title: Influenza vaccination type, live, attenuated influenza vaccine (LAIV) versus inactivated influenza vaccine (IIV), received by children, United States, 2011-12 through 2013-14 influenza seasons.
abstract: BACKGROUND
  Influenza vaccines available for children in the United States include inactivated influenza vaccine (IIV) and live, attenuated influenza vaccine (LAIV). Objectives of this study were to quantify proportions of IIV and LAIV received by vaccinated children, and examine associations between vaccine type received and demographic characteristics.
  
  
  METHODS
  National Immunization Survey-Flu (NIS-Flu) parental reported data for the 2011-12 through 2013-14 influenza seasons were used to estimate proportions of vaccinated children 2-17 years who received IIV and LAIV. Tests of association between vaccination type and demographic variables were conducted using Wald chi-square tests and pair-wise comparison t-tests. Multivariable logistic regression was used to determine variables independently associated with receipt of LAIV versus IIV.
  
  
  RESULTS
  In the 2013-14 season, 33.3% of vaccinated children received LAIV, similar to the proportion in the 2011-12 (32.2%) and 2012-13 (32.1%) seasons. Across all seasons studied, the strongest observed association was between vaccination type and child's age, with children 2-8 years (Adjusted Prevalence Ratio (95% confidence interval) [APR(95% CI)] 1.41(1.27-1.56), 1.46(1.34-1.59), and 1.50(1.38-1.63) for 2011-12, 2012-13, and 2013-14) and 9-12 years (APR(95% CI) 1.37(1.23-1.54), 1.38(1.26-1.51), and 1.50(1.38-1.63) for 2011-12, 2012-13, and 2013-14) being more likely to have received LAIV than children 13-17 years. Among those vaccinated, whites were more likely to have received LAIV compared with blacks (APR(95% CI) 1.19(1.05-1.35), 1.24(1.10-1.39), and 1.22(1.11-1.34) for 2011-12, 2012-13, and 2013-14), and children living above poverty (annual income >$75,000) were more likely to have received LAIV than those living at or below poverty (APR(95% CI) 1.43(1.23-1.67), 1.13(1.02-1.26), and 1.16(1.06-1.28) for 2011-12, 2012-13, and 2013-14).
  
  
  CONCLUSIONS
  This study provides a baseline of the extent and patterns of LAIV uptake that can be used to measure the impact of relevant public health policy. Additional research is needed to investigate parental and provider preferences and barriers regarding LAIV.
authors.affiliation: Leidos, Inc., Atlanta, GA, USA; Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, 1600 Clifton Road, NE; Mail Stop A-19, Atlanta, GA 30333, USA. Electronic address: xdo9@cdc.gov.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Kahn
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, 1600 Clifton Road, NE; Mail Stop A-19, Atlanta, GA 30333, USA.
authors.forename: Tammy A
authors.initials: TA
authors.lastname: Santibanez
authors.affiliation: Leidos, Inc., Atlanta, GA, USA; Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, 1600 Clifton Road, NE; Mail Stop A-19, Atlanta, GA 30333, USA.
authors.forename: Yusheng
authors.initials: Y
authors.lastname: Zhai
authors.affiliation: Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, 1600 Clifton Road, NE; Mail Stop A-19, Atlanta, GA 30333, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Singleton
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003710:Demography; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D014481:United States; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000276:immunology; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000276:immunology
chemical_list: D007252:Influenza Vaccines; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated
keywords: Child; Health surveys; Influenza vaccines; LAIV vaccine; Vaccination