Background paper to the recommendation for the preferential use of live-attenuated influenza vaccine in children aged 2-6 years in Germany.
Identifieur interne : 000215 ( Main/Exploration ); précédent : 000214; suivant : 000216Background paper to the recommendation for the preferential use of live-attenuated influenza vaccine in children aged 2-6 years in Germany.
Auteurs : G. Falkenhorst [Allemagne] ; T. Harder ; C. Remschmidt ; M. Terhardt ; F. Zepp ; T. Ledig ; S. Wicker ; B. Keller-Stanislawski ; T. MertensSource :
- Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz [ 1437-1588 ] ; 2013.
Descripteurs français
- KwdFr :
- Allemagne (épidémiologie), Enfant, Enfant d'âge préscolaire, Facteurs de risque, Femelle, Grippe humaine (), Grippe humaine (épidémiologie), Guides de bonnes pratiques cliniques comme sujet, Humains, Mâle, Médecine factuelle, Prévalence, Résultat thérapeutique, Vaccination (), Vaccination (normes), Vaccins antigrippaux (administration et posologie), Vaccins atténués (normes), Vaccins atténués (usage thérapeutique).
- MESH :
- administration et posologie : Vaccins antigrippaux.
- normes : Vaccination, Vaccins atténués.
- usage thérapeutique : Vaccins atténués.
- épidémiologie : Allemagne, Grippe humaine.
- Enfant, Enfant d'âge préscolaire, Facteurs de risque, Femelle, Grippe humaine, Guides de bonnes pratiques cliniques comme sujet, Humains, Mâle, Médecine factuelle, Prévalence, Résultat thérapeutique, Vaccination.
- Wicri :
- geographic : Allemagne.
English descriptors
- KwdEn :
- Child, Child, Preschool, Evidence-Based Medicine, Female, Germany (epidemiology), Humans, Influenza Vaccines (administration & dosage), Influenza, Human (epidemiology), Influenza, Human (prevention & control), Male, Practice Guidelines as Topic, Prevalence, Risk Factors, Treatment Outcome, Vaccination (standards), Vaccination (statistics & numerical data), Vaccines, Attenuated (standards), Vaccines, Attenuated (therapeutic use).
- MESH :
- chemical , administration & dosage : Influenza Vaccines.
- geographic , epidemiology : Germany.
- epidemiology : Influenza, Human.
- prevention & control : Influenza, Human.
- standards : Vaccination, Vaccines, Attenuated.
- statistics & numerical data : Vaccination.
- chemical , therapeutic use : Vaccines, Attenuated.
- Child, Child, Preschool, Evidence-Based Medicine, Female, Humans, Male, Practice Guidelines as Topic, Prevalence, Risk Factors, Treatment Outcome.
Abstract
The German Standing Committee on Vaccination (STIKO) recommends seasonal influenza vaccination for children and adolescents with chronic medical conditions that put them at risk for severe influenza illness. In addition to trivalent inactivated influenza vaccines (TIV), a trivalent live-attenuated influenza vaccine (LAIV) was licensed for children and adolescents aged 2-17 years in the European Union in 2011. Employing the methodology of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group, we examined the evidence for efficacy and safety of LAIV relative to TIV to guide STIKO's decision on whether LAIV should be preferentially recommended for at-risk children. In our meta-analysis of data from two randomized trials directly comparing LAIV and TIV in children aged ≤ 6 years, the protective efficacy of LAIV against laboratory-confirmed influenza was 53 % [95 % confidence interval (CI): 45-61 %] higher than that of TIV. A similar study in individuals aged 6-17 years showed a 32 % (95 % CI: 3-52 %) higher efficacy of LAIV. The quality of the evidence for a superior protective efficacy of LAIV against all relevant clinical outcomes was rated 'moderate' for children aged 2-6 years and 'low' for the age group 7-17 years. Regarding safety outcomes, the available data suggest no significant differences between LAIV and TIV. Based on these results, STIKO recommends that LAIV should be used preferentially for influenza vaccination of at-risk children aged 2-6 years. In children and adolescents aged 7-17 years, either LAIV or TIV may be used without specific preference. Possible contraindications and the vaccinee's and his/her guardians' preferences should be taken into account.
DOI: 10.1007/s00103-013-1844-9
PubMed: 24170085
Affiliations:
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Mertens</name></author></analytic><series><title level="j">Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz</title><idno type="eISSN">1437-1588</idno><imprint><date when="2013" type="published">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Child</term><term>Child, Preschool</term><term>Evidence-Based Medicine</term><term>Female</term><term>Germany (epidemiology)</term><term>Humans</term><term>Influenza Vaccines (administration & dosage)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (prevention & control)</term><term>Male</term><term>Practice Guidelines as Topic</term><term>Prevalence</term><term>Risk Factors</term><term>Treatment Outcome</term><term>Vaccination (standards)</term><term>Vaccination (statistics & numerical data)</term><term>Vaccines, Attenuated (standards)</term><term>Vaccines, Attenuated (therapeutic use)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Allemagne (épidémiologie)</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs de risque</term><term>Femelle</term><term>Grippe humaine ()</term><term>Grippe humaine (épidémiologie)</term><term>Guides de bonnes pratiques cliniques comme sujet</term><term>Humains</term><term>Mâle</term><term>Médecine factuelle</term><term>Prévalence</term><term>Résultat thérapeutique</term><term>Vaccination ()</term><term>Vaccination (normes)</term><term>Vaccins antigrippaux (administration et posologie)</term><term>Vaccins atténués (normes)</term><term>Vaccins atténués (usage thérapeutique)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Germany</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="normes" xml:lang="fr"><term>Vaccination</term><term>Vaccins atténués</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="standards" xml:lang="en"><term>Vaccination</term><term>Vaccines, Attenuated</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Vaccination</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Vaccines, Attenuated</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Vaccins atténués</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Allemagne</term><term>Grippe humaine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Child</term><term>Child, Preschool</term><term>Evidence-Based Medicine</term><term>Female</term><term>Humans</term><term>Male</term><term>Practice Guidelines as Topic</term><term>Prevalence</term><term>Risk Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs de risque</term><term>Femelle</term><term>Grippe humaine</term><term>Guides de bonnes pratiques cliniques comme sujet</term><term>Humains</term><term>Mâle</term><term>Médecine factuelle</term><term>Prévalence</term><term>Résultat thérapeutique</term><term>Vaccination</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Allemagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The German Standing Committee on Vaccination (STIKO) recommends seasonal influenza vaccination for children and adolescents with chronic medical conditions that put them at risk for severe influenza illness. In addition to trivalent inactivated influenza vaccines (TIV), a trivalent live-attenuated influenza vaccine (LAIV) was licensed for children and adolescents aged 2-17 years in the European Union in 2011. Employing the methodology of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group, we examined the evidence for efficacy and safety of LAIV relative to TIV to guide STIKO's decision on whether LAIV should be preferentially recommended for at-risk children. In our meta-analysis of data from two randomized trials directly comparing LAIV and TIV in children aged ≤ 6 years, the protective efficacy of LAIV against laboratory-confirmed influenza was 53 % [95 % confidence interval (CI): 45-61 %] higher than that of TIV. A similar study in individuals aged 6-17 years showed a 32 % (95 % CI: 3-52 %) higher efficacy of LAIV. The quality of the evidence for a superior protective efficacy of LAIV against all relevant clinical outcomes was rated 'moderate' for children aged 2-6 years and 'low' for the age group 7-17 years. Regarding safety outcomes, the available data suggest no significant differences between LAIV and TIV. Based on these results, STIKO recommends that LAIV should be used preferentially for influenza vaccination of at-risk children aged 2-6 years. In children and adolescents aged 7-17 years, either LAIV or TIV may be used without specific preference. Possible contraindications and the vaccinee's and his/her guardians' preferences should be taken into account. </div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24170085</PMID><DateCompleted><Year>2014</Year><Month>05</Month><Day>21</Day></DateCompleted><DateRevised><Year>2016</Year><Month>07</Month><Day>07</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1437-1588</ISSN><JournalIssue CitedMedium="Internet"><Volume>56</Volume><Issue>11</Issue><PubDate><Year>2013</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz</Title><ISOAbbreviation>Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz</ISOAbbreviation></Journal><ArticleTitle>Background paper to the recommendation for the preferential use of live-attenuated influenza vaccine in children aged 2-6 years in Germany.</ArticleTitle><Pagination><MedlinePgn>1557-64</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s00103-013-1844-9</ELocationID><Abstract><AbstractText>The German Standing Committee on Vaccination (STIKO) recommends seasonal influenza vaccination for children and adolescents with chronic medical conditions that put them at risk for severe influenza illness. In addition to trivalent inactivated influenza vaccines (TIV), a trivalent live-attenuated influenza vaccine (LAIV) was licensed for children and adolescents aged 2-17 years in the European Union in 2011. Employing the methodology of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group, we examined the evidence for efficacy and safety of LAIV relative to TIV to guide STIKO's decision on whether LAIV should be preferentially recommended for at-risk children. In our meta-analysis of data from two randomized trials directly comparing LAIV and TIV in children aged ≤ 6 years, the protective efficacy of LAIV against laboratory-confirmed influenza was 53 % [95 % confidence interval (CI): 45-61 %] higher than that of TIV. A similar study in individuals aged 6-17 years showed a 32 % (95 % CI: 3-52 %) higher efficacy of LAIV. The quality of the evidence for a superior protective efficacy of LAIV against all relevant clinical outcomes was rated 'moderate' for children aged 2-6 years and 'low' for the age group 7-17 years. Regarding safety outcomes, the available data suggest no significant differences between LAIV and TIV. Based on these results, STIKO recommends that LAIV should be used preferentially for influenza vaccination of at-risk children aged 2-6 years. In children and adolescents aged 7-17 years, either LAIV or TIV may be used without specific preference. Possible contraindications and the vaccinee's and his/her guardians' preferences should be taken into account. </AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Falkenhorst</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Immunization Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Seestr. 10, 13353, Berlin, Germany, FalkenhorstG@rki.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Harder</LastName><ForeName>T</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Remschmidt</LastName><ForeName>C</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Terhardt</LastName><ForeName>M</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Zepp</LastName><ForeName>F</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Ledig</LastName><ForeName>T</ForeName><Initials>T</Initials></Author><Author ValidYN="Y"><LastName>Wicker</LastName><ForeName>S</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Keller-Stanislawski</LastName><ForeName>B</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Mertens</LastName><ForeName>T</ForeName><Initials>T</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz</MedlineTA><NlmUniqueID>101181368</NlmUniqueID><ISSNLinking>1436-9990</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D014613">Vaccines, Attenuated</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="ErratumIn"><RefSource>Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Apr;57(4):473-4</RefSource></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019317" MajorTopicYN="Y">Evidence-Based Medicine</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N" Type="Geographic">Germany</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017410" MajorTopicYN="Y">Practice Guidelines as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015995" MajorTopicYN="N">Prevalence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014611" MajorTopicYN="N">Vaccination</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="Y">standards</QualifierName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014613" MajorTopicYN="N">Vaccines, Attenuated</DescriptorName><QualifierName UI="Q000592" MajorTopicYN="N">standards</QualifierName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>10</Month><Day>31</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>10</Month><Day>31</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2014</Year><Month>5</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">24170085</ArticleId><ArticleId IdType="doi">10.1007/s00103-013-1844-9</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li></country></list><tree><noCountry><name sortKey="Harder, T" sort="Harder, T" uniqKey="Harder T" first="T" last="Harder">T. Harder</name><name sortKey="Keller Stanislawski, B" sort="Keller Stanislawski, B" uniqKey="Keller Stanislawski B" first="B" last="Keller-Stanislawski">B. Keller-Stanislawski</name><name sortKey="Ledig, T" sort="Ledig, T" uniqKey="Ledig T" first="T" last="Ledig">T. Ledig</name><name sortKey="Mertens, T" sort="Mertens, T" uniqKey="Mertens T" first="T" last="Mertens">T. Mertens</name><name sortKey="Remschmidt, C" sort="Remschmidt, C" uniqKey="Remschmidt C" first="C" last="Remschmidt">C. Remschmidt</name><name sortKey="Terhardt, M" sort="Terhardt, M" uniqKey="Terhardt M" first="M" last="Terhardt">M. Terhardt</name><name sortKey="Wicker, S" sort="Wicker, S" uniqKey="Wicker S" first="S" last="Wicker">S. Wicker</name><name sortKey="Zepp, F" sort="Zepp, F" uniqKey="Zepp F" first="F" last="Zepp">F. Zepp</name></noCountry><country name="Allemagne"><noRegion><name sortKey="Falkenhorst, G" sort="Falkenhorst, G" uniqKey="Falkenhorst G" first="G" last="Falkenhorst">G. 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