Viral Shedding in Recipients of Live Attenuated Influenza Vaccine in the 2016–2017 and 2017–2018 Influenza Seasons in the United Kingdom
Abstract Background The (H1N1)pdm09 live attenuated influenza vaccine (LAIV) strain was changed for the 2017–2018 influenza season to improve viral fitness, following poor protection against (H1N1)pdm09 viruses in 2015–2016. We conducted LAIV virus shedding studies to assess the effect of this chang...
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| Veröffentlicht in: | Clinical infectious diseases 2020-06, Vol.70 (12), p.2505-2513 |
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| creator | Jackson, David Pitcher, Max Hudson, Chris Andrews, Nick Southern, Jo Ellis, Joanna Höschler, Katja Pebody, Richard Turner, Paul J Miller, Elizabeth Zambon, Maria |
| description | Abstract
Background
The (H1N1)pdm09 live attenuated influenza vaccine (LAIV) strain was changed for the 2017–2018 influenza season to improve viral fitness, following poor protection against (H1N1)pdm09 viruses in 2015–2016. We conducted LAIV virus shedding studies to assess the effect of this change.
Methods
Children aged 2–18 years were recruited to receive LAIV in the 2016–2017 (n = 641) and 2017–2018 (n = 362) influenza seasons. Viruses from nasal swabs taken 1, 3, and 6 days postvaccination were quantified by reverse-transcription polymerase chain reaction and area under the curve titers were determined. Presence and quantity of shedding were compared between strains and seasons with adjustment for age and prior LAIV (n = 436), inactivated seasonal vaccine (n = 100), or (H1N1)pdm09 vaccine (n = 166) receipt.
Results
(H1N1)pdm09 detection (positivity) in 2016–2017 and 2017–2018 (11.2% and 3.9%, respectively) was lower than that of H3N2 (19.7% and 18.7%, respectively) and B/Victoria (28.9% and 33.9%, respectively). (H1N1)pdm09 positivity was higher in 2016–2017 than 2017–2018 (P = .005), but within shedding-positive participants, the (H1N1)pdm09 titer increased in 2017–2018 (P = .02). H3N2 and influenza B titers were similar between seasons. Positivity declined with age, and prior vaccination reduced the likelihood of shedding influenza B but not (H1N1)pdm09.
Conclusions
The (H1N1)pdm09 titer increased in 2017–2018, indicating more efficient virus replication in shedding-positive children than the 2016–2017 strain, although overall positivity was reduced. Age and vaccination history require consideration when correlating virus shedding and protection.
Clinical Trials Registration
NCT02143882, NCT02866942, and NCT03104790.
We observed differences in (H1N1)pdm09 vaccine virus shedding rates with a change in the (H1N1)pdm09 live attenuated influenza vaccine strain. We show that age and vaccination history impact shedding levels. |
| doi_str_mv | 10.1093/cid/ciz719 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7286380</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/cid/ciz719</oup_id><sourcerecordid>2308171553</sourcerecordid><originalsourceid>FETCH-LOGICAL-c408t-815a77c814c8a6af9201304ac2c47aba717a391307deaa47657beb457d40979c3</originalsourceid><addsrcrecordid>eNp9Uc1qFTEUDmKxtbrxASQboQijySQzSTZCKdYWLxSs7Tacm5zpjcxNrpOZgl31Adz5hj5Jc5m21I2LcHKS7-ckHyFvOPvAmREfXfBl3ShunpE93ghVtY3hz8ueNbqSWuhd8jLnH4xxrlnzguwK3spaG7NHfl-GAXp6vkLvQ7yiIdJv6MImYBwzTR1dhGukh-OIcYIRPT2NXT9hvAF6Cc6FiFvKuEJaM97-vf1TiqIQ_bZXc6-fkM4Rcor5gXQRw1b0a7H2af2K7HTQZ3x9X_fJxfHn70cn1eLsy-nR4aJykumx0rwBpZzm0mlooTPFQzAJrnZSwRIUVyBMOVIeAaRqG7XEpWyUl8wo48Q--TTrbqblGr0rby2fYDdDWMPwyyYI9t-bGFb2Kl1bVetWaFYEDu4FhvRzwjzadcgO-x4ipinbWjDNFW8aUaDvZ6gbUs4Ddo82nNltfLbEZ-f4Cvjt08EeoQ95FcC7GZCmzf-E7gDvWKRQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2308171553</pqid></control><display><type>article</type><title>Viral Shedding in Recipients of Live Attenuated Influenza Vaccine in the 2016–2017 and 2017–2018 Influenza Seasons in the United Kingdom</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Jackson, David ; Pitcher, Max ; Hudson, Chris ; Andrews, Nick ; Southern, Jo ; Ellis, Joanna ; Höschler, Katja ; Pebody, Richard ; Turner, Paul J ; Miller, Elizabeth ; Zambon, Maria</creator><creatorcontrib>Jackson, David ; Pitcher, Max ; Hudson, Chris ; Andrews, Nick ; Southern, Jo ; Ellis, Joanna ; Höschler, Katja ; Pebody, Richard ; Turner, Paul J ; Miller, Elizabeth ; Zambon, Maria</creatorcontrib><description>Abstract
Background
The (H1N1)pdm09 live attenuated influenza vaccine (LAIV) strain was changed for the 2017–2018 influenza season to improve viral fitness, following poor protection against (H1N1)pdm09 viruses in 2015–2016. We conducted LAIV virus shedding studies to assess the effect of this change.
Methods
Children aged 2–18 years were recruited to receive LAIV in the 2016–2017 (n = 641) and 2017–2018 (n = 362) influenza seasons. Viruses from nasal swabs taken 1, 3, and 6 days postvaccination were quantified by reverse-transcription polymerase chain reaction and area under the curve titers were determined. Presence and quantity of shedding were compared between strains and seasons with adjustment for age and prior LAIV (n = 436), inactivated seasonal vaccine (n = 100), or (H1N1)pdm09 vaccine (n = 166) receipt.
Results
(H1N1)pdm09 detection (positivity) in 2016–2017 and 2017–2018 (11.2% and 3.9%, respectively) was lower than that of H3N2 (19.7% and 18.7%, respectively) and B/Victoria (28.9% and 33.9%, respectively). (H1N1)pdm09 positivity was higher in 2016–2017 than 2017–2018 (P = .005), but within shedding-positive participants, the (H1N1)pdm09 titer increased in 2017–2018 (P = .02). H3N2 and influenza B titers were similar between seasons. Positivity declined with age, and prior vaccination reduced the likelihood of shedding influenza B but not (H1N1)pdm09.
Conclusions
The (H1N1)pdm09 titer increased in 2017–2018, indicating more efficient virus replication in shedding-positive children than the 2016–2017 strain, although overall positivity was reduced. Age and vaccination history require consideration when correlating virus shedding and protection.
Clinical Trials Registration
NCT02143882, NCT02866942, and NCT03104790.
We observed differences in (H1N1)pdm09 vaccine virus shedding rates with a change in the (H1N1)pdm09 live attenuated influenza vaccine strain. We show that age and vaccination history impact shedding levels.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciz719</identifier><identifier>PMID: 31642899</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Adolescent ; and Commentaries ; Child ; Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype - genetics ; Influenza A Virus, H3N2 Subtype - genetics ; Influenza Vaccines ; Influenza, Human - epidemiology ; Influenza, Human - prevention & control ; Seasons ; United Kingdom - epidemiology ; Vaccines, Attenuated ; Virus Shedding</subject><ispartof>Clinical infectious diseases, 2020-06, Vol.70 (12), p.2505-2513</ispartof><rights>The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. 2019</rights><rights>The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-815a77c814c8a6af9201304ac2c47aba717a391307deaa47657beb457d40979c3</citedby><cites>FETCH-LOGICAL-c408t-815a77c814c8a6af9201304ac2c47aba717a391307deaa47657beb457d40979c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,1583,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31642899$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jackson, David</creatorcontrib><creatorcontrib>Pitcher, Max</creatorcontrib><creatorcontrib>Hudson, Chris</creatorcontrib><creatorcontrib>Andrews, Nick</creatorcontrib><creatorcontrib>Southern, Jo</creatorcontrib><creatorcontrib>Ellis, Joanna</creatorcontrib><creatorcontrib>Höschler, Katja</creatorcontrib><creatorcontrib>Pebody, Richard</creatorcontrib><creatorcontrib>Turner, Paul J</creatorcontrib><creatorcontrib>Miller, Elizabeth</creatorcontrib><creatorcontrib>Zambon, Maria</creatorcontrib><title>Viral Shedding in Recipients of Live Attenuated Influenza Vaccine in the 2016–2017 and 2017–2018 Influenza Seasons in the United Kingdom</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Abstract
Background
The (H1N1)pdm09 live attenuated influenza vaccine (LAIV) strain was changed for the 2017–2018 influenza season to improve viral fitness, following poor protection against (H1N1)pdm09 viruses in 2015–2016. We conducted LAIV virus shedding studies to assess the effect of this change.
Methods
Children aged 2–18 years were recruited to receive LAIV in the 2016–2017 (n = 641) and 2017–2018 (n = 362) influenza seasons. Viruses from nasal swabs taken 1, 3, and 6 days postvaccination were quantified by reverse-transcription polymerase chain reaction and area under the curve titers were determined. Presence and quantity of shedding were compared between strains and seasons with adjustment for age and prior LAIV (n = 436), inactivated seasonal vaccine (n = 100), or (H1N1)pdm09 vaccine (n = 166) receipt.
Results
(H1N1)pdm09 detection (positivity) in 2016–2017 and 2017–2018 (11.2% and 3.9%, respectively) was lower than that of H3N2 (19.7% and 18.7%, respectively) and B/Victoria (28.9% and 33.9%, respectively). (H1N1)pdm09 positivity was higher in 2016–2017 than 2017–2018 (P = .005), but within shedding-positive participants, the (H1N1)pdm09 titer increased in 2017–2018 (P = .02). H3N2 and influenza B titers were similar between seasons. Positivity declined with age, and prior vaccination reduced the likelihood of shedding influenza B but not (H1N1)pdm09.
Conclusions
The (H1N1)pdm09 titer increased in 2017–2018, indicating more efficient virus replication in shedding-positive children than the 2016–2017 strain, although overall positivity was reduced. Age and vaccination history require consideration when correlating virus shedding and protection.
Clinical Trials Registration
NCT02143882, NCT02866942, and NCT03104790.
We observed differences in (H1N1)pdm09 vaccine virus shedding rates with a change in the (H1N1)pdm09 live attenuated influenza vaccine strain. We show that age and vaccination history impact shedding levels.</description><subject>Adolescent</subject><subject>and Commentaries</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Humans</subject><subject>Influenza A Virus, H1N1 Subtype - genetics</subject><subject>Influenza A Virus, H3N2 Subtype - genetics</subject><subject>Influenza Vaccines</subject><subject>Influenza, Human - epidemiology</subject><subject>Influenza, Human - prevention & control</subject><subject>Seasons</subject><subject>United Kingdom - epidemiology</subject><subject>Vaccines, Attenuated</subject><subject>Virus Shedding</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><recordid>eNp9Uc1qFTEUDmKxtbrxASQboQijySQzSTZCKdYWLxSs7Tacm5zpjcxNrpOZgl31Adz5hj5Jc5m21I2LcHKS7-ckHyFvOPvAmREfXfBl3ShunpE93ghVtY3hz8ueNbqSWuhd8jLnH4xxrlnzguwK3spaG7NHfl-GAXp6vkLvQ7yiIdJv6MImYBwzTR1dhGukh-OIcYIRPT2NXT9hvAF6Cc6FiFvKuEJaM97-vf1TiqIQ_bZXc6-fkM4Rcor5gXQRw1b0a7H2af2K7HTQZ3x9X_fJxfHn70cn1eLsy-nR4aJykumx0rwBpZzm0mlooTPFQzAJrnZSwRIUVyBMOVIeAaRqG7XEpWyUl8wo48Q--TTrbqblGr0rby2fYDdDWMPwyyYI9t-bGFb2Kl1bVetWaFYEDu4FhvRzwjzadcgO-x4ipinbWjDNFW8aUaDvZ6gbUs4Ddo82nNltfLbEZ-f4Cvjt08EeoQ95FcC7GZCmzf-E7gDvWKRQ</recordid><startdate>20200610</startdate><enddate>20200610</enddate><creator>Jackson, David</creator><creator>Pitcher, Max</creator><creator>Hudson, Chris</creator><creator>Andrews, Nick</creator><creator>Southern, Jo</creator><creator>Ellis, Joanna</creator><creator>Höschler, Katja</creator><creator>Pebody, Richard</creator><creator>Turner, Paul J</creator><creator>Miller, Elizabeth</creator><creator>Zambon, Maria</creator><general>Oxford University Press</general><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200610</creationdate><title>Viral Shedding in Recipients of Live Attenuated Influenza Vaccine in the 2016–2017 and 2017–2018 Influenza Seasons in the United Kingdom</title><author>Jackson, David ; Pitcher, Max ; Hudson, Chris ; Andrews, Nick ; Southern, Jo ; Ellis, Joanna ; Höschler, Katja ; Pebody, Richard ; Turner, Paul J ; Miller, Elizabeth ; Zambon, Maria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-815a77c814c8a6af9201304ac2c47aba717a391307deaa47657beb457d40979c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>and Commentaries</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Humans</topic><topic>Influenza A Virus, H1N1 Subtype - genetics</topic><topic>Influenza A Virus, H3N2 Subtype - genetics</topic><topic>Influenza Vaccines</topic><topic>Influenza, Human - epidemiology</topic><topic>Influenza, Human - prevention & control</topic><topic>Seasons</topic><topic>United Kingdom - epidemiology</topic><topic>Vaccines, Attenuated</topic><topic>Virus Shedding</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jackson, David</creatorcontrib><creatorcontrib>Pitcher, Max</creatorcontrib><creatorcontrib>Hudson, Chris</creatorcontrib><creatorcontrib>Andrews, Nick</creatorcontrib><creatorcontrib>Southern, Jo</creatorcontrib><creatorcontrib>Ellis, Joanna</creatorcontrib><creatorcontrib>Höschler, Katja</creatorcontrib><creatorcontrib>Pebody, Richard</creatorcontrib><creatorcontrib>Turner, Paul J</creatorcontrib><creatorcontrib>Miller, Elizabeth</creatorcontrib><creatorcontrib>Zambon, Maria</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jackson, David</au><au>Pitcher, Max</au><au>Hudson, Chris</au><au>Andrews, Nick</au><au>Southern, Jo</au><au>Ellis, Joanna</au><au>Höschler, Katja</au><au>Pebody, Richard</au><au>Turner, Paul J</au><au>Miller, Elizabeth</au><au>Zambon, Maria</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Viral Shedding in Recipients of Live Attenuated Influenza Vaccine in the 2016–2017 and 2017–2018 Influenza Seasons in the United Kingdom</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>2020-06-10</date><risdate>2020</risdate><volume>70</volume><issue>12</issue><spage>2505</spage><epage>2513</epage><pages>2505-2513</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><abstract>Abstract
Background
The (H1N1)pdm09 live attenuated influenza vaccine (LAIV) strain was changed for the 2017–2018 influenza season to improve viral fitness, following poor protection against (H1N1)pdm09 viruses in 2015–2016. We conducted LAIV virus shedding studies to assess the effect of this change.
Methods
Children aged 2–18 years were recruited to receive LAIV in the 2016–2017 (n = 641) and 2017–2018 (n = 362) influenza seasons. Viruses from nasal swabs taken 1, 3, and 6 days postvaccination were quantified by reverse-transcription polymerase chain reaction and area under the curve titers were determined. Presence and quantity of shedding were compared between strains and seasons with adjustment for age and prior LAIV (n = 436), inactivated seasonal vaccine (n = 100), or (H1N1)pdm09 vaccine (n = 166) receipt.
Results
(H1N1)pdm09 detection (positivity) in 2016–2017 and 2017–2018 (11.2% and 3.9%, respectively) was lower than that of H3N2 (19.7% and 18.7%, respectively) and B/Victoria (28.9% and 33.9%, respectively). (H1N1)pdm09 positivity was higher in 2016–2017 than 2017–2018 (P = .005), but within shedding-positive participants, the (H1N1)pdm09 titer increased in 2017–2018 (P = .02). H3N2 and influenza B titers were similar between seasons. Positivity declined with age, and prior vaccination reduced the likelihood of shedding influenza B but not (H1N1)pdm09.
Conclusions
The (H1N1)pdm09 titer increased in 2017–2018, indicating more efficient virus replication in shedding-positive children than the 2016–2017 strain, although overall positivity was reduced. Age and vaccination history require consideration when correlating virus shedding and protection.
Clinical Trials Registration
NCT02143882, NCT02866942, and NCT03104790.
We observed differences in (H1N1)pdm09 vaccine virus shedding rates with a change in the (H1N1)pdm09 live attenuated influenza vaccine strain. We show that age and vaccination history impact shedding levels.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>31642899</pmid><doi>10.1093/cid/ciz719</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical infectious diseases, 2020-06, Vol.70 (12), p.2505-2513 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adolescent and Commentaries Child Child, Preschool Humans Influenza A Virus, H1N1 Subtype - genetics Influenza A Virus, H3N2 Subtype - genetics Influenza Vaccines Influenza, Human - epidemiology Influenza, Human - prevention & control Seasons United Kingdom - epidemiology Vaccines, Attenuated Virus Shedding |
| title | Viral Shedding in Recipients of Live Attenuated Influenza Vaccine in the 2016–2017 and 2017–2018 Influenza Seasons in the United Kingdom |
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