Pediatr Infect Vaccine.  2019 Dec;26(3):161-169. 10.14776/piv.2019.26.e18.

Comparison of Split versus Subunit Seasonal Influenza Vaccine in Korean Children over 3 to under 18 Years of Age

Affiliations
  • 1Department of Pediatrics, Korea University College of Medicine, Seoul, the Republic of Korea. byelhana@korea.ac.kr
  • 2Department of Pediatrics, Korea Cancer Center Hospital, Seoul, the Republic of Korea.
  • 3Department of Pediatrics, Eulji General Hospital, Seoul, the Republic of Korea.
  • 4Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, the Republic of Korea.
  • 5Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, the Republic of Korea.
  • 6Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, the Republic of Korea.

Abstract

PURPOSE
This study was conducted to compare immunogenicities and reactogenicities of the trivalent inactivated subunit influenza vaccine and split influenza vaccine in Korean children and adolescents.
METHODS
In total, 202 healthy children aged 36 months to <18 years were enrolled at six hospitals in Korea from October to December 2008. The subjects were vaccinated with either the split or subunit influenza vaccine. The hemagglutinin inhibition antibody titers against the H1N1, H3N2, and B virus strains were measured, and the seroconversion rates, seroprotection rates, and geometric mean titers were calculated. All subjects were observed for local and systemic reactions.
RESULTS
Both the split and subunit vaccine groups had similar seroprotection rates against all strains (95.9%, 94.9%, 96.9% vs. 96.0%, 90.9%, and 87.9%). In children aged 36 to <72 months, the seroprotection rates were similar between the two vaccine groups. In children aged 72 months to <18 years, both vaccines showed high seroprotection rates against the H1N1, H3N2, and B strain (98.4%, 98.4%, 98.4% vs. 97.0%, 95.5%, and 91.0%), but showed relatively low seroconversion rates (39.1%, 73.4%, 35.9% vs. 34.3%, 55.2%, and 38.8%). There were more local and systemic reactions in the split vaccine group than in the subunit vaccine group; however, no serious adverse reactions were observed in both groups.
CONCLUSIONS
Both the split and subunit vaccines showed acceptable immunogenicity in all age groups. There were no serious adverse events with both vaccines.

Keyword

Influenza vaccine; Influenza; Safety; Children

MeSH Terms

Adolescent
Child*
Hemagglutinins
Herpesvirus 1, Cercopithecine
Humans
Influenza Vaccines*
Influenza, Human*
Korea
Seasons*
Seroconversion
Vaccines
Vaccines, Subunit
Hemagglutinins
Influenza Vaccines
Vaccines
Vaccines, Subunit

Reference

1. Peltola V, Heikkinen T, Ruuskanen O. Clinical courses of croup caused by influenza and parainfluenza viruses. Pediatr Infect Dis J. 2002; 21:76–78.
Article
2. Ryan-Poirier K. Influenza virus infection in children. Adv Pediatr Infect Dis. 1995; 10:125–156.
3. Steininger C, Popow-Kraupp T, Laferl H, Seiser A, Gödl I, Djamshidian S, et al. Acute encephalopathy associated with influenza A virus infection. Clin Infect Dis. 2003; 36:567–574.
Article
4. Reichert TA, Sugaya N, Fedson DS, Glezen WP, Simonsen L, Tashiro M. The Japanese experience with vaccinating schoolchildren against influenza. N Engl J Med. 2001; 344:889–896.
Article
5. Neuzil KM, Zhu Y, Griffin MR, Edwards KM, Thompson JM, Tollefson SJ, et al. Burden of interpandemic influenza in children younger than 5 years: a 25-year prospective study. J Infect Dis. 2002; 185:147–152.
Article
6. Glezen WP, Taber LH, Frank AL, Gruber WC, Piedra PA. Influenza virus infections in infants. Pediatr Infect Dis J. 1997; 16:1065–1068.
Article
7. Neuzil KM, Wright PF, Mitchel EF Jr, Griffin MR. The burden of influenza illness in children with asthma and other chronic medical conditions. J Pediatr. 2000; 137:856–864.
Article
8. Kim YK, Eun BW, Kim NH, Kang EK, Lee BS, Kim DH, et al. Comparison of immunogenicity and reactogenicity of split versus subunit influenza vaccine in Korean children aged 6-35 months. Scand J Infect Dis. 2013; 45:460–468.
Article
9. Sauerbrei A, Langenhan T, Brandstadt A, Schmidt-Ott R, Krumbholz A, Girschick H, et al. Prevalence of antibodies against influenza A and B viruses in children in Germany, 2008 to 2010. Euro Surveill. 2014; 19:20687.
Article
10. Fraaij PL, Heikkinen T. Seasonal influenza: the burden of disease in children. Vaccine. 2011; 29:7524–7528.
Article
11. Sauerbrei A, Schmidt-Ott R, Hoyer H, Wutzler P. Seroprevalence of influenza A and B in German infants and adolescents. Med Microbiol Immunol. 2009; 198:93–101.
Article
12. Coudeville L, Bailleux F, Riche B, Megas F, Andre P, Ecochard R. Relationship between haemagglutination-inhibiting antibody titres and clinical protection against influenza: development and application of a bayesian random-effects model. BMC Med Res Methodol. 2010; 10:18.
Article
13. Hobson D, Curry RL, Beare AS, Ward-Gardner A. The role of serum haemagglutination-inhibiting antibody in protection against challenge infection with influenza A2 and B viruses. J Hyg (Lond). 1972; 70:767–777.
Article
14. The European Agency for the Evaluation of Medicinal Products (EMEA). Committee for Proprietary Medicinal Products (CPMP). Note for guidance on harmonisation of requirements for influenza vaccines (CPMP/BWP/214/96). London: EMEA;1997.
15. Fiore AE, Shay DK, Haber P, Iskander JK, Uyeki TM, Mootrey G, et al. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2007. MMWR Recomm Rep. 2007; 56:1–54.
16. Neuzil KM, Dupont WD, Wright PF, Edwards KM. Efficacy of inactivated and cold-adapted vaccines against influenza A infection, 1985 to 1990: the pediatric experience. Pediatr Infect Dis J. 2001; 20:733–740.
Article
17. Talbot HK, Nian H, Zhu Y, Chen Q, Williams JV, Griffin MR. Clinical effectiveness of split-virion versus subunit trivalent influenza vaccines in older adults. Clin Infect Dis. 2015; 60:1170–1175.
Article
18. Kissling E, Valenciano M, Buchholz U, Larrauri A, Cohen JM, Nunes B, et al. Influenza vaccine effectiveness estimates in Europe in a season with three influenza type/subtypes circulating: the I-MOVE multicentre case-control study, influenza season 2012/13. Euro Surveill. 2014; 19:20701.
Article
19. Ruf BR, Colberg K, Frick M, Preusche A. Open, randomized study to compare the immunogenicity and reactogenicity of an influenza split vaccine with an MF59-adjuvanted subunit vaccine and a virosome-based subunit vaccine in elderly. Infection. 2004; 32:191–198.
Article
20. Black S, Nicolay U, Vesikari T, Knuf M, Del Giudice G, Della Cioppa G, et al. Hemagglutination inhibition antibody titers as a correlate of protection for inactivated influenza vaccines in children. Pediatr Infect Dis J. 2011; 30:1081–1085.
Article
21. Chaloupka I, Schuler A, Marschall M, Meier-Ewert H. Comparative analysis of six European influenza vaccines. Eur J Clin Microbiol Infect Dis. 1996; 15:121–127.
Article
22. Zangwill KM, Belshe RB. Safety and efficacy of trivalent inactivated influenza vaccine in young children: a summary for the new era of routine vaccination. Pediatr Infect Dis J. 2004; 23:189–197.
Article
23. Baxter R, Jeanfreau R, Block SL, Blatter M, Pichichero M, Jain VK, et al. A phase III evaluation of immunogenicity and safety of two trivalent inactivated seasonal influenza vaccines in US children. Pediatr Infect Dis J. 2010; 29:924–930.
Article
Full Text Links
  • PIV
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr