Genetic sequence analysis of influenza viruses and illness severity in ill children previously vaccinated with live attenuated or inactivated influenza vaccine.
In a large comparative study in 2004-2005, children aged 6-59 months vaccinated with live attenuated influenza vaccine (LAIV) experienced 55% fewer cases of culture-confirmed influenza illness compared with trivalent inactivated influenza vaccine (TIV) recipients. To better understand the characteristics of the breakthrough influenza illnesses, we analyzed the HA1 genetic sequence for all available samples and examined disease severity by strain and treatment group. All 48 A/H1N1 viruses were well-matched to the vaccine, whereas all 276 A/H3N2 viruses and 349 (96%) influenza B viruses were mismatched to the vaccine. The incidence of fever or lower respiratory illness did not differ by strain; however, LAIV recipients had less febrile disease and fewer lower respiratory illnesses than TIV recipients. Viruses of each influenza B lineage caused more illnesses than A/H1N1 viruses; strategies to enhance protection against multiple influenza B lineages should be pursued.
Yang
Chin-Fen
CF
MedImmune, Gaithersburg, MD, USA.
Belshe
Robert B
RB
Kemble
George
G
Song
Eyun
E
Ye
Dan
D
Liang
Brandon
B
Yi
Tingting
T
Ambrose
Christopher S
CS
Coelingh
Kathy
K
Walker
Robert E
RE
D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000145:classification / Q000235:genetics*; D053122:Influenza A Virus, H3N2 Subtype / Q000145:classification / Q000235:genetics*; D009981:Influenza B virus / Q000145:classification / Q000235:genetics*; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology*; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics; D017423:Sequence Analysis, RNA; D014613:Vaccines, Attenuated / Q000008:administration & dosage; D015164:Vaccines, Inactivated / Q000008:administration & dosage
D007252:Influenza Vaccines; D012367:RNA, Viral; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated