Published ahead of print on December 4, 2003, doi:10.1164/rccm.200309-1251OC
Am. J. Respir. Crit. Care Med., Volume 169, Number 4, February 2004, 488-493
A more recent version of this article appeared on February 15, 2004
Submitted on September 9, 2003
Accepted on November 27, 2003
Influenza vaccination in asthmatic children: randomised double-blind placebo-controlled trial
Herman J Bueving1, Roos M.D Bernsen1, Johan C de Jongste2, Lisette W.A van Suijlekom-Smit3, Guus F Rimmelzwaan4, Albert D.M.E Osterhaus4, Maureen P.M.H Rutten-van Molken5, Siep Thomas1, and Johannes C van der Wouden1*
1 General Practice, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands,
2 Pediatrics, Subdivision of Pediatric Respiratory Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands,
3 Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands,
4 Virology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands,
5 Institute for Medical Technology Assessment, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
* To whom correspondence should be addressed. E-mail: j.vanderwouden{at}erasmusmc.nl.
There is little evidence that influenza vaccination reduces asthma exacerbations. We determined whether influenza vaccination is more effective than placebo in asthmatic children 6-18 years of age.
We performed a randomised double-blind placebo-controlled trial. Parenteral vaccination with inactivated influenza vaccine or placebo took place around November 1st and children were followed until April 1st of the next year. Airway symptoms were reported in a diary. When symptom scores reached a predefined level, a pharyngeal swab was taken. Primary outcome was the number of asthma exacerbations associated with virologically proven influenza infection.
349 children were assigned placebo and 347 were assigned vaccine. Pharyngeal swabs positive for influenza were related to 42 asthma exacerbations, 24 in the vaccine group, 18 in the placebo group, a difference of 33% favouring placebo (31% after adjustment for confounders, 95%CI -34% to 161%). Influenza-related asthma exacerbations were of similar severity in both groups, they lasted 3.1 days shorter in the vaccine group (95%CI -6.2 to 0.002 days, p=0.06).
We conclude that influenza vaccination did not result in a significant reduction of the number, severity or duration of asthma exacerbations caused by influenza. Additional studies are warranted to justify routine influenza vaccination of asthmatic children.
Key words: influenza vaccination, asthma, children
This article has been cited by other articles:
|
|
|
|
 
T. Jartti and O. Ruuskanen
Influenza Virus and Acute Asthma in Children
Pediatrics,
May 1, 2008;
121(5):
1079 - 1080.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. D. Bateman, S. S. Hurd, P. J. Barnes, J. Bousquet, J. M. Drazen, M. FitzGerald, P. Gibson, K. Ohta, P. O'Byrne, S. E. Pedersen, et al.
Global strategy for asthma management and prevention: GINA executive summary
Eur. Respir. J.,
January 1, 2008;
31(1):
143 - 178.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Carroll and R. Burkimsher
Is there any evidence for influenza vaccination in children with asthma?
Arch. Dis. Child.,
July 1, 2007;
92(7):
644 - 645.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Damoiseaux, J. C. van der Wouden, and H. Bueving
Influenza Vaccination Effectiveness Is Not Proven in Younger Individuals at Risk
Arch Intern Med,
September 12, 2005;
165(16):
1921 - 1922.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Hak, E. Buskens, and T. J. M. Verheij
Influenza Vaccination Effectiveness Is Not Proven in Younger Individuals at Risk--Reply
Arch Intern Med,
September 12, 2005;
165(16):
1922 - 1922.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. P. Ritzwoller, C. B. Bridges, S. Shetterly, K. Yamasaki, M. Kolczak, and E. K. France
Effectiveness of the 2003-2004 Influenza Vaccine Among Children 6 Months to 8 Years of Age, With 1 vs 2 Doses
Pediatrics,
July 1, 2005;
116(1):
153 - 159.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D M Fleming, R S Pannell, A J Elliot, and K W Cross
Respiratory illness associated with influenza and respiratory syncytial virus infection
Arch. Dis. Child.,
July 1, 2005;
90(7):
741 - 746.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. M. Fleming and A. S. Monto
Influenza Vaccination in Children with Asthma: No Reason to Change Current Recommendations
Am. J. Respir. Crit. Care Med.,
April 15, 2005;
171(8):
931 - 931.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. J. Bueving, S. Thomas, and J. C. van der Wouden
Influenza Vaccination in Children with Asthma: No Reason to Change Current Recommendations
Am. J. Respir. Crit. Care Med.,
April 15, 2005;
171(8):
931 - 932.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Bush, F. Accurso, W. MacNee, S. C. Lazarus, and E. Abraham
Cystic Fibrosis, Pediatrics, Control of Breathing, Pulmonary Physiology and Anatomy, and Surfactant Biology in AJRCCM in 2004
Am. J. Respir. Crit. Care Med.,
March 15, 2005;
171(6):
545 - 553.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Hak, E. Buskens, G. A. van Essen, D. H. de Bakker, D. E. Grobbee, M. A. J. B. Tacken, B. A. van Hout, and T. J. M. Verheij
Clinical Effectiveness of Influenza Vaccination in Persons Younger Than 65 Years With High-Risk Medical Conditions: The PRISMA Study
Arch Intern Med,
February 14, 2005;
165(3):
274 - 280.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H.J. Bueving, J.C. van der Wouden, H. Raat, R.M.D. Bernsen, J.C. de Jongste, L.W.A. van Suijlekom-Smit, A.D.M.E. Osterhaus, G.F. Rimmelzwaan, M. R.-v. Molken, and S. Thomas
Influenza vaccination in asthmatic children: effects on quality of life and symptoms
Eur. Respir. J.,
December 1, 2004;
24(6):
925 - 931.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Other articles noted: 06 Feb 2004 to 16 Apr 2004
Evid. Based Nurs.,
July 1, 2004;
7(3):
e3 - e3.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Other articles noted
Evid. Based Med.,
May 1, 2004;
9(3):
95 - 96.
[Full Text]
[PDF]
|
|
|
Copyright © 2003 American Thoracic Society
|
|
|
