at health centres, free of charge, but an epidemic of mumps began in 1995, firstly in northern Portugal and

Download Full-text

A retrospective cohort study assessing relative effectiveness of adjuvanted versus high-dose trivalent influenza vaccines among older adults in the United States during the 2018–19 influenza season

Vaccine ◽

10.1016/j.vaccine.2021.03.054 ◽

2021 ◽

Author(s):

Stephen I. Pelton ◽

Victoria Divino ◽

Maarten J. Postma ◽

Drishti Shah ◽

Joaquin Mould-Quevedo ◽

...

Keyword(s):

United States ◽

Older Adults ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Influenza Season ◽

Relative Effectiveness ◽

The United States ◽

Influenza Vaccines ◽

High Dose

Download Full-text

Effectiveness of seasonal influenza vaccine for adults and children in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2015/16 end-of-season results

Eurosurveillance ◽

10.2807/1560-7917.es.2016.21.38.30348 ◽

2016 ◽

Vol 21 (38) ◽

Cited By ~ 56

Author(s):

Richard Pebody ◽

Fiona Warburton ◽

Joanna Ellis ◽

Nick Andrews ◽

Alison Potts ◽

...

Keyword(s):

Primary Care ◽

United Kingdom ◽

Influenza Vaccine ◽

Influenza A ◽

Immunisation Programme ◽

Influenza B ◽

Live Attenuated Influenza Vaccine ◽

The United Kingdom ◽

Influenza A H1n1 ◽

The Uk

The United Kingdom (UK) is in the third season of introducing universal paediatric influenza vaccination with a quadrivalent live attenuated influenza vaccine (LAIV). The 2015/16 season in the UK was initially dominated by influenza A(H1N1)pdm09 and then influenza of B/Victoria lineage, not contained in that season’s adult trivalent inactivated influenza vaccine (IIV). Overall adjusted end-of-season vaccine effectiveness (VE) was 52.4% (95% confidence interval (CI): 41.0–61.6) against influenza-confirmed primary care consultation, 54.5% (95% CI: 41.6–64.5) against influenza A(H1N1)pdm09 and 54.2% (95% CI: 33.1–68.6) against influenza B. In 2–17 year-olds, adjusted VE for LAIV was 57.6% (95% CI: 25.1 to 76.0) against any influenza, 81.4% (95% CI: 39.6–94.3) against influenza B and 41.5% (95% CI: −8.5 to 68.5) against influenza A(H1N1)pdm09. These estimates demonstrate moderate to good levels of protection, particularly against influenza B in children, but relatively less against influenza A(H1N1)pdm09. Despite lineage mismatch in the trivalent IIV, adults younger than 65 years were still protected against influenza B. These results provide reassurance for the UK to continue its influenza immunisation programme planned for 2016/17.

Download Full-text

Rotavirus vaccine impact assessment surveillance in India: protocol and methods

BMJ Open ◽

10.1136/bmjopen-2018-024840 ◽

2019 ◽

Vol 9 (4) ◽

pp. e024840 ◽

Cited By ~ 12

Author(s):

Nayana P Nair ◽

Samarasimha Reddy N ◽

Sidhartha Giri ◽

Venkata Raghava Mohan ◽

Umesh Parashar ◽

...

Keyword(s):

Data Entry ◽

Immunisation Programme ◽

Ethics Committees ◽

Rotavirus Vaccine ◽

Routine Immunisation ◽

National Immunisation Programme ◽

National Immunisation ◽

Institutional Ethics ◽

Institutional Review ◽

Vaccine Impact

IntroductionRotavirus infection accounts for 39% of under-five diarrhoeal deaths globally and 22% of these deaths occur in India. Introduction of rotavirus vaccine in a national immunisation programme is considered to be the most effective intervention in preventing severe rotavirus disease. In 2016, India introduced an indigenous rotavirus vaccine (Rotavac) into the Universal Immunisation Programme in a phased manner. This paper describes the protocol for surveillance to monitor the performance of rotavirus vaccine following its introduction into the routine childhood immunisation programme.MethodsAn active surveillance system was established to identify acute gastroenteritis cases among children less than 5 years of age. For all children enrolled at sentinel sites, case reporting forms are completed and a copy of vaccination record and a stool specimen obtained. The forms and specimens are sent to the referral laboratory for data entry, analysis, testing and storage. Data from sentinel sites in states that have introduced rotavirus vaccine into their routine immunisation schedule will be used to determine rotavirus vaccine impact and effectiveness.Ethics and disseminationThe Institutional Review Board of Christian Medical College, Vellore, and all the site institutional ethics committees approved the project. Results will be disseminated in peer-reviewed journals and with stakeholders of the universal immunisation programme in India.

Download Full-text

Disease burden of varicella versus other vaccine-preventable diseases before introduction of vaccination into the national immunisation programme in the Netherlands

Eurosurveillance ◽

10.2807/1560-7917.es.2019.24.18.1800363 ◽

2019 ◽

Vol 24 (18) ◽

Cited By ~ 2

Author(s):

Alies van Lier ◽

Brechje de Gier ◽

Scott A McDonald ◽

Marie-Josée J. Mangen ◽

Maarten van Wijhe ◽

...

Keyword(s):

Herpes Zoster ◽

The Netherlands ◽

Immunisation Programme ◽

Current Approach ◽

Published Data ◽

Uncertainty Interval ◽

National Immunisation Programme ◽

Vaccine Preventable Diseases ◽

National Immunisation ◽

Life Years

Introduction Estimating burden of disease (BoD) is an essential first step in the decision-making process on introducing new vaccines into national immunisation programmes (NIPs). For varicella, a common vaccine-preventable disease, BoD in the Netherlands was unknown. Aim To assess national varicella BoD and compare it to BoD of other vaccine-preventable diseases before their introduction in the NIP. Methods In this health estimates reporting study, BoD was expressed in disability-adjusted life years (DALYs) using methodology from the Burden of Communicable Diseases in Europe (BCoDE)-project. As no parameters/disease model for varicella (including herpes zoster) were available in the BCoDE toolkit, incidence, disease progression model and parameters were derived from seroprevalence, healthcare registries and published data. For most other diseases, BoD was estimated with existing BCoDE-parameters, adapted to the Netherlands if needed. Results In 2017, the estimated BoD of varicella in the Netherlands was 1,800 (95% uncertainty interval (UI): 1,800–1,900) DALYs. Herpes zoster mainly contributed to this BoD (1,600 DALYs; 91%), which was generally lower than the BoD of most current NIP diseases in the year before their introduction into the NIP. However, BoD for varicella was higher than for rotavirus gastroenteritis (1,100; 95%UI: 440–2,200 DALYs) and meningococcal B disease (620; 95%UI: 490–770 DALYs), two other potential NIP candidates. Conclusions When considering the introduction of a new vaccine in the NIP, BoD is usually estimated in isolation. The current approach assesses BoD in relation to other vaccine-preventable diseases’ BoD, which may help national advisory committees on immunisation and policymakers to set vaccination priorities.

Download Full-text