title: Live Attenuated Versus Inactivated Influenza Vaccine in Hutterite Children: A Cluster Randomized Blinded Trial.
abstract: BACKGROUND
  Whether vaccinating children with intranasal live attenuated influenza vaccine (LAIV) is more effective than inactivated influenza vaccine (IIV) in providing both direct protection in vaccinated persons and herd protection in unvaccinated persons is uncertain. Hutterite colonies, where members live in close-knit, small rural communities in which influenza virus infection regularly occurs, offer an opportunity to address this question.
  
  
  OBJECTIVE
  To determine whether vaccinating children and adolescents with LAIV provides better community protection than IIV.
  
  
  METHODS
  A cluster randomized blinded trial conducted between October 2012 and May 2015 over 3 influenza seasons. (ClinicalTrials.gov: NCT01653015).
  
  
  METHODS
  52 Hutterite colonies in Alberta and Saskatchewan, Canada.
  
  
  METHODS
  1186 Canadian children and adolescents aged 36 months to 15 years who received the study vaccine and 3425 community members who did not.
  
  
  METHODS
  Children were randomly assigned according to community in a blinded manner to receive standard dosing of either trivalent LAIV or trivalent IIV.
  
  
  METHODS
  The primary outcome was reverse transcriptase polymerase chain reaction-confirmed influenza A or B virus in all participants (vaccinated children and persons who did not receive the study vaccine).
  
  
  RESULTS
  Mean vaccine coverage among children in the LAIV group was 76.9% versus 72.3% in the IIV group. Influenza virus infection occurred at a rate of 5.3% (295 of 5560 person-years) in the LAIV group versus 5.2% (304 of 5810 person-years) in the IIV group. The hazard ratio comparing LAIV with IIV for influenza A or B virus was 1.03 (95% CI, 0.85 to 1.24).
  
  
  CONCLUSIONS
  The study was conducted in Hutterite communities, which may limit generalizability.
  
  
  CONCLUSIONS
  Immunizing children with LAIV does not provide better community protection against influenza than IIV.
  
  
  BACKGROUND
  The Canadian Institutes for Health Research.
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Loeb
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Russell
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Manning
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fonseca
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: David J D
authors.initials: DJ
authors.lastname: Earn
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Gregory
authors.initials: G
authors.lastname: Horsman
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Khami
authors.initials: K
authors.lastname: Chokani
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Vooght
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Lorne
authors.initials: L
authors.lastname: Babiuk
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Schwartz
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Binod
authors.initials: B
authors.lastname: Neupane
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Pardeep
authors.initials: P
authors.lastname: Singh
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Walter
authors.affiliation: From McMaster University, Hamilton, Ontario; University of Calgary, Calgary, Alberta; Saskatchewan Disease Control Laboratory, Regina, Saskatchewan; Prince Albert Parkland Health Region, Prince Albert, Saskatchewan; Five Hills Health Region, Moose Jaw, Saskatchewan; and Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Pullenayegum
mesh_terms: D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D032521:Immunity, Herd; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D007251:Influenza, Human / Q000453:epidemiology / Q000517:prevention & control*; D012424:Rural Population; D014611:Vaccination; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000009:adverse effects; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D007252:Influenza Vaccines; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated