Comparative trial of large-particle aerosol and nose drop administration of live attenuated influenza vaccines.
Healthy adult subjects (n = 198) were randomized to receive bivalent cold-adapted (ca) influenza A vaccine containing 10(7.4) TCID50 each of A/Kawasaki/9/86 (H1N1) and A/Los Angeles/2/87 (H3N2) by either nose drops (ND) or large-particle aerosol (LPA). All subjects had received monovalent inactivated influenza B vaccine intramuscularly in the previous year. Ninety percent of LPA recipients and 82% of ND recipients preferred intranasal administration to their previous experience with intramuscular vaccine. Twenty-six (27%) of 98 LPA recipients and 47 (49%) of 97 ND recipients reported swallowing vaccine (P = .008). Fever was observed uncommonly (< or = 5%), and incidence of respiratory symptoms was comparable between groups. Fourfold or greater hemagglutination antibody response to at least one of the influenza A vaccine viruses was significantly more frequent after LPA (64%) than ND vaccination (43%; P = .005). LPA administration of ca influenza to the nasopharynx was well tolerated, safe, and more immunogenic than ND delivery.
Gruber
W C
WC
Dept. of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232-2581.
Hinson
H P
HP
Holland
K L
KL
Thompson
J M
JM
Reed
G W
GW
Wright
P F
PF
D000281:Administration, Intranasal; D000328:Adult; D000336:Aerosols; D000914:Antibodies, Viral / Q000097:blood; D006801:Humans; D009980:Influenza A virus / Q000276:immunology*; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000627:therapeutic use; D007251:Influenza, Human / Q000517:prevention & control*; D008875:Middle Aged; D014613:Vaccines, Attenuated / Q000008:administration & dosage* / Q000627:therapeutic use
D000336:Aerosols; D000914:Antibodies, Viral; D007252:Influenza Vaccines; D014613:Vaccines, Attenuated