title: Live attenuated influenza vaccine use and safety in children and adults with asthma.
abstract: Live attenuated influenza vaccine (LAIV) might increase the risk of wheezing in persons with asthma or children younger than 5 years with a history of recurrent wheezing.
  
  
  
  To describe the use and assess the safety of LAIV in persons with asthma in the Vaccine Safety Datalink population.
  
  
  
  We identified persons with asthma using diagnosis codes and medication records in 7 health care organizations over 3 influenza seasons (2008-2009 through 2010-2011) and determined their influenza vaccination rates. Using the self-controlled risk interval method, we calculated the incidence rate ratio of medically attended respiratory events in the 14 days after LAIV compared with 29 to 42 days after vaccination in persons 2 through 49 years old.
  
  
  
  In our population of 6.3 million, asthma prevalence was 5.9%. Of persons with asthma, approximately 50% received any influenza vaccine but less than 1% received LAIV. The safety study included 12,354 LAIV doses (75% in children; 93% in those with intermittent or mild persistent asthma). The incidence rate ratio for inpatient and emergency department visits for lower respiratory events (including asthma exacerbation and wheezing) was 0.98 (95% confidence interval 0.63-1.51) and the incidence rate ratio for upper respiratory events was 0.94 (95% confidence interval 0.48-1.86). The risk of lower respiratory events was similar for intermittent and mild persistent asthma, across age groups, and for seasonal trivalent LAIV and 2009 H1N1 pandemic monovalent LAIV.
  
  
  
  LAIV use in asthma was mostly in persons with intermittent or mild persistent asthma. LAIV was not associated with an increased risk of medically attended respiratory adverse events.
authors.affiliation: Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: jduffy@cdc.gov.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Duffy
authors.affiliation: Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Lewis
authors.affiliation: Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Theresa
authors.initials: T
authors.lastname: Harrington
authors.affiliation: Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California, Oakland, California.
authors.forename: Roger
authors.initials: R
authors.lastname: Baxter
authors.affiliation: Marshfield Clinic Research Foundation, Marshfield, Wisconsin.
authors.forename: Edward A
authors.initials: EA
authors.lastname: Belongia
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Jackson
authors.affiliation: Kaiser Permanente Southern California, Pasadena, California.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
authors.affiliation: Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
authors.forename: Grace M
authors.initials: GM
authors.lastname: Lee
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
authors.forename: Allison L
authors.initials: AL
authors.lastname: Naleway
authors.affiliation: HealthPartners Institute, Minneapolis, Minnesota.
authors.forename: James
authors.initials: J
authors.lastname: Nordin
authors.affiliation: Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Daley
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007252:Influenza Vaccines / Q000009:adverse effects / Q000276:immunology*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012135:Respiratory Sounds / Q000209:etiology; D012621:Seasons; D012720:Severity of Illness Index; D014611:Vaccination / Q000009:adverse effects; D014613:Vaccines, Attenuated / Q000009:adverse effects / Q000276:immunology*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines; D014613:Vaccines, Attenuated