Viral shedding in recipients of live attenuated influenza vaccine in the 2016/17 and 2017/18 influenza seasons in the United Kingdom
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Author(s)
Type
Journal Article
Abstract
Background: Live attenuated influenza vaccine(LAIV) use inchildren was suspended in the USA due to an apparentlack of protection against (H1N1)pdm09 virusesin the 2015/16 influenza season. The (H1N1)pdm09 vaccine strain was subsequently changed in 2017/18 to improve viral fitness. We conducted LAIV virus shedding studies to assess the effect of this change. Methods: Children aged2-18 yearswere recruited to receive quadrivalent LAIV in the 2016/17 (n=641) and 2017/18(n=362)influenza seasons. Viruses from nasal swabs taken 1, 3 and 6 days post-vaccination were quantified byreverse transcription-PCR and area under curve titres determined. Presence and quantity of shedding was compared between strains and seasons with adjustment for age and prior receipt of LAIV (n=436), inactivated seasonal (n=100) or (H1N1)pdm09 vaccine (n=166). Results: (H1N1)pdm09 detection (positivity) in 2016/17 and 2017/18 (11.2% and 3.9% respectively) was lower than that of H3N2 (19.7% and 18.7% respectively) and influenza B (28.9% and 33.9% respectively for B/Victoria). (H1N1)pdm09 positivity was significantly higher in 2016/17 than 2017/18 (p=0.005), butwithin participants that shed, the (H1N1)pdm09 titre increased in 2017/18 (p=0.02), whereasH3N2 and influenza B titres were similar between seasons. Positivity ratesdeclined with age and prior vaccination reduced the likelihood of shedding influenza B but not (H1N1)pdm09. Conclusions: The (H1N1)pdm09 titre increased in 2017/18, indicating more efficientvirusreplication in childrenthat shed virusthan the 2016/17 strain, although overall positivity was reduced. Age and prior vaccine receipt negatively correlated with shedding rates, therefore these factors require consideration when correlating virus shedding with clinical protection.
Date Issued
2020-06-15
Date Acceptance
2019-06-19
Citation
Clinical Infectious Diseases, 2020, 70 (12), pp.2505-2513
ISSN
1058-4838
Publisher
Oxford University Press (OUP)
Start Page
2505
End Page
2513
Journal / Book Title
Clinical Infectious Diseases
Volume
70
Issue
12
Copyright Statement
© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.comDOI: 10.1093/cid/ciz719
Publication Status
Published
Date Publish Online
2019-08-13