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. 2017 Sep 1;6(3):e7-e14.
doi: 10.1093/jpids/piw028.

Assessing Fever Frequency After Pediatric Live Attenuated Versus Inactivated Influenza Vaccination

Melissa S Stockwell  1   2   3 , Karen R Broder  4 , Paige Lewis  4 , Kathleen Jakob  1 , Shahed Iqbal  4 , Nadira Fernandez  1 , Devindra Sharma  4 , Angela Barrett  1 , Philip LaRussa  1
Affiliations

Assessing Fever Frequency After Pediatric Live Attenuated Versus Inactivated Influenza Vaccination

Melissa S Stockwell et al. J Pediatric Infect Dis Soc. .

Abstract

Background: Some studies have found a higher frequency of fever with trivalent live attenuated influenza vaccine (LAIV) than with inactivated influenza vaccine (IIV), but quadrivalent LAIV has not been assessed. Understanding fever is important for safety reviews and for parents and providers. In addition, there have been only a limited number of studies in which text messaging was used for vaccine adverse-event (AE) surveillance.

Methods: We conducted a prospective observational study in 3 community clinics in New York City to assess post-influenza vaccination fever in 24- to 59-month-olds during the 2013-2014 season. Enrolled families of children who received quadrivalent LAIV (LAIV4) or IIV (trivalent IIV3 or quadrivalent IIV4) replied to text messages that assessed their temperature on vaccination night and the next 10 nights (days 0 to 10); missing data were collected via telephone and a diary. We compared frequencies of fever (temperature ≥ 100.4°F) according to vaccine group on days 0 to 2 and 3 to 10 by using χ2 and multivariate log-binomial regression adjusted for age, previous influenza vaccination, and vaccine coadministration. We also assessed outcomes using all sources versus only text messages.

Results: Most (84.1% [n = 540]) eligible parents enrolled. Fever frequencies on days 0 to 2 did not differ between LAIV4 and any IIV (3.8% vs 5.7%, respectively; adjusted relative risk [aRR] [95% confidence interval], 0.60 [0.25-1.46]), between LAIV4 and IIV4 (4.2% vs 7.1%, respectively; aRR, 0.58 [0.19-1.72]), or between IIV4 and IIV3 (7.1% vs 6.0%, respectively; aRR, 1.02 [0.30-3.46]). The findings were similar when all data sources versus text-message data alone were used. There were no significant differences on days 3 to 10.

Conclusions: Postvaccination fever frequencies were low overall and did not differ according to influenza vaccine type during the 2013-2014 influenza season. The similarity of results when data were limited to text messages lends support to its use for surveillance of vaccine adverse events.

Keywords: fever; influenza; live attenuated; text message; vaccination; vaccine safety.

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Conflict of interest statement

Potential conflicts of interest. Dr Stockwell is a coinvestigator but receives no financial support for an unrelated investigator-initiated grant from the Pfizer Medical Education Group. Dr Iqbal currently works for Daiichi Sankyo, Inc., but not at the time of this study. The other authors have no reported conflicts.

All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Study flow for enrollment during the 2013–2014 influenza season. aFor 5 children who received inactivated influenza vaccine (IIV), inadequate information regarding subtype was available; bAll live attenuated influenza vaccines (LAIVs) were LAIV4.
Figure 2.
Figure 2.
Source of fever data for enrolled children during the 2013–2014 influenza season.
See this image and copyright information in PMC

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References

    1. Fiore AE, Uyeki TM, Broder K, et al. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010. MMWR Recomm Rep 2010; 59:1–62. - PubMed
    1. Belshe RB, Edwards KM, Vesikari T, et al. Live attenuated versus inactivated influenza vaccine in infants and young children. N Engl J Med 2007; 356:685–96. - PubMed
    1. Ambrose CS, Wu X, Knuf M, Wutzler P. The efficacy of intranasal live attenuated influenza vaccine in children 2 through 17 years of age: a meta-analysis of 8 randomized controlled studies. Vaccine 2012; 30:886–92. - PubMed
    1. Ashkenazi S, Vertruyen A, Aristegui J, et al. Superior relative efficacy of live attenuated influenza vaccine compared with inactivated influenza vaccine in young children with recurrent respiratory tract infections. Pediatr Infect Dis J 2006; 25:870–9. - PubMed
    1. Grohskopf LA, Olsen SJ, Sokolow LZ, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP)—United States, 2014–15 influenza season. MMWR Morb Mortal Wkly Rep 2014; 63:691–7. - PMC - PubMed

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