Live Attenuated Flu Vaccine Does Not Increase Frequency of Asthma Exacerbations

TUESDAY, March 29, 2022 (HealthDay News) — For children aged 5 to 17 years with asthma, quadrivalent live attenuated influenza vaccine (LAIV4) is noninferior to quadrivalent inactivated influenza vaccine (IIV4) for frequency of asthma exacerbations, according to a study published online March 28 in Pediatrics.

Andrew G. Sokolow, M.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues enrolled 151 children with asthma (aged 5 to 17 years) during two influenza seasons, from Oct. 15, 2018, to Dec. 31, 2019. Participants were randomly assigned to receive IIV4 or LAIV4 and were monitored for asthma symptoms and exacerbations for 42 days after vaccination.

The per-protocol analysis included 142 participants. The researchers found that 13 percent of the participants experienced an asthma exacerbation within 42 days after vaccination: 11 and 15 percent in the LAIV4 and IIV4 groups, respectively, meeting the bounds for noninferiority. LAIV4 remained noninferior to IIV4 when adjusting for asthma severity. No significant differences were seen between the groups in the frequency of asthma symptoms, change in peak expiratory flow rate, or childhood asthma control test/asthma control test scores in the 14 days after vaccination. Vaccine reactogenicity was similar between the groups; in the IIV4 group, sore throat and myalgia were more common.

“These data support reexamining precautions to using LAIV4 in children with asthma, which could be particularly important during influenza pandemics, at times when IIV4 supplies are limited, in situations of public/school mass vaccination clinics using LAIV, or for children with significant needle aversions,” the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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