Intranasal Flu Vaccine Use in Cystic Fibrosis Patients: Assessing the Risks

the MPR take:

Children with cystic fibrosis (CF) have an increased risk of morbidity and higher case fatality during the influenza pandemic compared to patients with other chronic respiratory diseases or healthy controls. An intranasal quadrivalent, live attenuated influenza vaccine (virus types A and B) (LAIV) is currently approved for ages 2–49 but it is unknown if the greater efficacy of LAIV outweighs the potential for severe adverse events after immunization (AEFI) in children and adolescents with CF. In a new study in the journal Pediatrics, 168 children ages 2–18 with CF received at least one dose of LAIV. No significant differences were seen in the rate of incident respiratory deteriorations or all-cause hospitalizations during the at-risk period (days 0–28) vs. the non-at-risk period (days 29–56). The influenza virus was not detected in any cases of respiratory deterioration in both periods. An increased risk of AEFI, notably wheezing, was identified following LAIV vaccination, but this risk is outweighed by those associated with influenza infection in CF patients. Future research on the use of LAIV in other pediatric populations with non-immunosuppressed chronic conditions should be explored, the authors conclude.

Live-Attenuated Flu Vaccine in Pediatric CF: Assessing the Risks
Intranasal Flu Vaccine Use in Cystic Fibrosis Patients: Assessing the Risks
OBJECTIVES: Given the improved efficacy of the nasal live-attenuated influenza virus vaccine (LAIV) compared with the injectable vaccine in children, we aimed to determine its safety in individuals with cystic fibrosis (CF). Days 0 to 28 post-LAIV were considered the at-risk period for all outcomes of interest, and days 29 to 56 post-LAIV were considered the non-at-risk period.

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