Adjuvant-attenuated symptom severity of influenza infections in vaccinated children.

Livestock production science Pub Date : 2022-09-15 eCollection Date: 2022-09-01 DOI:10.1016/j.imj.2022.09.002
Charlotte Switzer, Chris P Verschoor, Eleanor Pullenayegum, Pardeep Singh, Mark Loeb
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Abstract

Background: Young children are at high risk for developing complications of influenza, as well as severe clinical presentation of disease. Vaccination provides direct protection and reduces symptom severity in breakthrough infections. We assessed whether adjuvanted trivalent seasonal influenza vaccine is associated with symptom severity in children who developed laboratory-confirmed influenza, as compared to children who received quadrivalent inactivated influenza.

Methods: A cluster randomized controlled trial of influenza vaccines in Canadian Hutterite colonies was conducted from the 2016-2017 to the 2018-2019 influenza season. Children were vaccinated with either quadrivalent inactivated influenza vaccine (QIV), or the MF59 adjuvanted trivalent influenza vaccine (aTIV). We assessed children who developed PCR-confirmed influenza infection for symptom severity outcomes using multivariable generalized negative binomial regression.

Results: Among vaccinated children, 49 infections were observed across 1779 person-days. Vaccine formulation (aTIV vs QIV) was not significantly associated with composite symptom outcomes, including total number of symptoms or total duration of symptom presentation (p > 0.05 for all outcomes). Receipt of aTIV vaccination was significantly associated with attenuation of fever, with an estimated 74% reduction in fever severity. In influenza A type infections, adjuvanted vaccination was significantly associated with reduced systemic symptoms (incidence rate ratios: 0.16, 95% confidence intervals: 0.03, 0.64, p = 0.01). No associations were observed between vaccine formulation and symptom severity in influenza B infections.

Conclusions: In vaccinated children who develop an influenza infection, vaccine formulation was associated with attenuated fever severity, leading to reduced systemic symptoms. In influenza A infections, adjuvanted vaccination was significantly associated with reduced systemic symptoms.

Conclusions: Clinical Trials Registry: NCT02871206.

接种疫苗的儿童感染流感后,佐剂可减轻症状的严重程度。
背景:幼儿是流感并发症和严重临床表现的高危人群。接种疫苗可提供直接保护并降低突破性感染的症状严重程度。与接种四价灭活流感疫苗的儿童相比,我们评估了佐剂三价季节性流感疫苗是否与出现实验室确诊流感的儿童的症状严重程度有关:从 2016-2017 年到 2018-2019 年流感季节,在加拿大哈特派聚居地开展了一项流感疫苗群集随机对照试验。儿童接种了四价灭活流感疫苗(QIV)或 MF59 佐剂三价流感疫苗(aTIV)。我们采用多变量广义负二项回归法评估了经 PCR 证实感染流感的儿童的症状严重程度:结果:在接种疫苗的儿童中,在 1779 人天中观察到 49 例感染。疫苗剂型(aTIV 与 QIV)与综合症状结果(包括症状总数或症状总持续时间)无显著相关性(所有结果的 p > 0.05)。接种 aTIV 与退烧有明显关系,估计退烧严重程度降低了 74%。在甲型流感感染中,接种佐剂疫苗与全身症状的减轻有显著相关性(发病率比:0.16,95% 置信区间:0.03,0.64,p = 0.01)。在乙型流感感染中,未观察到疫苗配方与症状严重程度之间存在关联:结论:在感染流感的接种儿童中,疫苗配方与发烧严重程度减弱有关,从而导致全身症状减轻。在甲型流感感染中,佐剂疫苗接种与全身症状减轻有显著关系:临床试验登记:NCT02871206。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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