Constantina Boikos1, Gaston De Serres2, Larry C Lands3, François D Boucher4, Bruce Tapiéro5, Patrick Daigneault6, Caroline Quach7. 1. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada; 2. Department of Social and Preventive Medicine, Laval University, Quebec City, Canada; Institut national de santé publique du Québec, Quebec, Canada; 3. Divisions of Respiratory Medicine, and. 4. Divisions of Infectious Diseases, and. 5. Division of Infectious Diseases, Department of Pediatrics, CHU Sainte-Justine, Montreal, Canada; and. 6. Respiratory Medicine, Department of Pediatrics, Centre Mère-Enfant Soleil du CHU de Québec, Quebec, Canada; 7. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada; Institut national de santé publique du Québec, Quebec, Canada; Infectious Diseases, Department of Pediatrics, The Montreal Children's Hospital, McGill University, Montreal, Canada; McGill University Health Centre, Vaccine Study Centre, Research Institute of the MUHC, Montreal, Canada caroline.quach@mcgill.ca.
Abstract
OBJECTIVES: Given the improved efficacy of the nasal live-attenuated influenza virus vaccine (LAIV) compared with the injectable vaccine in children, we aimed to determine its safety in individuals with cystic fibrosis (CF). METHODS: A cohort of 168 study participants, aged 2 to 18 years with CF, vaccinated with LAIV between October 1, 2012, and January 30, 2013, was followed prospectively for 56 days after initial vaccination in 3 pediatric CF clinics across the province of Quebec. Days 0 to 28 post-LAIV were considered the at-risk period for all outcomes of interest, and days 29 to 56 post-LAIV were considered the non-at-risk period. Incident respiratory deteriorations were defined as an unscheduled medical visit, hospitalization, or a new course of oral antibiotics for respiratory complaints. Using a self-controlled design, incidence rate ratios (IRR) were used to compare at-risk and non-at-risk periods. RESULTS: Comparing at-risk to non-at-risk periods, there was no significant increase in the rate of incident respiratory deteriorations (IRR, 0.72; 95% confidence interval, 0.11-4.27) or all-cause hospitalizations (IRR, 1.16; 95% confidence interval, 0.30-4.81). A greater proportion of participants reported experiencing at least 1 minor respiratory and/or systemic adverse event after immunization during the at-risk period compared with the non-at-risk period (77% vs 54%, respectively). During the first week after LAIV, 13 of 168 (8%) children reported some wheezing, with the vast majority, 9 of 13 (69%), on the day of vaccination. CONCLUSIONS: There was no increased risk of respiratory deterioration or all-cause hospitalization associated with LAIV in our study population. LAIV seems well tolerated in children and adolescents with CF.
OBJECTIVES: Given the improved efficacy of the nasal live-attenuated influenza virus vaccine (LAIV) compared with the injectable vaccine in children, we aimed to determine its safety in individuals with cystic fibrosis (CF). METHODS: A cohort of 168 study participants, aged 2 to 18 years with CF, vaccinated with LAIV between October 1, 2012, and January 30, 2013, was followed prospectively for 56 days after initial vaccination in 3 pediatric CF clinics across the province of Quebec. Days 0 to 28 post-LAIV were considered the at-risk period for all outcomes of interest, and days 29 to 56 post-LAIV were considered the non-at-risk period. Incident respiratory deteriorations were defined as an unscheduled medical visit, hospitalization, or a new course of oral antibiotics for respiratory complaints. Using a self-controlled design, incidence rate ratios (IRR) were used to compare at-risk and non-at-risk periods. RESULTS: Comparing at-risk to non-at-risk periods, there was no significant increase in the rate of incident respiratory deteriorations (IRR, 0.72; 95% confidence interval, 0.11-4.27) or all-cause hospitalizations (IRR, 1.16; 95% confidence interval, 0.30-4.81). A greater proportion of participants reported experiencing at least 1 minor respiratory and/or systemic adverse event after immunization during the at-risk period compared with the non-at-risk period (77% vs 54%, respectively). During the first week after LAIV, 13 of 168 (8%) children reported some wheezing, with the vast majority, 9 of 13 (69%), on the day of vaccination. CONCLUSIONS: There was no increased risk of respiratory deterioration or all-cause hospitalization associated with LAIV in our study population. LAIV seems well tolerated in children and adolescents with CF.
Authors: Constantina Boikos; Jesse Papenburg; Christine Martineau; Lawrence Joseph; David Scheifele; Mark Chilvers; Larry C Lands; Gaston De Serres; Caroline Quach Journal: Hum Vaccin Immunother Date: 2017-03-08 Impact factor: 3.452
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