Burden, effectiveness and safety of influenza vaccines in elderly, paediatric and pregnant populations

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Abstract

Vaccination is the most practical means available for preventing influenza. Influenza vaccines require frequent updates to keep pace with antigenic drift of the virus, and the effectiveness, and sometimes the safety, of the vaccine can therefore vary from season to season. Three key populations that the World Health Organization recommends should be prioritized for influenza vaccination are pregnant women, children younger than 5 years of age and the elderly. This review discusses the burden of influenza and the safety and effectiveness profile of influenza vaccines recommended for these groups.

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Most cited references 126

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Estimates of global seasonal influenza-associated respiratory mortality: a modelling study

A. Iuliano, Katherine M Roguski, Howard H. Chang … (2018)

Estimates of influenza-associated mortality are important for national and international decision making on public health priorities. Previous estimates of 250 000-500 000 annual influenza deaths are outdated. We updated the estimated number of global annual influenza-associated respiratory deaths using country-specific influenza-associated excess respiratory mortality estimates from 1999-2015.

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Efficacy of high-dose versus standard-dose influenza vaccine in older adults.

Carlos DiazGranados, Andrew J Dunning, Murray Kimmel … (2014)

As compared with a standard-dose vaccine, a high-dose, trivalent, inactivated influenza vaccine (IIV3-HD) improves antibody responses to influenza among adults 65 years of age or older. This study evaluated whether IIV3-HD also improves protection against laboratory-confirmed influenza illness.

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Live attenuated versus inactivated influenza vaccine in infants and young children.

Robert Belshe, Kathryn Edwards, Timo Vesikari … (2007)

Universal vaccination of children 6 to 59 months of age with trivalent inactivated influenza vaccine has recently been recommended by U.S. advisory bodies. To evaluate alternative vaccine approaches, we compared the safety and efficacy of intranasally administered live attenuated influenza vaccine with those of inactivated vaccine in infants and young children. Children 6 to 59 months of age, without a recent episode of wheezing illness or severe asthma, were randomly assigned in a 1:1 ratio to receive either cold-adapted trivalent live attenuated influenza vaccine (a refrigeration-stable formulation of live attenuated intranasally administered influenza vaccine) or trivalent inactivated vaccine in a double-blind manner. Influenza-like illness was monitored with cultures throughout the 2004-2005 influenza season. Safety data were available for 8352 children, and 7852 children completed the study according to the protocol. There were 54.9% fewer cases of cultured-confirmed influenza in the group that received live attenuated vaccine than in the group that received inactivated vaccine (153 vs. 338 cases, P<0.001). The superior efficacy of live attenuated vaccine, as compared with inactivated vaccine, was observed for both antigenically well-matched and drifted viruses. Among previously unvaccinated children, wheezing within 42 days after the administration of dose 1 was more common with live attenuated vaccine than with inactivated vaccine, primarily among children 6 to 11 months of age; in this age group, 12 more episodes of wheezing were noted within 42 days after receipt of dose 1 among recipients of live attenuated vaccine (3.8%) than among recipients of inactivated vaccine (2.1%, P=0.076). Rates of hospitalization for any cause during the 180 days after vaccination were higher among the recipients of live attenuated vaccine who were 6 to 11 months of age (6.1%) than among the recipients of inactivated vaccine in this age group (2.6%, P=0.002). Among young children, live attenuated vaccine had significantly better efficacy than inactivated vaccine. An evaluation of the risks and benefits indicates that live attenuated vaccine should be a highly effective, safe vaccine for children 12 to 59 months of age who do not have a history of asthma or wheezing. (ClinicalTrials.gov number, NCT00128167 [ClinicalTrials.gov].). Copyright 2007 Massachusetts Medical Society.

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Author and article information

Contributors

Sheena G. Sullivan:

ORCID: https://orcid.org/0000-0002-0856-0294

Olivia H. Price

Annette K. Regan

Journal

Journal ID (nlm-ta): Ther Adv Vaccines Immunother

Journal ID (iso-abbrev): Ther Adv Vaccines Immunother

Journal ID (publisher-id): TAV

Journal ID (hwp): sptav

Title: Therapeutic Advances in Vaccines and Immunotherapy

Publisher: SAGE Publications (Sage UK: London, England )

ISSN (Print): 2515-1355

ISSN (Electronic): 2515-1363

Publication date (Electronic): 07 February 2019

Publication date Collection: 2019

Volume: 7

Electronic Location Identifier: 2515135519826481

Affiliations

[1-2515135519826481]WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria 3000, Australia

[2-2515135519826481]School of Population and Global Health, University of Melbourne, Australia Fielding School of Public Health, University of California, Los Angeles, CA, USA

[3-2515135519826481]WHO Collaborating Centre for Reference and Research on Influenza, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia

[4-2515135519826481]School of Public Health, Texas A&M University, College Station, TX, United States; School of Public Health, Curtin University, Perth, Western Australia, Australia, and Wesfamers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Crawley, Western Australia, Australia

Author notes

[*] Sheena.Sullivan@ 123456influenzacentre.org

Author information

Sheena G. Sullivan https://orcid.org/0000-0002-0856-0294

Article

Publisher ID: 10.1177_2515135519826481

DOI: 10.1177/2515135519826481

PMC ID: 6376509

PubMed ID: 30793097

SO-VID: bb931211-c06c-4716-8bfc-1183de6fb903

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This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 24 September 2018

Date accepted : 20 December 2018

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cover-date January-December 2019

Keywords: influenza,vaccination,child,pregnancy,aged,safety,efficacy,effectiveness,immunogenicity,reactogenicity

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Keywords: influenza, vaccination, child, pregnancy, aged, safety, efficacy, effectiveness, immunogenicity, reactogenicity

Burden, effectiveness and safety of influenza vaccines in elderly, paediatric and pregnant populations

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Vaccines

Most cited references 126

Estimates of global seasonal influenza-associated respiratory mortality: a modelling study

Efficacy of high-dose versus standard-dose influenza vaccine in older adults.

Live attenuated versus inactivated influenza vaccine in infants and young children.

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