Cold-adapted live influenza vaccine versus inactivated vaccine: systemic vaccine reactions, local and systemic antibody response, and vaccine efficacy A meta-analysis
Identifieur interne : 001790 ( Main/Exploration ); précédent : 001789; suivant : 001791Cold-adapted live influenza vaccine versus inactivated vaccine: systemic vaccine reactions, local and systemic antibody response, and vaccine efficacy A meta-analysis
Auteurs : W. E. P. Beyer [Pays-Bas] ; A. M. Palache [Pays-Bas] ; J. C. De Jong [Pays-Bas] ; A. D. M. E. Osterhaus [Pays-Bas]Source :
- Vaccine [ 0264-410X ] ; 2002.
Descripteurs français
- KwdFr :
- Adaptation physiologique, Administration par voie nasale, Adolescent, Adulte, Adulte d'âge moyen, Anticorps antiviraux (sang), Basse température, Enfant, Enfant d'âge préscolaire, Grippe humaine (), Humains, Immunoglobuline A (sang), Injections musculaires, Nourrisson, Sujet âgé, Vaccins antigrippaux (administration et posologie), Vaccins antigrippaux (effets indésirables), Vaccins antigrippaux (immunologie), Vaccins inactivés (immunologie).
- MESH :
- administration et posologie : Vaccins antigrippaux.
- effets indésirables : Vaccins antigrippaux.
- immunologie : Vaccins antigrippaux, Vaccins inactivés.
- sang : Anticorps antiviraux, Immunoglobuline A.
- Pascal (Inist)
- Wicri :
- topic : Vaccin.
English descriptors
- KwdEn :
- Adaptation, Physiological, Administration, Intranasal, Adolescent, Adult, Aged, Antibodies, Viral (blood), Antibody, Child, Child, Preschool, Cold Temperature, Humans, Immunoglobulin A (blood), Infant, Influenza, Influenza Vaccines (administration & dosage), Influenza Vaccines (adverse effects), Influenza Vaccines (immunology), Influenza, Human (prevention & control), Injections, Intramuscular, Middle Aged, Vaccine, Vaccines, Inactivated (immunology).
- MESH :
- chemical , administration & dosage : Influenza Vaccines.
- chemical , adverse effects : Influenza Vaccines.
- chemical , blood : Antibodies, Viral, Immunoglobulin A.
- chemical , immunology : Influenza Vaccines, Vaccines, Inactivated.
- prevention & control : Influenza, Human.
- Adaptation, Physiological, Administration, Intranasal, Adolescent, Adult, Aged, Child, Child, Preschool, Cold Temperature, Humans, Infant, Injections, Intramuscular, Middle Aged.
Abstract
Since the 1940s, influenza vaccines are inactivated and purified virus or virus subunit preparations (IIV) administered by the intramuscular route. Since decades, attempts have been made to construct, as an alternative, attenuated live influenza vaccines (LIV) for intranasal administration. Presently, the most successful LIV is derived from the cold-adapted master strains A/Ann Arbor/6/60 (H2N2) and B/Ann Arbor/1/66 (AA-LIV, for Ann-Arbor-derived live influenza vaccine). It has been claimed that AA-LIV is more efficacious than IIV. In order to assess differences between the two vaccines with respect to systemic reactogenicity, antibody response, and efficacy, we performed a meta-analysis on eighteen randomised comparative clinical trials involving a total of 5000 vaccinees of all ages. Pooled odds ratios (AA-LIV versus IIV) were calculated according to the random effects model. The two vaccines were associated with similarly low frequencies of systemic vaccine reactions (pooled odds ratio: 0.96, 95% confidence interval: 0.74-1.24). AA-LIV induced significantly lower levels of serum haemagglutination inhibiting antibody and significantly greater levels of local IgA antibody (influenza virus-specific respiratory IgA assayed by ELISA in nasal wash specimens) than IIV. Yet, although they predominantly stimulate different antibody compartments, the two vaccines were similarly efficacious in preventing culture-positive influenza illness. In all trials assessing clinical efficacy, the odds ratios were not significantly different from one (point of equivalence). The pooled odds ratio for influenza A-H3N2 was 1.50 (95% CI: 0.80-2.82). and for A-H IN 1, 1.03 (95% CI: 0.58-1.82). The choice between the two vaccine types should be based on weighing the advantage of the attractive non-invasive mode of administration of AA-LIV, against serious concerns about the biological risks inherent to large-scale use of infectious influenza virus, in particular the hazard of gene reassortment with non-human influenza virus strains.
Affiliations:
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Palache</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>WHO National Influenza Centre, Institute of Virology, Erasmus University Rotterdam, P.O. Box 1738</s1><s2>3000 DR Rotterdam</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>3000 DR Rotterdam</wicri:noRegion></affiliation></author><author><name sortKey="De Jong, J C" sort="De Jong, J C" uniqKey="De Jong J" first="J. C." last="De Jong">J. C. De Jong</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>WHO National Influenza Centre, Institute of Virology, Erasmus University Rotterdam, P.O. Box 1738</s1><s2>3000 DR Rotterdam</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>3000 DR Rotterdam</wicri:noRegion></affiliation></author><author><name sortKey="Osterhaus, A D M E" sort="Osterhaus, A D M E" uniqKey="Osterhaus A" first="A. D. M. 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E. P." last="Beyer">W. E. P. Beyer</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>WHO National Influenza Centre, Institute of Virology, Erasmus University Rotterdam, P.O. Box 1738</s1><s2>3000 DR Rotterdam</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>3000 DR Rotterdam</wicri:noRegion></affiliation></author><author><name sortKey="Palache, A M" sort="Palache, A M" uniqKey="Palache A" first="A. M." last="Palache">A. M. Palache</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>WHO National Influenza Centre, Institute of Virology, Erasmus University Rotterdam, P.O. Box 1738</s1><s2>3000 DR Rotterdam</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>3000 DR Rotterdam</wicri:noRegion></affiliation></author><author><name sortKey="De Jong, J C" sort="De Jong, J C" uniqKey="De Jong J" first="J. C." last="De Jong">J. C. De Jong</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>WHO National Influenza Centre, Institute of Virology, Erasmus University Rotterdam, P.O. Box 1738</s1><s2>3000 DR Rotterdam</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>3000 DR Rotterdam</wicri:noRegion></affiliation></author><author><name sortKey="Osterhaus, A D M E" sort="Osterhaus, A D M E" uniqKey="Osterhaus A" first="A. D. M. E." last="Osterhaus">A. D. M. E. Osterhaus</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>WHO National Influenza Centre, Institute of Virology, Erasmus University Rotterdam, P.O. Box 1738</s1><s2>3000 DR Rotterdam</s2><s3>NLD</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Pays-Bas</country><wicri:noRegion>3000 DR Rotterdam</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Vaccine</title><title level="j" type="abbreviated">Vaccine</title><idno type="ISSN">0264-410X</idno><imprint><date when="2002">2002</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Vaccine</title><title level="j" type="abbreviated">Vaccine</title><idno type="ISSN">0264-410X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adaptation, Physiological</term><term>Administration, Intranasal</term><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Antibodies, Viral (blood)</term><term>Antibody</term><term>Child</term><term>Child, Preschool</term><term>Cold Temperature</term><term>Humans</term><term>Immunoglobulin A (blood)</term><term>Infant</term><term>Influenza</term><term>Influenza Vaccines (administration & dosage)</term><term>Influenza Vaccines (adverse effects)</term><term>Influenza Vaccines (immunology)</term><term>Influenza, Human (prevention & control)</term><term>Injections, Intramuscular</term><term>Middle Aged</term><term>Vaccine</term><term>Vaccines, Inactivated (immunology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adaptation physiologique</term><term>Administration par voie nasale</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Anticorps antiviraux (sang)</term><term>Basse température</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Grippe humaine ()</term><term>Humains</term><term>Immunoglobuline A (sang)</term><term>Injections musculaires</term><term>Nourrisson</term><term>Sujet âgé</term><term>Vaccins antigrippaux (administration et posologie)</term><term>Vaccins antigrippaux (effets indésirables)</term><term>Vaccins antigrippaux (immunologie)</term><term>Vaccins inactivés (immunologie)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Antibodies, Viral</term><term>Immunoglobulin A</term></keywords><keywords scheme="MESH" type="chemical" qualifier="immunology" xml:lang="en"><term>Influenza Vaccines</term><term>Vaccines, Inactivated</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="immunologie" xml:lang="fr"><term>Vaccins antigrippaux</term><term>Vaccins inactivés</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Anticorps antiviraux</term><term>Immunoglobuline A</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adaptation, Physiological</term><term>Administration, Intranasal</term><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Child</term><term>Child, Preschool</term><term>Cold Temperature</term><term>Humans</term><term>Infant</term><term>Injections, Intramuscular</term><term>Middle Aged</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adaptation physiologique</term><term>Administration par voie nasale</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Basse température</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Grippe humaine</term><term>Humains</term><term>Injections musculaires</term><term>Nourrisson</term><term>Sujet âgé</term><term>Vaccin</term><term>Anticorps</term><term>Grippe</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Vaccin</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Since the 1940s, influenza vaccines are inactivated and purified virus or virus subunit preparations (IIV) administered by the intramuscular route. Since decades, attempts have been made to construct, as an alternative, attenuated live influenza vaccines (LIV) for intranasal administration. Presently, the most successful LIV is derived from the cold-adapted master strains A/Ann Arbor/6/60 (H2N2) and B/Ann Arbor/1/66 (AA-LIV, for Ann-Arbor-derived live influenza vaccine). It has been claimed that AA-LIV is more efficacious than IIV. In order to assess differences between the two vaccines with respect to systemic reactogenicity, antibody response, and efficacy, we performed a meta-analysis on eighteen randomised comparative clinical trials involving a total of 5000 vaccinees of all ages. Pooled odds ratios (AA-LIV versus IIV) were calculated according to the random effects model. The two vaccines were associated with similarly low frequencies of systemic vaccine reactions (pooled odds ratio: 0.96, 95% confidence interval: 0.74-1.24). AA-LIV induced significantly lower levels of serum haemagglutination inhibiting antibody and significantly greater levels of local IgA antibody (influenza virus-specific respiratory IgA assayed by ELISA in nasal wash specimens) than IIV. Yet, although they predominantly stimulate different antibody compartments, the two vaccines were similarly efficacious in preventing culture-positive influenza illness. In all trials assessing clinical efficacy, the odds ratios were not significantly different from one (point of equivalence). The pooled odds ratio for influenza A-H3N2 was 1.50 (95% CI: 0.80-2.82). and for A-H IN 1, 1.03 (95% CI: 0.58-1.82). The choice between the two vaccine types should be based on weighing the advantage of the attractive non-invasive mode of administration of AA-LIV, against serious concerns about the biological risks inherent to large-scale use of infectious influenza virus, in particular the hazard of gene reassortment with non-human influenza virus strains.</div></front></TEI><affiliations><list><country><li>Pays-Bas</li></country></list><tree><country name="Pays-Bas"><noRegion><name sortKey="Beyer, W E P" sort="Beyer, W E P" uniqKey="Beyer W" first="W. E. P." last="Beyer">W. E. P. Beyer</name></noRegion><name sortKey="De Jong, J C" sort="De Jong, J C" uniqKey="De Jong J" first="J. C." last="De Jong">J. C. De Jong</name><name sortKey="Osterhaus, A D M E" sort="Osterhaus, A D M E" uniqKey="Osterhaus A" first="A. D. M. E." last="Osterhaus">A. D. M. E. Osterhaus</name><name sortKey="Palache, A M" sort="Palache, A M" uniqKey="Palache A" first="A. M." last="Palache">A. M. 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