Nasal shedding of vaccine viruses after immunization with a Russian-backbone live attenuated influenza vaccine in India.


Journal

Influenza and other respiratory viruses
ISSN: 1750-2659
Titre abrégé: Influenza Other Respir Viruses
Pays: England
ID NLM: 101304007

Informations de publication

Date de publication:
06 2023
Historique:
revised: 24 03 2023
received: 28 10 2022
accepted: 07 05 2023
medline: 30 6 2023
pubmed: 29 6 2023
entrez: 28 6 2023
Statut: ppublish

Résumé

We present post-vaccination nasal shedding findings from the phase IV, community-based, triple-blinded RCT conducted to assess efficacy of trivalent LAIV and inactivated influenza vaccines in rural north India. Children aged 2-10 years received LAIV or intranasal placebo across 2015 and 2016, as per initial allocation. On days 2 and 4 post-vaccination, trained study nurses collected nasal swabs from randomly selected subset of trial participants based on operational feasibility, accounting for 10.0% and 11.4% of enrolled participants in 2015 and 2016, respectively. Swabs were collected in viral transport medium and transported under cold chain to laboratory for testing by reverse transcriptase real-time polymerase chain reaction. In year 1, on day 2 post-vaccination, 71.2% (74/104) of LAIV recipients shed at least one of vaccine virus strains compared to 42.3% (44/104) on day 4. During year 1, on day 2 post-vaccination, LAIV-A(H1N1)pdm09 was detected in nasal swabs of 12% LAIV recipients, LAIV-A(H3N2) in 41%, and LAIV-B in 59%. In year 2, virus shedding was substantially lower; 29.6% (32/108) of LAIV recipients shed one of the vaccine virus strains on day 2 compared to 21.3% on day 4 (23/108). At day 2 post-vaccination in year 1, two-thirds of LAIV recipients were shedding vaccine viruses. Shedding of vaccine viruses varied between strains and was lower in year 2. More research is needed to determine the reason for lower virus shedding and vaccine efficacy for LAIV-A(H1N1)pdm09.

Sections du résumé

BACKGROUND
We present post-vaccination nasal shedding findings from the phase IV, community-based, triple-blinded RCT conducted to assess efficacy of trivalent LAIV and inactivated influenza vaccines in rural north India.
METHODS
Children aged 2-10 years received LAIV or intranasal placebo across 2015 and 2016, as per initial allocation. On days 2 and 4 post-vaccination, trained study nurses collected nasal swabs from randomly selected subset of trial participants based on operational feasibility, accounting for 10.0% and 11.4% of enrolled participants in 2015 and 2016, respectively. Swabs were collected in viral transport medium and transported under cold chain to laboratory for testing by reverse transcriptase real-time polymerase chain reaction.
RESULTS
In year 1, on day 2 post-vaccination, 71.2% (74/104) of LAIV recipients shed at least one of vaccine virus strains compared to 42.3% (44/104) on day 4. During year 1, on day 2 post-vaccination, LAIV-A(H1N1)pdm09 was detected in nasal swabs of 12% LAIV recipients, LAIV-A(H3N2) in 41%, and LAIV-B in 59%. In year 2, virus shedding was substantially lower; 29.6% (32/108) of LAIV recipients shed one of the vaccine virus strains on day 2 compared to 21.3% on day 4 (23/108).
CONCLUSION
At day 2 post-vaccination in year 1, two-thirds of LAIV recipients were shedding vaccine viruses. Shedding of vaccine viruses varied between strains and was lower in year 2. More research is needed to determine the reason for lower virus shedding and vaccine efficacy for LAIV-A(H1N1)pdm09.

Identifiants

pubmed: 37380175
doi: 10.1111/irv.13149
pmc: PMC10293783
doi:

Substances chimiques

Influenza Vaccines 0
Vaccines, Attenuated 0

Types de publication

Randomized Controlled Trial Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13149

Subventions

Organisme : NCIRD CDC HHS
ID : U01 IP000492
Pays : United States

Informations de copyright

© 2023 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.

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Auteurs

Lalit Dar (L)

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Anand Krishnan (A)

Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

Ramesh Kumar (R)

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Shivram Dhakad (S)

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Avinash Choudekar (A)

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Sumedha Bagga (S)

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Amrit Sharma (A)

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Amit Kumar (A)

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Jyoti Jethani (J)

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Siddhartha Saha (S)

Influenza Division, US Centers for Disease Control and Prevention, New Delhi, India.

Ritvik Amarchand (R)

Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

Rakesh Kumar (R)

Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

Aashish Choudhary (A)

Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

Venkatesh Vinayak Narayan (VV)

Influenza Division, US Centers for Disease Control and Prevention, New Delhi, India.

Giridara Gopal (G)

Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.

Kathryn E Lafond (KE)

Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Stephen Lindstrom (S)

Influenza Division, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

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