Unlocking the Power of Influenza Vaccines for Pediatric Population: A Narrative Review

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Apr 1

PMID 38558642

Authors

Ahmad Raja S Albalawi

Joud Abdulhamid S Alhassun

Raghad K Almarshud

Hamad A Almejali

Salwa M Alharbi

Amal M Shaybah

Zahra Mohammed A Alshehab

Saleh M Alzahrani

Lama S Abomelha

Alwaleed A Almalki

Abdulrahman O Alkhurayyif

Mariyam S Alalawi

Anwar J Alnass

Khalid F Alzibali

Jehad M Alabdulrahim

Affiliations

Soon will be listed here.

Abstract

The flu, often known as influenza, is a dangerous public health hazard for the pediatric population. Immunization is essential for decreasing the burden of the disease and avoiding complications related to influenza. However, the immunogenicity, efficacy, and safety of different influenza vaccines in children warrant careful evaluation. The purpose of this narrative review is to give a summary of the existing literature on the immunogenicity, efficacy, and safety of several vaccinations against influenza viruses in children. The review incorporates evidence from a range of studies focusing on the outcomes of interest. Immunogenicity studies have shown that influenza vaccines induce a robust immune response in children, primarily through neutralizing antibodies' formation. However, variations in vaccine composition influence the duration and magnitude of immune responses. Safety is a crucial consideration in pediatric vaccination. In children, influenza vaccinations have generally shown a high safety profile, with mild and temporary side effects being the most common. Vaccinations against influenza have shown a modest level of efficacy in avoiding hospitalizations linked to influenza, laboratory-confirmed influenza infections, and serious consequences in children. Live attenuated vaccines have shown higher effectiveness against matched strains compared to inactivated vaccines. In conclusion, this narrative review highlights that receiving influenza vaccination in children aged six to 47 months is very important. While different vaccines exhibit varying immunogenicity, safety profiles, and effectiveness, they all contribute to reducing the burden of influenza among children. Future research should focus on optimizing vaccine strategies, improving vaccine coverage, and evaluating long-term protection.

References

Crepey P, de Boer P, Postma M, Pitman R . Retrospective public health impact of a quadrivalent influenza vaccine in the United States. Influenza Other Respir Viruses. 2015; 9 Suppl 1:39-46. PMC: 4549101. DOI: 10.1111/irv.12318. View

Alsuwaidi A, Al-Mekaini L, Kamal S, Narchi H, Souid A . Seroprevalence of influenza A and B viruses among unvaccinated children in the United Arab Emirates: a cross-sectional study. BMC Res Notes. 2017; 10(1):379. PMC: 5553759. DOI: 10.1186/s13104-017-2720-8. View

Trombetta C, Montomoli E . Influenza immunology evaluation and correlates of protection: a focus on vaccines. Expert Rev Vaccines. 2016; 15(8):967-76. DOI: 10.1586/14760584.2016.1164046. View

Al-Qerem W, Jarab A, Hammad A, Alasmari F, Ling J, Al-Zayadneh E . Knowledge, Attitudes, and Practices of Influenza Vaccination among Parents of Children with Asthma: A Cross-Sectional Study. Vaccines (Basel). 2023; 11(6). PMC: 10301876. DOI: 10.3390/vaccines11061074. View

Vemula S, Zhao J, Liu J, Wang X, Biswas S, Hewlett I . Current Approaches for Diagnosis of Influenza Virus Infections in Humans. Viruses. 2016; 8(4):96. PMC: 4848591. DOI: 10.3390/v8040096. View

DiazGranados C, Denis M, Plotkin S . Seasonal influenza vaccine efficacy and its determinants in children and non-elderly adults: a systematic review with meta-analyses of controlled trials. Vaccine. 2012; 31(1):49-57. DOI: 10.1016/j.vaccine.2012.10.084. View

Pepin S, Nicolas J, Szymanski H, Leroux-Roels I, Schaum T, Bonten M . Immunogenicity and safety of a quadrivalent high-dose inactivated influenza vaccine compared with a standard-dose quadrivalent influenza vaccine in healthy people aged 60 years or older: a randomized Phase III trial. Hum Vaccin Immunother. 2021; 17(12):5475-5486. PMC: 8903946. DOI: 10.1080/21645515.2021.1983387. View

Grohskopf L, Alyanak E, Broder K, Walter E, Fry A, Jernigan D . Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2019-20 Influenza Season. MMWR Recomm Rep. 2019; 68(3):1-21. PMC: 6713402. DOI: 10.15585/mmwr.rr6803a1. View

Essink B, Heeringa M, Jeanfreau R, Finn D, Matassa V, Edelman J . Safety and Immunogenicity of Cell-Based Quadrivalent Influenza Vaccine: A Randomized Trial. Pediatrics. 2022; 150(5). DOI: 10.1542/peds.2022-057509. View

10.

Xu Q, Wei H, Wen S, Chen J, Lei Y, Cheng Y . Factors affecting the immunogenicity of influenza vaccines in human. BMC Infect Dis. 2023; 23(1):211. PMC: 10078025. DOI: 10.1186/s12879-023-08158-3. View

11.

Robertson C, Mercer M, Selmani A, Klein N, Jeanfreau R, Greenberg D . Safety and Immunogenicity of a Full-dose, Split-virion, Inactivated, Quadrivalent Influenza Vaccine in Healthy Children 6-35 Months of Age: A Randomized Controlled Clinical Trial. Pediatr Infect Dis J. 2018; 38(3):323-328. PMC: 6437098. DOI: 10.1097/INF.0000000000002227. View

12.

Sauerbrei A, Langenhan T, Brandstadt A, Schmidt-Ott R, Krumbholz A, Girschick H . Prevalence of antibodies against influenza A and B viruses in children in Germany, 2008 to 2010. Euro Surveill. 2014; 19(5). DOI: 10.2807/1560-7917.es2014.19.5.20687. View

13.

Xie H, Wan X, Ye Z, Plant E, Zhao Y, Xu Y . H3N2 Mismatch of 2014-15 Northern Hemisphere Influenza Vaccines and Head-to-head Comparison between Human and Ferret Antisera derived Antigenic Maps. Sci Rep. 2015; 5:15279. PMC: 4607887. DOI: 10.1038/srep15279. View

14.

Puzelli S, Di Martino A, Facchini M, Fabiani C, Calzoletti L, Di Mario G . Co-circulation of the two influenza B lineages during 13 consecutive influenza surveillance seasons in Italy, 2004-2017. BMC Infect Dis. 2019; 19(1):990. PMC: 6873537. DOI: 10.1186/s12879-019-4621-z. View

15.

Ambrose C, Levin M . The rationale for quadrivalent influenza vaccines. Hum Vaccin Immunother. 2012; 8(1):81-8. PMC: 3350141. DOI: 10.4161/hv.8.1.17623. View

16.

Chang L, Anderson E, Jeanfreau R, He Y, Hicks B, Shrestha A . Safety and immunogenicity of high doses of quadrivalent influenza vaccine in children 6 months through <18 years of age: A randomized controlled phase II dose-finding trial. Vaccine. 2021; 39(11):1572-1582. DOI: 10.1016/j.vaccine.2021.02.014. View

17.

Chung J, Flannery B, Thompson M, Gaglani M, Jackson M, Monto A . Seasonal Effectiveness of Live Attenuated and Inactivated Influenza Vaccine. Pediatrics. 2016; 137(2):e20153279. PMC: 4732363. DOI: 10.1542/peds.2015-3279. View

18.

Wilkins A, Kazmin D, Napolitani G, Clutterbuck E, Pulendran B, Siegrist C . AS03- and MF59-Adjuvanted Influenza Vaccines in Children. Front Immunol. 2018; 8:1760. PMC: 5733358. DOI: 10.3389/fimmu.2017.01760. View

19.

Ilyushina N, Haynes B, Hoen A, Khalenkov A, Housman M, Brown E . Live attenuated and inactivated influenza vaccines in children. J Infect Dis. 2014; 211(3):352-60. PMC: 4296173. DOI: 10.1093/infdis/jiu458. View

20.

Heikkinen T, Ikonen N, Ziegler T . Impact of influenza B lineage-level mismatch between trivalent seasonal influenza vaccines and circulating viruses, 1999-2012. Clin Infect Dis. 2014; 59(11):1519-24. DOI: 10.1093/cid/ciu664. View