Asthma exacerbations among asthmatic children receiving live attenuated versus inactivated influenza vaccines
- PMID: 28404355
- PMCID: PMC6636629
- DOI: 10.1016/j.vaccine.2017.03.082
Asthma exacerbations among asthmatic children receiving live attenuated versus inactivated influenza vaccines
Abstract
Objective: To investigate whether there is a difference in the risk of asthma exacerbations between children with pre-existing asthma who receive live attenuated influenza vaccine (LAIV) compared with inactivated influenza vaccine (IIV).
Material and methods: We identified IIV and LAIV immunizations occurring between July 1, 2007 and March 31, 2014 among Kaiser Permanente Northern California members aged 2 to <18years with a history of asthma, and subsequent asthma exacerbations seen in the inpatient or Emergency Department (ED) setting. We calculated the ratio of the odds (OR) of an exacerbation being in the risk interval (1-14days) versus the comparison interval (29-42days) following immunization, separately for LAIV and IIV, and then examined whether the OR differed between children receiving LAIV and those receiving IIV ("difference-in-differences").
Results: Among 387,633 immunizations, 85% were IIV and 15% were LAIV. Children getting LAIV vs. IIV were less likely to have "current or recent, persistent" asthma (25% vs. 47%), and more likely to have "remote history" of asthma (47% vs. 25%). Among IIV-vaccinated asthmatic children, the OR of an inpatient/ED asthma exacerbation was 0.97 (95% CI: 0.82-1.15). Among LAIV-vaccinated asthmatic children the OR was 0.38 (95% CI: 0.17-0.90). In the difference-in-differences analysis, the odds of asthma exacerbation following LAIV were less than IIV (Ratio of ORs: 0.40, CI: 0.17-0.95, p value: 0.04).
Conclusion: Among children ≥2years old with asthma, we found no increased risk of asthma exacerbation following LAIV or IIV, and a decreased risk following LAIV compared to IIV.
Keywords: Asthma; Influenza; Safety; Vaccines.
Copyright © 2017 Elsevier Ltd. All rights reserved.
Conflict of interest statement
Potential conflicts of interest
G. Thomas Ray has received research support on grants to Kaiser Permanente Division of Research in the past 3 years from Pfizer, Merck & Co, Genentech, and Purdue Pharma. Roger Baxter has received research grants through his institution from MedImmune, GlaxoSmithKline (GSK), Sanofi Pasteur, and Protein Science. Nicola Klein has received research grants through her institution from MedImmune, GSK, Sanofi Pasteur, Novartis (now GSK), Protein Science, Merck & Co, and Pfizer. The remaining authors have no potential conflicts of interest to disclose.
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