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- Title
Protective efficacy of combined live intranasal and inactivated influenza A virus vaccines in the elderly.
- Authors
Treanor, John J.; Mattison, H. Reid; Dumyati, Ghinwa; Yinnon, Amos; Erb, Shirley; Dolin, Raphael; Betts, Robert F.; Treanor, J J; Mattison, H R; Dumyati, G; Yinnon, A; Erb, S; O'Brien, D; Dolin, R; Betts, R F
- Abstract
<bold>Objective: </bold>To evaluate the efficacy of adding intranasal live attenuated cold-adapted influenza A vaccine to inactivated influenza vaccine to prevent influenza A in elderly residents of long-term-care institutions.<bold>Design: </bold>Randomized, double-blind, placebo-controlled study conducted over 3 years.<bold>Setting: </bold>Three large nursing homes.<bold>Participants: </bold>A total of 523 residents of nursing homes (mean age, 84.2 years).<bold>Interventions: </bold>All participants received trivalent inactivated influenza vaccine parenterally and were randomly assigned to receive either live attenuated influenza A (H3N2) virus vaccine or placebo intranasally.<bold>Measurements: </bold>Laboratory-documented influenza A was defined as a respiratory illness plus isolation of influenza A virus from nasal secretions, significant serologic response, or both. Participants were considered to have been exposed to influenza A if they resided in an institution in which cases of influenza A were documented. Outbreak-associated illnesses were defined as those occurring between the first and last isolation of influenza virus from within the institution, +/- 3 days.<bold>Results: </bold>Participants who received intranasal vaccine and were subsequently exposed to influenza A had significantly lower rates of laboratory-documented influenza A (9 of 162 vaccine recipients compared with 24 of 169 placebo recipients; vaccine protective efficacy, 60.6%; 95% CI, 18% to 82%), outbreak-associated respiratory illnesses (13 of 162 vaccine recipients compared with 34 of 169 placebo recipients; vaccine protective efficacy, 56.8%; CI 23% to 76%), and outbreak-associated influenza-like illnesses (6 of 162 vaccine recipients compared with 18 of 169 placebo recipients; vaccine protective efficacy, 65.0%; CI 17% to 86%).<bold>Conclusions: </bold>Intranasal immunization with live attenuated influenza A virus vaccine provided additional protection against influenza A when added to parenteral trivalent inactivated influenza vaccine among elderly nursing home residents.
- Subjects
INFLUENZA vaccines; INFLUENZA; OLDER people
- Publication
Annals of Internal Medicine, 1992, Vol 117, Issue 8, p625
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-117-8-625