Boikos Constantina, Joseph Lawrence, Martineau Christine, Papenburg Jesse, Scheifele David, Lands Larry C, De Serres Gaston, Chilvers Mark, Quach Caroline
Department of Epidemiology , Biostatistics & Occupational Health, McGill University , Montreal.
Laboratoire de santé publique du Québec , Institut national de santé publique du Québec.
Open Forum Infect Dis. 2016 Aug 30;3(4):ofw187. doi: 10.1093/ofid/ofw187. eCollection 2016 Oct.
We aimed to explore the detection profile of influenza viruses following live-attenuated intranasal influenza vaccination (LAIV) in children aged 2-19 years with and without cystic fibrosis (CF). Before the 2013-2014 influenza season, flocked nasal swabs were obtained before vaccination and 4 times in the week of follow-up from 76 participants (n: 57; n: 19). Influenza was detected by reverse transcription polymerase chain reaction (RT-PCR) assays. A Bayesian hierarchical logistic regression model was used to estimate the effect of CF status and age on influenza detection. Overall, 69% of the study cohort shed influenza RNA during follow-up. The mean duration of RT-PCR detection was 2.09 days (95% credible interval [CrI]: 1.73-2.48). The odds of influenza RNA detection on day 1 following vaccination decreased with age in years (odds ratio [OR]: 0.82 per year; 95% CrI: 0.70-0.95), and subjects with CF had higher odds of influenza RNA detection on day 1 of follow-up (OR: 5.09; 95% CrI: 1.02-29.9). Despite the small sample size, our results indicate that LAIV vaccine strains are detectable during the week after LAIV, mainly in younger individuals and vaccinees with CF. It remains unclear whether recommendations for avoiding contact with severely immunocompromised patients should differ for these groups.
我们旨在探索2至19岁患有和未患有囊性纤维化（CF）的儿童在接种减毒活流感疫苗（LAIV）后流感病毒的检测情况。在2013 - 2014年流感季节之前，在接种疫苗前以及随访周内的4个时间点，从76名参与者（57名无CF，19名有CF）中获取了植绒鼻拭子。通过逆转录聚合酶链反应（RT-PCR）检测流感。使用贝叶斯分层逻辑回归模型来估计CF状态和年龄对流感检测的影响。总体而言，69%的研究队列在随访期间排出流感RNA。RT-PCR检测的平均持续时间为2.09天（95%可信区间[CrI]：1.73 - 2.48）。接种疫苗后第1天检测到流感RNA的几率随年龄增长而降低（优势比[OR]：每年0.82；95% CrI：0.70 - 0.95），并且患有CF的受试者在随访第1天检测到流感RNA的几率更高（OR：5.09；95% CrI：1.02 - 29.9）。尽管样本量较小，但我们的结果表明，在接种LAIV后的一周内可检测到LAIV疫苗株，主要在较年轻个体和患有CF的接种者中。对于这些群体，是否应区别对待避免与严重免疫功能低下患者接触的建议仍不明确。
