Greenberg David P, Robertson Corwin A, Landolfi Victoria A, Bhaumik Amitabha, Senders Shelly D, Decker Michael D
From the *Sanofi Pasteur, Swiftwater, PA; †Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA; ‡Senders Pediatrics, Cleveland, OH; and §Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN.
Pediatr Infect Dis J. 2014 Jun;33(6):630-6. doi: 10.1097/INF.0000000000000254.
Strains of 2 distinct influenza B lineages (Victoria and Yamagata) have cocirculated in the United States for over a decade, but trivalent influenza vaccines (TIVs) contain only 1 B-lineage strain. Each season, some or most influenza B disease is caused by the B lineage not represented in that season's TIV. Quadrivalent influenza vaccines (QIVs) containing a strain from each B lineage should resolve this problem.
This was a Phase III, randomized, multicenter trial in the United States among children 6 months to <9 years of age to evaluate the safety and immunogenicity of inactivated QIV compared with inactivated control TIVs containing opposite B-lineage strains. Participants were randomized at a ratio of approximately 4:1:1 to receive QIV, TIV containing a Victoria-lineage B strain or TIV containing a Yamagata-lineage B strain. Sera were collected pre- and 28-days post-final vaccination and safety was assessed for 6 months after the last injection.
A total of 4363 participants were enrolled. QIV induced noninferior antibody responses to all A strains and corresponding B strains compared with the control TIVs and superior antibody responses to the noncorresponding B strain in each TIV. Rates of solicited reactions and unsolicited and serious adverse events were similar in all groups.
This study demonstrated that QIV is safe and immunogenic among children 6 months to <9 years of age. These findings, along with data from 2 other studies of this QIV in adults, suggest that QIV should offer protection against both B lineages with a safety profile similar to TIV across all ages.
两种不同的乙型流感谱系(维多利亚和山形)毒株已在美国共同流行了十多年,但三价流感疫苗(TIV)仅包含一种乙型流感谱系毒株。每个季节,部分或大部分乙型流感疾病是由该季节TIV中未包含的乙型流感谱系引起的。包含每种乙型流感谱系毒株的四价流感疫苗(QIV)应能解决这一问题。
这是一项在美国6个月至未满9岁儿童中进行的III期随机多中心试验,旨在评估灭活QIV与包含相反乙型流感谱系毒株的灭活对照TIV相比的安全性和免疫原性。参与者按约4:1:1的比例随机分组,分别接受QIV、含维多利亚谱系乙型流感毒株的TIV或含山形谱系乙型流感毒株的TIV。在最后一次接种前和接种后28天采集血清,并在最后一针注射后6个月评估安全性。
共招募了4363名参与者。与对照TIV相比,QIV对所有甲型流感毒株和相应乙型流感毒株诱导的抗体反应不劣,且对每种TIV中不相应的乙型流感毒株诱导的抗体反应更优。所有组中,预期反应、非预期及严重不良事件的发生率相似。
本研究表明,QIV在6个月至未满9岁儿童中是安全且具有免疫原性的。这些发现,连同该QIV在成人中的另外两项研究数据表明QIV应能对两种乙型流感谱系提供保护,且在所有年龄段的安全性概况与TIV相似。