Reactogenicity and immunogenicity of three inactivated influenza virus vaccines in children

Inactivated Influenza Virus Vaccines in Children

Healthy children aged < or =2 years have hospitalization rates during influenza periods 12 times those of older children and comparable to rates in the elderly population. In 2003, killed influenza vaccines were "recommended" for children with high-risk conditions and were "encouraged" for children aged 6-23 months. Studies involving several thousand children show that split-virus vaccines are safe and immunogenic in healthy children aged > or =6 months and in high-risk children. In children aged < or =9 years, 2 doses of vaccine are required initially to achieve maximum protection. Studies of children aged 6 months to 15 years show vaccine efficacies of 31%-91% against influenza A and 45% against influenza B. Among children attending day care, a reduction in the rate of acute otitis media of 32%-36% was demonstrated. Studies suggest that use of killed vaccines among children is cost-saving. In conclusion, the data show that killed influenza vaccines in children are safe, immunogenic, effective, and potentially cost-saving.

Interference following dual inoculation with influenza A (H3N2) and (H1N1) viruses in ferrets and volunteers

The effects of simultaneous inoculation with two attenuated influenza A viruses was studied in ferrets and volunteers. Groups of ferrets were inoculated with an influenza A (H3N2) or (H1N1), virus or a combination of both viruses: the temperature response, serum and local antibody response, and the change in nasal wash protein concentration was determined. The results showed that both viruses were attenuated for ferrets, and that inoculation with both viruses together did not cause clinical reactions. Serological studies on paired serum samples obtained from ferrets showed that both viruses when given separately infected all the inoculated animals; however, dual infection resulted in all ferrets being infected with the influenza A (H3N2) virus strain, but this infection interfered with infection by the influenza A (H1N1) strain. Similar investigations were carried out in volunteers. Again, the clinical reactions and temperature response of volunteers to infection by one or other of the viruses showed both strains to be attenuated for man even when given together. In addition, no adverse clinical reactions were seen in volunteers inoculated with both viruses simultaneously. Serum antibody studies showed that infection by influenza A (H1N1) virus interfered with infection by the influenza A (H2N2) virus strain. These results show evidence of interference by influenza A viruses; however, the direction of interference was one-way, and differed for ferrets and for volunteers.