title: Live attenuated and inactivated influenza vaccines in children.
abstract: BACKGROUND
  Live attenuated influenza vaccine (LAIV) and inactivated influenza vaccine (IIV) are available for children. Local and systemic immunity induced by LAIV followed a month later by LAIV and IIV followed by LAIV were investigated with virus recovery after LAIV doses as surrogates for protection against influenza on natural exposure.
  
  
  METHODS
  Fifteen children received IIV followed by LAIV, 13 an initial dose of LAIV, and 11 a second dose of LAIV. The studies were done during autumn 2009 and autumn 2010 with the same seasonal vaccine (A/California/07/09 [H1N1], A/Perth/16/09 [H3N2], B/Brisbane/60/08).
  
  
  RESULTS
  Twenty-eight of 39 possible influenza viral strains were recovered after the initial dose of LAIV. When LAIV followed IIV, 21 of 45 viral strains were identified. When compared to primary LAIV infection, the decreased frequency of shedding with the IIV-LAIV schedule was significant (P = .023). With LAIV-LAIV, the fewest viral strains were recovered (3/33)--numbers significantly lower (P < .001) than shedding after initial LAIV and after IIV-LAIV (P < .001). Serum hemagglutination inhibition antibody responses were more frequent after IIV than LAIV (P = .02). In contrast, more mucosal immunoglobulin A responses were seen with LAIV.
  
  
  CONCLUSIONS
  LAIV priming induces greater inhibition of virus recovery on LAIV challenge than IIV priming. The correlate(s) of protection are the subject of ongoing analysis.
  
  
  BACKGROUND
  NCT01246999.
authors.affiliation: Department of Pediatrics.
authors.forename: Natalia A
authors.initials: NA
authors.lastname: Ilyushina
authors.affiliation: Department of Pediatrics.
authors.forename: Brenda C
authors.initials: BC
authors.lastname: Haynes
authors.affiliation: Department of Community and Family Medicine.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Hoen
authors.affiliation: Department of Pediatrics.
authors.forename: Alexey M
authors.initials: AM
authors.lastname: Khalenkov
authors.affiliation: Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth.
authors.forename: Molly L
authors.initials: ML
authors.lastname: Housman
authors.affiliation: Department of Thayer School of Engineering at Dartmouth, Hanover, New Hampshire.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Brown
authors.affiliation: Department of Thayer School of Engineering at Dartmouth, Hanover, New Hampshire.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Ackerman
authors.affiliation: Department of Medicine, University of Rochester Medical Center, New York.
authors.forename: John J
authors.initials: JJ
authors.lastname: Treanor
authors.affiliation: Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Luke
authors.affiliation: Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: Kanta
authors.initials: K
authors.lastname: Subbarao
authors.affiliation: Department of Pediatrics.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Wright
mesh_terms: D000914:Antibodies, Viral / Q000276:immunology; D000917:Antibody Formation / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006385:Hemagglutination Inhibition Tests / Q000379:methods; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D053118:Influenza A Virus, H1N1 Subtype / Q000276:immunology; D053122:Influenza A Virus, H3N2 Subtype / Q000276:immunology; D009981:Influenza B virus / Q000276:immunology; D007252:Influenza Vaccines / Q000276:immunology*; D007251:Influenza, Human / Q000276:immunology* / Q000517:prevention & control*; D008297:Male; D014613:Vaccines, Attenuated / Q000276:immunology*; D015164:Vaccines, Inactivated / Q000276:immunology*; D014765:Viral Vaccines / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D007070:Immunoglobulin A; D007252:Influenza Vaccines; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated; D014765:Viral Vaccines
keywords: children; influenza; vaccines