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Comparison of Split versus Subunit Seasonal Influenza Vaccine in Korean Children over 3 to under 18 Years of Age

  • Kang, Seah (Department of Pediatrics, Korea University College of Medicine) ;
  • Kim, Dong Ho (Department of Pediatrics, Korea Cancer Center Hospital) ;
  • Eun, Byung Wook (Department of Pediatrics, Eulji General Hospital) ;
  • Kim, Nam Hee (Department of Pediatrics, Inje University Ilsan Paik Hospital) ;
  • Kang, Eun Kyeong (Department of Pediatrics, Dongguk University Ilsan Hospital) ;
  • Lee, Byong Sop (Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Yun-Kyung (Department of Pediatrics, Korea University College of Medicine)
  • Received : 2019.06.20
  • Accepted : 2019.09.17
  • Published : 2019.12.25

Abstract

Purpose: This study was conducted to compare immunogenicities and reactogenicities of the trivalent inactivated subunit influenza vaccine and split influenza vaccine in Korean children and adolescents. Methods: In total, 202 healthy children aged 36 months to <18 years were enrolled at six hospitals in Korea from October to December 2008. The subjects were vaccinated with either the split or subunit influenza vaccine. The hemagglutinin inhibition antibody titers against the H1N1, H3N2, and B virus strains were measured, and the seroconversion rates, seroprotection rates, and geometric mean titers were calculated. All subjects were observed for local and systemic reactions. Results: Both the split and subunit vaccine groups had similar seroprotection rates against all strains (95.9%, 94.9%, 96.9% vs. 96.0%, 90.9%, and 87.9%). In children aged 36 to <72 months, the seroprotection rates were similar between the two vaccine groups. In children aged 72 months to <18 years, both vaccines showed high seroprotection rates against the H1N1, H3N2, and B strain (98.4%, 98.4%, 98.4% vs. 97.0%, 95.5%, and 91.0%), but showed relatively low seroconversion rates (39.1%, 73.4%, 35.9% vs. 34.3%, 55.2%, and 38.8%). There were more local and systemic reactions in the split vaccine group than in the subunit vaccine group; however, no serious adverse reactions were observed in both groups. Conclusions: Both the split and subunit vaccines showed acceptable immunogenicity in all age groups. There were no serious adverse events with both vaccines.

Acknowledgement

Supported by : Korea Food & Drug Administration

References

  1. Peltola V, Heikkinen T, Ruuskanen O. Clinical courses of croup caused by influenza and parainfluenza viruses. Pediatr Infect Dis J 2002;21:76-8. https://doi.org/10.1097/00006454-200201000-00020
  2. Ryan-Poirier K. Influenza virus infection in children. Adv Pediatr Infect Dis 1995;10:125-56.
  3. Steininger C, Popow-Kraupp T, Laferl H, Seiser A, Godl I, Djamshidian S, et al. Acute encephalopathy associated with influenza A virus infection. Clin Infect Dis 2003;36:567-74. https://doi.org/10.1086/367623
  4. Reichert TA, Sugaya N, Fedson DS, Glezen WP, Simonsen L, Tashiro M. The Japanese experience with vaccinating schoolchildren against influenza. N Engl J Med 2001;344:889-96. https://doi.org/10.1056/NEJM200103223441204
  5. Neuzil KM, Zhu Y, Griffin MR, Edwards KM, Thompson JM, Tollefson SJ, et al. Burden of interpandemic influenza in children younger than 5 years: a 25-year prospective study. J Infect Dis 2002;185:147-52. https://doi.org/10.1086/338363
  6. Glezen WP, Taber LH, Frank AL, Gruber WC, Piedra PA. Influenza virus infections in infants. Pediatr Infect Dis J 1997;16:1065-8. https://doi.org/10.1097/00006454-199711000-00012
  7. Neuzil KM, Wright PF, Mitchel EF Jr, Griffin MR. The burden of influenza illness in children with asthma and other chronic medical conditions. J Pediatr 2000;137:856-64. https://doi.org/10.1067/mpd.2000.110445
  8. Kim YK, Eun BW, Kim NH, Kang EK, Lee BS, Kim DH, et al. Comparison of immunogenicity and reactogenicity of split versus subunit influenza vaccine in Korean children aged 6-35 months. Scand J Infect Dis 2013;45:460-8. https://doi.org/10.3109/00365548.2012.755267
  9. Sauerbrei A, Langenhan T, Brandstadt A, Schmidt-Ott R, Krumbholz A, Girschick H, et al. Prevalence of antibodies against influenza A and B viruses in children in Germany, 2008 to 2010. Euro Surveill 2014;19:20687. https://doi.org/10.2807/1560-7917.ES2014.19.5.20687
  10. Fraaij PL, Heikkinen T. Seasonal influenza: the burden of disease in children. Vaccine 2011;29:7524-8. https://doi.org/10.1016/j.vaccine.2011.08.010
  11. Sauerbrei A, Schmidt-Ott R, Hoyer H, Wutzler P. Seroprevalence of influenza A and B in German infants and adolescents. Med Microbiol Immunol 2009;198:93-101. https://doi.org/10.1007/s00430-009-0108-7
  12. Coudeville L, Bailleux F, Riche B, Megas F, Andre P, Ecochard R. Relationship between haemagglutination-inhibiting antibody titres and clinical protection against influenza: development and application of a bayesian random-effects model. BMC Med Res Methodol 2010;10:18. https://doi.org/10.1186/1471-2288-10-18
  13. Hobson D, Curry RL, Beare AS, Ward-Gardner A. The role of serum haemagglutination-inhibiting antibody in protection against challenge infection with influenza A2 and B viruses. J Hyg (Lond) 1972;70:767-77.
  14. The European Agency for the Evaluation of Medicinal Products (EMEA); Committee for Proprietary Medicinal Products (CPMP). Note for guidance on harmonisation of requirements for influenza vaccines (CPMP/BWP/214/96). London: EMEA; 1997.
  15. Fiore AE, Shay DK, Haber P, Iskander JK, Uyeki TM, Mootrey G, et al. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007. MMWR Recomm Rep 2007;56:1-54.
  16. Neuzil KM, Dupont WD, Wright PF, Edwards KM. Efficacy of inactivated and cold-adapted vaccines against influenza A infection, 1985 to 1990: the pediatric experience. Pediatr Infect Dis J 2001;20:733-40.
  17. Talbot HK, Nian H, Zhu Y, Chen Q, Williams JV, Griffin MR. Clinical effectiveness of split-virion versus subunit trivalent influenza vaccines in older adults. Clin Infect Dis 2015;60:1170-5. https://doi.org/10.1093/cid/civ019
  18. Kissling E, Valenciano M, Buchholz U, Larrauri A, Cohen JM, Nunes B, et al. Influenza vaccine effectiveness estimates in Europe in a season with three influenza type/subtypes circulating: the I-MOVE multicentre case-control study, influenza season 2012/13. Euro Surveill 2014;19:20701.
  19. Ruf BR, Colberg K, Frick M, Preusche A. Open, randomized study to compare the immunogenicity and reactogenicity of an influenza split vaccine with an MF59-adjuvanted subunit vaccine and a virosome-based subunit vaccine in elderly. Infection 2004;32:191-8.
  20. Black S, Nicolay U, Vesikari T, Knuf M, Del Giudice G, Della Cioppa G, et al. Hemagglutination inhibition antibody titers as a correlate of protection for inactivated influenza vaccines in children. Pediatr Infect Dis J 2011;30:1081-5. https://doi.org/10.1097/INF.0b013e3182367662
  21. Chaloupka I, Schuler A, Marschall M, Meier-Ewert H. Comparative analysis of six European influenza vaccines. Eur J Clin Microbiol Infect Dis 1996;15:121-7. https://doi.org/10.1007/BF01591484
  22. Zangwill KM, Belshe RB. Safety and efficacy of trivalent inactivated influenza vaccine in young children: a summary for the new era of routine vaccination. Pediatr Infect Dis J 2004;23:189-97. https://doi.org/10.1097/01.inf.0000116292.46143.d6
  23. Baxter R, Jeanfreau R, Block SL, Blatter M, Pichichero M, Jain VK, et al. A phase III evaluation of immunogenicity and safety of two trivalent inactivated seasonal influenza vaccines in US children. Pediatr Infect Dis J 2010;29:924-30. https://doi.org/10.1097/INF.0b013e3181e075be